تبیین تسهیل کننده‌ها و موانع جستجوی درمان در زنان مبتلا به افتادگی اعضای لگن: مطالعه کیفی

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی دکتری تخصصی بهداشت باروری، مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 استادیار گروه آموزشی مامایی، مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استاد، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 استاد گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: جستجوی درمان در حوزه­ افتادگی اعضای لگن، متأثر از مؤلفه­های اجتماعی- فرهنگی می­باشد. مطالعات نشان می­دهند که زنان در حوزه­ بیماری­های ادراری- تناسلی کمتر به جستجوی درمان و مراقبت از خود می­پردازند. مطالعه حاضر با هدف تبیین تسهیل‌کننده­ها و موانع جستجوی درمان در زنان مبتلا به افتادگی اعضای لگن انجام گرفت.
روش‌کار: این مطالعه کیفی در سال 1397 بر روی 15 نفر از زنان مبتلا به افتادگی و مراجعه‌کننده به درمانگاه­های زنان بیمارستان قائم (عج) و امام رضا (ع) مشهد انجام شد. جمع­آوری داده­ها با مصاحبه­ عمیق نیمه‌ساختار یافته تا اشباع داده­ها ادامه یافت. تمام مصاحبه­ها ضبط و به دقت تایپ گردید و تجزیه و تحلیل داده­ها با استفاده از روش تحلیل محتوای مرسوم گریهام به‌وسیله­ نرم‌افزار MAXqda انجام گرفت.
یافته‌ها: پس از طبقه­بندی و کدبندی داده­ها از مجموع مضمون­های یافت شده، 2 طبقه اصلی استخراج شد. درون‌ﻣﺎﻳﻪ تسهیل کننده­های جستجوی درمان شامل 8 زیرطبقه: درک حمایت همسر و خانواده، دریافت توصیه­های تیم بهداشتی به درمان، درک تشدید علائم، وجود تجربیات مثبت درمان در اطرافیان، اعتقاد به ضرورت درمان در سنین پایین‌تر، ترس از عوارض آینده، مشقت‌بار شدن انجام تکالیف دینی و زجرآور شدن برقراری رابطه­ جنسی بود. موانع جستجوی سلامت شامل 9 طبقه: عدم آگاهی در مورد افتادگی اعضای لگن، بی­میلی شخصی برای مراجعه جهت درمان، میزان دسترسی و فراهم بودن درمان، وجود تجربیات منفی درمان در اطرافیان، وضعیت اقتصادی- مالی، شرم از بازگو کردن مشکل تناسلی، عوامل مرتبط با فرزندان و خانواده، نداشتن فردی جهت حمایت و همراهی و بهبود نسبی و گهگاهی علائم بیماری بود.
نتیجه‌گیری:تسهیل­کننده­ها و موانع در جستجوی سلامت و درمان زنان در حوزه­ افتادگی اعضای لگن که در این مطالعه شناسایی شده است، در درک نیازهای بهداشتی آنان کمک می­کند و می­تواند به‌عنوان کمکی برای طراحی برنامه­های مداخله­ای و مشاوره­های مؤثر توسط برنامه­ریزان و ارائه‌دهندگان خدمات بهداشت باروری و مراقبین سلامت در نظر گرفته شود.

کلیدواژه‌ها


عنوان مقاله [English]

Explaining facilitators and barriers to treatment-seeking in women with pelvic organ prolapse: A qualitative study

نویسندگان [English]

  • Zahra Hadizadeh-Talasaz 1
  • Talaat khadivzadeh 2
  • Hossein Ebrahimipour 3
  • Nayereh Khadem Ghaebi 4
1 Ph.D student of Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant Professor, Department of Midwifery Education, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Professor, Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Professor, Department of Obstetrics and Genecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction:Treatment seeking in pelvic organ prolapse is influenced by socio-cultural components. Studies show that in the field of urinary-genital diseases, women are less likely to seek treatment and self-care behaviors. This study was performed with aim to explain the facilitators and barriers to treatment seeking in women with pelvic organ prolapse (POP).
Methods:This qualitative study was conducted on 15 women with POP referring to gynecologic clinics of Ghaem and Imam Reza Hospital in Mashhad in 2018. Data collection with semi-structured deep interviews continued until data saturation was achieved. All interviews were audio-taped and accurately typed, and then data were analyzed using conventional content analysis of Greinham approach with MAXqda software.
Results:After categorizing and coding the data among total obtained themes, two main themes were extracted. Facilitators to treatment seeking has eight subcategories: understanding the support of the spouse and family, the recommendations of the health team to the treatment, understanding the exacerbation of symptoms, positive experiences of treatment in the community, believing the need for treatment at an early age, fear of future complications, hardship of religious duties and disturbing sexual intercourse.Barriers of seeking treatment have nine sub-categories including: lack of knowledge about POP, personal reluctant to referring for treatment, accessibility and affordability of treatment, negative experiences of treatment in people around them, economic-financial status, shame on speak about genital problems, factors related to children and family, lack of support and companion and occasional relative improvement of symptoms of the disease.
Conclusion: The facilitators and barriers of treatment-seeking among women with pelvic organ prolapse which are identified in this study help them to understand health needs and can be considered as an important issue for designing the effective interventional and consulting programs by planners and providers of reproductive health services.

کلیدواژه‌ها [English]

  • Barriers
  • Facilitators
  • Pelvic organ prolapse
  • Qualitative research
  • Treatment-seeking
  • Women
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