Treatment of Consequences of Female Genital Cutting

女性生殖器切割后果的治疗

• 批准号: 10445319
• 负责人: Jennifer Jo Connor
• 金额: $ 58.44万
• 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 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10445319
• 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; Reduce health disparities; 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.

项目概要/摘要 国家疼痛战略指出了解决少数民族人口疼痛以降低健康水平的重要性 差异。其中之一就是女性难民，她们是女性生殖器切割（FGC）的受害者—— 众所周知，这会导致性交疼痛。拟议研究的目的是收集经验数据以（1） 让生活在明尼苏达州的索马里妇女了解性疼痛和其他结果的概念 经历过 FGC，(2) 推广减少性疼痛的医疗保健实践，以及 (3) 制定决策 根据研究结果制作工具和教育研讨会。大多数索马里女孩都经历过 最初切割时的锁阴术，涉及缝合阴道口。去阴锁（即打开 包皮环切术/锁阴术疤痕）可以减轻疼痛，并且在阴道分娩前是必要的。推荐 临产和分娩前；然而，许多患者等到临产时才进行去阴术——因此 增加流泪的风险。人们对性交疼痛和性功能如何受时间影响知之甚少 去阴锁术。为了更好地理解与 FGC 相关的性疼痛，我们将依靠概念模型 采用生物心理社会方法，整合生物、心理和文化因素。这些 模型包括回避恐惧、耐力和复原力。我们将与基于社区的 组织 (SoLaHmo) 和两家为索马里美国妇女提供服务的大型医疗诊所开展了 75 定性访谈，对 300 名 18-45 岁的索马里裔美国已婚妇女进行了计算机辅助调查 经历过 FGC 来实现以下目标： 目标 1：定性研究性疼痛 性疼痛的特征和意义。目标 2：使用描述性数据建立参考水平 量化性疼痛特征（存在、频率、强度）、性功能、疼痛的统计数据 反应（避免恐惧、耐力、复原力）和调节变量（文化适应和共同决策） ）在这个人群中。目标 3：在阴道分娩一名或多名婴儿的妇女中，确定 性疼痛特征和性功能是否与第一个孩子去阴部的时间有关。 目标 4：在目标 3 中报告性疼痛的女性中，确定是否存在疼痛反应（避免恐惧、耐力、 弹性）与性疼痛和性功能相关，以及这些关联是否被改变 根据文化适应程度——同时调整去阴锁的时间。长期目标是确定 将为该人群带来更好的疼痛管理的机制。完成这些新颖的研究目标 将产生信息来开发基于证据和文化敏感的医学和心理 对接受 FGC 的妇女进行干预。