"I am a person but I am not a person": experiences of women living with obstetric fistula in the central region of Malawi.
"I am a person but I am not a person": experiences of women living with obstetric fistula in the central region of Malawi.
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DOI：
10.1186/s12884-017-1604-1
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发表时间：
2017-12-21
影响因子：
3.1
通讯作者：
Kafulafula U
中科院分区：
文献类型：
--
作者：
Changole J;Thorsen VC;Kafulafula U
患有产科瘘管病的后果是多方面的，对妇女，特别是那些生活在资源贫乏环境中的妇女具有非常严重的破坏性。由于无法控制的尿液和/或粪便泄漏，这种情况使妇女的私处皮肤脱落，潮湿和气味使她们受到侮辱、嘲笑、羞辱和社会孤立。我们力求更深入地了解马拉维患有产科瘘管病的妇女的生活经历，以便提出既能预防产科瘘管病新发病例又能改善已受影响妇女生活质量的干预措施。我们在利隆圭的Bwaila瘘管护理中心及其周边地区对25名患有产科瘘管病的妇女进行了半结构化访谈。我们在Bwaila Fistula护理中心采访了20名妇女;通过滚雪球抽样确定了另外5名妇女，并在她们的家中接受了采访。我们还采访了20名家庭成员。为了分析数据，我们使用了主题分析。使用Nvivo 10对数据进行分类。Goffman的污名理论被用来为数据分析提供信息。这项研究中的所有女性都过着社交受限和混乱的生活，因为她们害怕非自愿的披露和尴尬。因此，“预期的”而不是“制定的”污名在参与者中特别普遍。许多人由于大小便失禁和气味而失去了积极的自我形象。为了避免羞耻和尴尬，这些妇女避免公共集会，如市场、教堂、葬礼和婚礼，从而失去了部分社会身份。参与者对自己的病情了解有限。在这项研究中，妇女对耻辱的预期限制了她们的社会生活。这种对耻辱的恐惧可能源于以前对大小便控制的社会规范的了解，这些规范没有考虑到产科瘘管病这样的疾病。这种误解也可能是由于缺乏对疾病本身原因的了解。因此，有必要提高认识，教育妇女及其社区了解产科瘘管病的原因、预防和治疗，这可能有助于预防瘘管病，减少所有方面的耻辱感，从而提高这些妇女的尊严和生活质量。
The consequences of living with obstetric fistula are multifaceted and very devastating for women, especially those living in poor resource settings. Due to uncontrollable leakages of urine and/or feces, the condition leaves women with peeling of skin on their private parts, and the wetness and smell subject them to stigmatization, ridicule, shame and social isolation. We sought to gain a deeper understanding of lived experiences of women with obstetric fistula in Malawi, in order to recommend interventions that would both prevent new cases of obstetric fistula as well as improve the quality of life for those already affected. We conducted semi-structured interviews with 25 women with obstetric fistula at Bwaila Fistula Care Center in Lilongwe and in its surrounding districts. We interviewed twenty women at Bwaila Fistula Care Center; five additional women were identified through snowball sampling and were interviewed in their homes. We also interviewed twenty family members. To analyze the data, we used thematic analysis. Data were categorized using Nvivo 10. Goffman’s theory of stigma was used to inform the data analysis. All the women in this study were living a socially restricted and disrupted life due to a fear of involuntary disclosure and embarrassment. Therefore, “anticipated” as opposed to “enacted” stigma was especially prevalent among the participants. Many lost their positive self-image due to incontinence and smell. As a way to avoid shame and embarrassment, these women avoided public gatherings; such as markets, church, funerals and weddings, thus losing part of their social identity. Participants had limited knowledge about their condition. The anticipation of stigma by women in this study consequently limited their social lives. This fear of stigma might have arisen from previous knowledge of social norms concerning bowel and bladder control, which do not take into account an illness like obstetric fistula. This misconception might have also arisen from lack of knowledge about causes of the condition itself. There is need therefore to create awareness and educate women and their communities about the causes of obstetric fistula, its prevention and treatment, which may help to prevent fistula as well as reduce all dimensions of stigma, and consequently increase dignity and quality of life for these women.
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影响因子：
2.4
作者：
Chaudoir SR;Earnshaw VA;Andel S
通讯作者：
Andel S
DOI：
10.1186/s12905-015-0232-z
发表时间：
2015-09-10
期刊：
BMC women's health
影响因子：
--
作者：
Barageine JK;Beyeza-Kashesya J;Byamugisha JK;Tumwesigye NM;Almroth L;Faxelid E
通讯作者：
Faxelid E
影响因子：
4.6
作者：
Quinn, Diane M.;Earnshaw, Valerie A.
通讯作者：
Earnshaw, Valerie A.
影响因子：
0.9
作者：
Hassan, M. A.;Ekele, B. A.
通讯作者：
Ekele, B. A.
影响因子：
2.5
作者：
Mselle, Lilian T.;Moland, Karen Marie;Kohi, Thecla W.
通讯作者：
Kohi, Thecla W.