Treatment of Consequences of Female Genital Cutting

项目摘要/摘要 《国家疼痛战略》指出了解决少数群体疼痛问题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(FGC)的受害者 众所周知，这会导致性疼痛。拟议研究的目标是收集经验数据，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后果的概念化 有FGC经验，(2)促进将性痛苦降至最低的医疗实践，以及(3)制定决策- 制作工具(S)和由研究成果驱动的教育研讨会。大多数索马里女孩都经历了 最初切断时的阴部不结扎，包括缝合阴道开口。去腹股沟手术(即开腹 包皮环切/阴部疤痕)可能会减轻疼痛，在阴道分娩之前是必要的。建议您使用 然而，在分娩和分娩之前，许多患者要等到分娩和分娩时才进行去腹股沟手术--因此 增加流泪的风险。关于性痛和性功能是如何受时机影响的，我们知之甚少。 去腹股沟手术。为了更好地理解与FGC有关的性疼痛，我们将依赖于 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 模型包括恐惧回避、耐力和韧性。我们将与以社区为基础的 组织(SoLaHmo)和两家大型医疗诊所为索马里裔美国妇女提供75 定性访谈，300份计算机辅助调查18-45岁索马里裔美国已婚妇女 有经验的FGC完成了以下目标：目标1：定性调查性疼痛 归因于性疼痛的特征和意义。目标2：使用描述性方法建立参考水平 量化性痛特征(存在、频率、强度)、性功能、疼痛的统计数据 反应(恐惧回避、耐力、韧性)和调节变量(文化适应和共同决策 制造)在这个人口中。目标3：在通过阴道分娩一个或多个婴儿的妇女中，确定 如果性疼痛特征和性功能与第一个孩子的除脊椎手术时间有关。 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、 恢复力)与性疼痛和性功能有关，以及这些联系是否被修改 根据文化适应的程度-同时调整去腹股沟的时机。长期目标是确定 这些机制将导致在这一人群中更好地管理疼痛。完成这些新颖的研究目标 将产生信息以发展以证据为基础和文化敏感的医疗和心理 对接受FGC的妇女进行干预。

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.