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Title
Trajectories of women's physical and psychosocial health following obstetric fistula repair in Uganda: a longitudinal study. |
Full text
https://escholarship.org/uc/item/3w1873pp |
Date
2019 |
Author(s)
El Ayadi, Alison M; Barageine, Justus; Korn, Abner; Kakaire, Othman; Turan, Janet; Obore, Susan; Byamugisha, Josaphat; Lester, Felicia; Nalubwama, Hadija; Mwanje, Haruna; Tripathi, Vandana; Miller, Suellen |
Abstract
ObjectivesTo explore trajectories of physical and psychosocial health, and their interrelationship, among women completing fistula repair in Uganda for 1 year post-surgery.MethodsWe recruited a 60-woman longitudinal cohort at surgical hospitalisation from Mulago Hospital in Kampala Uganda (Dec 2014-June 2015) and followed them for 1 year. We collected survey data on physical and psychosocial health at surgery and at 3, 6, 9 and 12 months via mobile phone. Fistula characteristics were abstracted from medical records. All participants provided written informed consent. We present univariate analysis and linear regression results.ResultsAcross post-surgical follow-up, most women reported improvements in physical and psychosocial health, largely within the first 6 months. By 12 months, urinary incontinence had declined from 98% to 33% and general weakness from 33% to 17%, while excellent to good general health rose from 0% to 60%. Reintegration, self-esteem and quality of life all increased through 6 months and remained stable thereafter. Reported stigma reduced, yet some negative self-perception remained at 12 months (mean 17.8). Psychosocial health was significantly impacted by the report of physical symptoms; at 12 months, physical symptoms were associated with a 21.9 lower mean reintegration score (95% CI -30.1, -12.4).ConclusionsOur longitudinal cohort experienced dramatic improvements in physical and psychosocial health after surgery. Continuing fistula-related symptoms and the substantial differences in psychosocial health by physical symptoms support additional intervention to support women's recovery or more targeted psychosocial support and reintegration services to ensure that those coping with physical or psychosocial challenges are appropriately supported. |
Subject(s)
Humans; Rectovaginal Fistula; Vesicovaginal Fistula; Vaginal Fistula; Longitudinal Studies; Adaptation; Psychological; Self Concept; Quality of Life; Women's Health; Uganda; Female; Social Stigma; complications obstétricales du travail; fistule recto-vaginale; fistule vésico-vaginale; incontinence urinaire; obstetric labour complications; quality of life; qualité de vie; rectovaginal fistula; social stigma; stigmatisation sociale; urinary incontinence; vesicovaginal fistula; Adaptation; Psychological; Tropical Medicine; Public Health and Health Services |
Coverage
53 - 64 |
Publisher
eScholarship, University of California |
Type of publication
article |
Format
application/pdf |
Source
Tropical medicine & international health: TM & IH, vol 24, iss 1 |
Rights
public |
Identifier
qt3w1873pp |
Repository
Berkeley - University of California
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Added to C-A: 2021-03-03;09:37:22 |
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