Psychological wellbeing of women after surgical correction of obstetric fistula in Northwest Ethiopia: a pre-post design

ABSTRACT

The physical problems associated with fistula result in psychological alteration. This study was aimed to assess whether psychological wellbeing of women with fistula after surgical treatment differ from that of before treatment. Institution-based pre-post follow-up design was conducted. Self-reported incontinence and psychological wellbeing score were assessed. Data were analyzed using Stata 12. Paired t-test and multiple linear regressions were fitted to identify variables correlate with the score difference. In this study, 117 women were interviewed giving response rate of 98.3 percent. Their mean (±sd) age was 27.13 ± 5.37 years. On admission, all women had urinary or fecal incontinence and their mean psychological score was 31.1 (95 percent CI; 30.5–31.6). After treatment, however, 89.7 percent (n = 105) of women reported that they regained continence. Similarly, the mean psychological score has dropped to 18.05 (95 percent CI; 16.4–21.6, p < .001). Pre-treatment score, normal body weight, regaining continence, and getting counseling service were correlates of score difference. Psychological wellbeing of women with genital fistula was improved drastically after treatment. Establishing a system for early identification and treatment of cases could reduce prolonged psychological alteration.

KEYWORDS:

• Northwest Ethiopia
• obstetric fistula
• psychological wellbeing
• treatment effect

Acknowledgments

The authors would like to thank the University of Gondar for the financial support to conduct the study. The study participants, data collectors, and supervisors deserve our deep gratitude for their time and willingness to participate in the study. Mrs. Ginny Carter also deserves our acknowledgment for written English language edition of the manuscript. The authors also wish to acknowledge the valuable contributions of the anonymous reviewers of this paper which have enabled them to improve the manuscript.

Authors’ contribution

DT conceived the study, performed data analysis and interpretation, and drafted the manuscript. AG participated in data analysis and manuscript review. MY participated in the proposal review, interpreted the data and edited the manuscript. TA assisted in analysis, critically review and proof reading of the manuscript. All authors read and approved the final version of manuscript.

Disclosure statement

The authors declare that they have no competing interests!

Ethical approval and consent for participation

Ethical clearance was obtained from the Institutional Review Board of University of Gondar (ref number: O/V/P/RCS/05/935/2016) and permission was obtained from Chief Clinical Directorate Office of the University of Gondar Specialized Referral Hospital and from the Fistula Center Coordinating Office. Prior to interview an Amharic version information sheet was read to the study participants to explain the purpose of the research and procedure. They were also informed that participation is voluntary; they do have the right to withdraw from the study at any time without any form of prejudice. Respondents were told the attainment of confidentiality and the information they give will not be used for any purpose other than the study. Their name and/or hospital number or any identification which refer to them was not recorded, potentially identifying details were changed and codes were assigned to link for the post treatment measurement. They were interviewed in separate room keeping their visual and auditory privacy. The study was interview based and reports are based on cumulative result. Written informed consent was obtained from the participant.

Availability of data and material

The data sets used and/analysed during the current study are available from the corresponding author on reasonable request.

Dedication

This article is dedicated to all women who experienced obstetric fistula and its consequences.

Additional information

Funding

There is no special funding received to conduct the study