MP86-15 EFFECTS OF GROUP REHABILITATION UPON WOMEN UNDERGOING SURGERY FOR OBSTETRIC FISTULA

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making V1 Apr 2017MP86-15 EFFECTS OF GROUP REHABILITATION UPON WOMEN UNDERGOING SURGERY FOR OBSTETRIC FISTULA Pooja Parameshwar, Musa Kayondo, A. Lenore Ackerman, Jennifer Anger, and Christopher Tarnay Pooja ParameshwarPooja Parameshwar More articles by this author , Musa KayondoMusa Kayondo More articles by this author , A. Lenore AckermanA. Lenore Ackerman More articles by this author , Jennifer AngerJennifer Anger More articles by this author , and Christopher TarnayChristopher Tarnay More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2698AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Obstetric fistula due to prolonged obstructed labor is a significant public health concern in the developing world. Fistula patients experience chronically elevated levels of social isolation, stigmatization, and depression. In this qualitative study, we aimed to evaluate the experience of group rehabilitation during postoperative recovery in the setting of a “fistula camp” upon women seeking surgical care for fistula and related birth injuries. As this population is marginalized and ostracized, we predicted that group rehabilitation might be particularly germane. METHODS Study participants were women who received surgical care for obstetric fistula and high-grade perineal lacerations at the Mbarara Regional Referral Hospital in Uganda during 2 fistula camps in 2015 and 2016. Using semi-structured interviews, we sought to characterize the lived experiences of these women and their feelings surrounding their medical and surgical care in the setting of a group-based rehabilitative fistula camp. Interviews were conducted via translators who spoke the native dialects. Data was transcribed and analyzed using grounded theory methods, as described by Charmaz. We also directly observed women during their stay and recorded the frequency and types of interpersonal behaviors and interactions. RESULTS Twenty-six women participated in the interviews. Themes of social isolation, depression, shame, and stress were present in women's testimonials of their experiences prior to fistula camp arrival (see Table). When discussing experiences during and after fistula camp stay, themes of social support and hopefulness emerged. Behaviors and interactions indicating social integration with bond formation and social support within the fistula ward were observed. CONCLUSIONS Exposure to other women who had obstetric fistula was of therapeutic benefit to women with these same conditions. We found that the impact of shared experience amongst the women played a critical role in their understanding, perception, and outlook towards their condition and their hope for recovery. A group-based model of postoperative care that integrates physical and psychosocial healing may be highly effective for this population. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1162 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Pooja Parameshwar More articles by this author Musa Kayondo More articles by this author A. Lenore Ackerman More articles by this author Jennifer Anger More articles by this author Christopher Tarnay More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...