Family planning for women with severe mental illness in rural Ethiopia: a qualitative study.
Family planning for women with severe mental illness in rural Ethiopia: a qualitative study.
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DOI：
10.1186/s12978-021-01245-1
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发表时间：
2021-09-28
影响因子：
3.4
通讯作者：
Hanlon C
中科院分区：
文献类型：
--
作者：
Zerihun T;Sorsdahl K;Hanlon C
计划生育对所有育龄妇女来说都是一个至关重要的问题，但对患有严重精神疾病的妇女来说，可能会有特别的挑战和关切。随着以初级保健为基础的精神卫生服务在低收入和中等收入国家（LMICs）的扩大，有机会改善重度精神障碍妇女的计划生育服务。然而，研究探索未满足的计划生育需求的妇女与重度精神病患者在这种情况下是稀缺的。因此，本研究探讨了计划生育的经验和偏好的妇女与SMI谁居住在一个主要是农村地区的埃塞俄比亚。进行了定性研究。根据对当前计划生育利用率定量调查的反应，有目的地选择了正在Butajira进行的基于人群的队列研究中的重度精神分裂症妇女。对16名育龄期重度精神分裂症妇女进行了深入访谈。音频文件用阿姆哈拉语转录，翻译成英文，并按主题进行分析。参与者报告了SMI对女性亲密关系和性生活的普遍影响。虽然重度精神障碍妇女认为计划生育很重要，但她们对计划生育的知识普遍有限，而且对与重度精神障碍有关的具体计划生育需求缺乏了解。在本研究中，没有一名患有重度精神障碍的妇女在接受精神卫生保健服务时得到任何使用计划生育服务的建议。与会者确定了以初级保健为基础的精神卫生服务可以更好地满足其计划生育需求的方法。这项研究提供了深入的观点，从妇女与SMI的更广泛的背景下，他们的计划生育的经验，需求，障碍，以及如何综合初级保健服务可以更好地满足他们的需求。赋予重度营养不良妇女获得信息和服务的权利，需要成为今后改善这一弱势群体生殖经验的工作重点。在线版本包含补充材料，可通过10.1186/s12978-021-01245-1获得。计划生育对所有育龄妇女来说都是一个至关重要的问题，但对于患有严重精神疾病（SMI）的妇女，包括精神分裂症，双相情感障碍和严重抑郁症等疾病，可能会有特殊的挑战和担忧。对于生活在低收入和中等收入国家的重度精神疾病妇女未得到满足的计划生育需求知之甚少。在这项研究中，我们探讨了计划生育的经验，未满足的需求和偏好的妇女与SMI谁住在埃塞俄比亚的农村地区。我们确定了患有重度精神分裂症的妇女，她们参加了一项社区研究，询问她们使用计划生育的情况。我们选择了16名计划生育使用率低和高的妇女进行深入访谈。这项研究的女性谈到了精神疾病如何严重影响她们的亲密关系和性生活。虽然妇女认为计划生育很重要，但她们对计划生育的一般知识有限，对精神疾病可能对计划生育选择产生的具体问题缺乏了解。没有一名妇女在获得精神保健服务时得到任何使用计划生育服务的建议。与会者确定了以初级保健为基础的精神卫生服务可以更好地满足其计划生育需求的方法。我们得出的结论是，重要的是要把重点放在增强埃塞俄比亚农村社区重度精神病患者的权能上，确保她们能够获得计划生育所需的信息和服务。在线版本包含补充材料，可通过10.1186/s12978-021-01245-1获得。
Family planning is a crucial issue for all women of reproductive age, but in women with severe mental illness (SMI), there may be particular challenges and concerns. As primary care-based mental health services are expanding in low- and middle-income countries (LMICs), there is an opportunity to improve family planning services for women with SMI. However, research exploring unmet family planning needs of women with SMI in such settings is scarce. Therefore, the present study explored the family planning experiences and preferences of women with SMI who reside in a predominantly rural area of Ethiopia. A qualitative study was conducted. Women with SMI who were participating in the ongoing population-based cohort study in Butajira were selected purposively based on their responses to a quantitative survey of current family planning utilisation. In-depth interviews were conducted with 16 women with SMI who were of reproductive age. Audio files were transcribed in Amharic, translated into English and analysed thematically. Participants reported pervasive effects of SMI upon the intimate relationships and sexual lives of women. Although women with SMI felt that family planning was important, they had limited knowledge of family planning generally, and a lack of understanding of the specific family planning needs relevant to having SMI. None of the women with SMI in the present study had received any recommendations to use family planning services while accessing mental health care services. The participants identified ways in which primary care-based mental health services could better meet their family planning needs. This study provided in-depth perspectives from women with SMI about the broader context of their family planning experience, needs, barriers and how integrated primary care services could better meet their needs. Empowerment of women with SMI to access information and services needs to be an important focus of future efforts to improve the reproductive experiences of this vulnerable group. The online version contains supplementary material available at 10.1186/s12978-021-01245-1. Family planning is a crucial issue for all women of reproductive age, but in women with severe mental illnesses (SMI), including conditions like schizophrenia, bipolar disorder and severe depression, there may be particular challenges and concerns. Very little is known about the unmet family planning needs of women with SMI who live in low- and middle-income countries. In this study, we explored the family planning experiences, unmet needs and preferences of women with SMI who live in a rural area of Ethiopia. We identified women with SMI who were taking part in a community study asking about their use of family planning. We selected 16 women with low and high use of family planning to interview in depth. The study women spoke of how having a mental illness drastically affected their intimate relationships and sexual life. Although the women felt that family planning was important, they had limited knowledge of family planning generally and a lack of understanding of the specific issues that mental illness might have on family planning choices. None of the women had received any recommendations to use family planning services while accessing mental health care services. The participants identified ways in which primary care-based mental health services could better meet their family planning needs. We concluded that it is important to focus on empowerment of women with SMI in this rural Ethiopian community, making sure that they have access to the kind of information and services that they need for family planning. The online version contains supplementary material available at 10.1186/s12978-021-01245-1.
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