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.

项目总结/摘要 国家疼痛战略指出，解决少数民族人群的疼痛，以减少健康的重要性， 差距。其中一个群体是女性难民，她们是女性生殖器切割的受害者- 会引起性疼痛本研究的目的是收集经验数据，以（1） 告知生活在明尼苏达州的索马里妇女对性疼痛和其他结果的概念化， 经历过FGC，（2）促进医疗保健实践，最大限度地减少性疼痛，（3）制定决策- 根据研究结果制作工具和举办教育研讨会。大多数索马里女孩 在最初切割时，包括缝合阴道口关闭。去干扰（即打开 包皮环切术/包皮环切术疤痕）可以减少疼痛，并且在阴道分娩前是必要的。建议 在分娩和分娩之前;然而，许多患者等到分娩和分娩才进行去神经化-因此， 增加了流泪的风险。关于性疼痛和性功能如何受到时间的影响，我们知之甚少。 去兴奋为了更好地理解与FGC相关的性疼痛，我们将依赖于概念模型， 利用生物心理社会方法，综合生物、心理和文化方面的考虑。这些 模型包括避免恐惧、耐力和恢复力。我们将与一个以社区为基础的 组织（SoLaHmo）和两家为索马里裔美国妇女服务的大型医疗诊所进行了75次 定性访谈，300台计算机辅助调查的索马里-美国已婚妇女18-45岁， 我经历过FGC，以实现以下目标：目标1：定性调查性疼痛 归因于性疼痛的特征和含义。目标2：使用描述性方法确定参考水平 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（恐惧回避，耐力，弹性）和调节变量（文化适应和共同决策 在这个人口中。目标3：在阴道分娩过一个或多个婴儿的妇女中，确定 性疼痛特征和性功能是否与第一胎的解除兴奋时间有关。 目标4：在目标3中报告性疼痛的女性中，确定疼痛反应（恐惧回避，耐力， 弹性）与性疼痛和性功能有关，以及这些关联是否被修改 根据文化适应的程度---同时调整去文化适应的时间。长期目标是确定 这些机制将导致更好的疼痛管理。完成这些新的研究目标 将产生信息，以发展基于证据和文化敏感的医疗和心理 对接受过切割女性生殖器手术的妇女进行干预。