Vesicovaginal fistula: Do the patients know the cause
Vesicovaginal fistula: Do the patients know the cause
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DOI：
10.4103/1596-3519.56241
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发表时间：
2009-04-01
影响因子：
0.9
通讯作者：
Ekele, B. A.
中科院分区：
文献类型：
--
作者：
Hassan, M. A.;Ekele, B. A.
背景：关于膀胱阴道瘘（VVF）的报道很多，但关于患者对该病的看法却很少。本研究的目的是确定谁开发VVF的患者对瘘管的原因和他们的态度，以防止未来发生的措施的知识。研究方法：这项基于问卷的调查是在2003年6月至8月期间在尼日利亚索科托的Maryam Abacha妇女和儿童福利医院对VVF患者进行的。在访谈后审查患者的病例记录，以将患者的回答与文件夹中记录的回答相匹配。与产科工作人员进行了重点小组讨论，以确定现有咨询的内容和质量。结果：130例患者中有121例（93%）没有接受过正规教育。青少年占37%，初产妇占57%。35例（27%）患者因VVF而离婚或分居。有7例在之前成功修复后复发。在110例（85%）患者中，VVF的原因是分娩时间延长，77例（70%）正确地将其问题归因于分娩时间延长。33名无法确定难产原因的患者要么将其病情归因于上帝/命运，要么归因于为解除梗阻而进行的手术，因此在随后的怀孕中不会住院分娩。从焦点小组讨论，它被证实，术前和术后的辅导是不够的。结论：尽管大多数患者（70%）从健康讲座中了解了瘘管的原因，但仍有一些患者（32%）不会改变危险的产科行为。应确保由经过培训的咨询人员强制性地向所有VVF患者及其亲属或配偶提供准确和适当的信息和教育。这种宣传和教育应强调产科瘘管病的病因和管理，以防止复发。
Background : So much has been written on vesicovaginal fistula (VVF) but there is little on the patients perspective of the condition. The objectives of this study were to determine the knowledge of patients who have developed VVF on the causes of the fistula and their attitude toward measures that would prevent future occurrence. Methods : The questionnaire-based survey was conducted on VVF patients on admission from June to August 2003 at Maryam Abacha Women and Children Welfare Hospital, Sokoto, Nigeria. The case notes of the patients were reviewed after the interview to match the responses from the patients with those documented in the folders. Focus group discussions were held with the maternity staff to ascertain the content and quality of existing counseling. Results : One hundred and thirty patients were studied out of which 121 (93%) had no formal education. Teenagers constituted 37%, while 57% were primiparae. Thirty-five (27%) patients were divorced or separated because of the VVF. There were seven cases of recurrence after a previous successful repair. Prolonged obstructed labor was the cause of the VVF in 110 (85%) patients and 77 (70%) correctly attributed their problem to the prolonged labor. The 33 patients who could not identify the prolonged obstructed labor as the cause either attributed their condition to God/destiny or to the operation that was done to relief the obstruction and therefore would not have hospital delivery in their subsequent pregnancies. From the focus group discussions, it was confirmed that pre and post-operative counseling were inadequate. Conclusion : Even though majority (70%) of the patients knew the cause of their fistula from the health talks, some (32%) would still not change from risky obstetric behavior. Mandatory provision of accurate and appropriate information and education to all VVF patients and their relatives or spouses by trained counselors should be ensured. Such information and education should emphasize the etiology and management of obstetric fistula in order to prevent a recurrence.