Treatment of Consequences of Female Genital Cutting

女性生殖器切割后果的治疗

• 批准号: 10200870
• 负责人: Jennifer Jo Connor
• 金额: $ 58.43万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10200870
• 关键词: Acculturation; Address; Advocacy; American; Back; Biological; Caregivers; Characteristics; Child; Chronic; Cicatrix; Clinic; Coitus; Communities; Computer Assisted; Confidence Intervals; Data; Decision Making; Development; Education; Effect Modifiers (Epidemiology); Episiotomy; Female; Female Circumcision; Frequencies; Fright; Goals; Headache; Health; Healthcare; Healthcare Systems; Immigrant; Immigration; Infibulations; Intervention; Interview; Knowledge; Male Circumcision; Measures; Medical; Mental Health; Minnesota; Minority Groups; Modeling; Mothers; Outcome; Pain; Pain management; Patients; Pattern; Physicians; Population; Postpartum Hemorrhage; Refugees; Reporting; Research; Research Project Grants; Risk; Sampling; Sex Behavior; Sex Functioning; Social support; Somalia; Surveys; Testing; Time; UNICEF; Vagina; Vaginal delivery procedure; Vision; Woman; base; biopsychosocial; evidence base; experience; female genital cutting; girls; health disparity; novel; psychologic; resilience; response; shared decision making; statistics; tool

Project Summary/Abstract The National Pain Strategy notes the importance of addressing pain in minority populations to reduce health disparities. One such population is female refugees who have been victim to female genital cutting (FGC) --- which is known to cause sexual pain. The objective of the proposed research is to collect empirical data to (1) inform the conceptualization of sexual pain and other outcomes among Somali women living in Minnesota who have experienced FGC, (2) promote healthcare practices that minimize sexual pain, and (3) develop decision- making tool(s) and education seminars driven by study findings. The majority of Somali girls undergo infibulation when originally cut, which involves stitching the vaginal opening shut. Deinfibulation (i.e. opening the circumcision/infibulation scar) may decrease pain and is necessary before vaginal birth. It is recommended before labor and delivery; however, many patients wait until labor and delivery to undergo deinfibulation –thus increasing a risk in tears. Little is known about how sexual pain and sexual function are impacted by the timing of deinfibulation. To better understand sexual pain in relation to FGC, we will rely upon conceptual models that utilize a biopsychosocial approach, integrating biological, psychological, and cultural considerations. These models include fear-avoidance, endurance, and resilience. We will partner with a community-based organization (SoLaHmo) and two large medical clinics serving Somali American women to conduct 75 qualitative interviews, 300 computer assisted surveys of Somali-American married women 18-45 years who have experienced FGC to accomplish the following aims: Aim 1: Qualitatively investigate sexual pain characteristics and meaning ascribed to sexual pain. Aim 2: Establish reference levels using descriptive statistics to quantify sexual pain characteristics (presence, frequency, intensity), sexual function, pain responses (fear avoidance, endurance, resilience), and moderator variables (acculturation and shared decision making) in this population. Aim 3: Among women who have vaginally delivered one or more babies, determine if sexual pain characteristics and sexual function are associated with the timing of deinfibulation with first child. Aim 4: Among women reporting sexual pain in Aim 3, determine if pain responses (fear avoidance, endurance, resilience) are associated with sexual pain and sexual function, and whether these associations are modified by degree of acculturation --- while adjusting for timing of deinfibulation. The long-term goal is to identify mechanisms that will lead to better pain management in this population. Completion of these novel study aims will generate information to develop evidence-based and culturally- sensitive medical and psychological interventions for women who have undergone FGC.

项目摘要/摘要 国家疼痛战略指出了解决少数族裔疼痛以减少健康的重要性 差异。这样一个人口是女性难民，这些难民是女性生殖器切割的受害者（FGC）--- 已知会导致性痛苦。拟议的研究的目的是将经验数据收集到（1） 告知居住在明尼苏达州的索马里妇女的性痛苦和其他结果的概念化 经历了FGC，（2）促进最大程度减少性痛苦的医疗保健实践，以及（3）发展决策 - 由研究结果驱动的工具和教育半手。大多数索马里女孩经历了 最初切割时，添加涉及缝制阴道开口的关闭。除外（即开放 电路/接收疤痕）可能会减轻疼痛，并且在阴道出生之前是必要的。建议使用 劳动和分娩前；但是，许多患者等到分娩和分娩进行脱毛 - 增加眼泪的风险。关于性痛苦和性功能如何受到时间的影响，知之甚少 去剥落。为了更好地了解与FGC有关的性痛苦，我们将依靠 利用生物心理社会方法，整合生物学，心理和文化考虑因素。这些 模型包括避免恐惧，耐力和韧性。我们将与社区合作 组织（Solahmo）和两家为索马里美国妇女提供服务75的大型医疗诊所 定性访谈，300次计算机协助调查，对索马裔美国人已婚妇女18-45岁 已经经历了FGC来实现以下目标：目标1：定性调查性痛苦 特征和意义分配给性痛苦。 AIM 2：使用描述性建立参考级别 量化性疼痛特征（存在，频率，强度），性功能，疼痛的统计数据 回应（避免恐惧，耐力，弹性）和主持人变量（适应和共同决定 制造）在这个人群中。目标3：在阴道分娩一个或多个婴儿的女性中，确定 如果性疼痛特征和性功能与第一个儿童的去剥落时间有关。 AIM 4：在AIM 3中报告性痛苦的妇女中，确定疼痛反应（恐惧，耐力， 韧性）与性痛苦和性功能有关，以及这些关联是否被修改 按照培养的程度---在调整去剥落的时机的同时。长期目标是确定 这将导致该人群更好地管理疼痛的机制。完成这些新研究的目的 将生成信息以开发循证和文化敏感的医学和心理 接受FGC的妇女的干预措施。