背景:在刚果民主共和国(DRC)的瘘管病患者中,对较少的患者进行了生育意愿研究。此外,这些研究采用了单变量描述方法。这项研究旨在研究刚果民主共和国瘘管患者生育意愿的决定因素。
方法:这项横断面研究包括年龄在15-49岁之间的女性,她们的瘘管在2013年至2018年期间由Panzi医院流动小组在七个刚果民主共和国地区修复。使用频率分布表和卡方检验进行单变量和双变量描述性分析。使用logistic回归的调整后的优势比及其95置信区间来分析与瘘管修复后生育意愿相关的因素。所有分析均按15-49岁和20-34岁女性的均等水平进行分层。
结果:在1,646名15-49岁的女性和808名20-34岁的女性中,948(57.6%)和597(73.8%),分别,想生孩子后瘘管修复术。在15-49岁和20-34岁的女性中,生孩子的愿望是平等的。在所有均等水平上,它与年龄呈负相关。在低均等的女性中,对孩子的渴望与大量手术显著负相关,堕胎,和瘘管持续时间。它倾向于随着时间的推移而减少,但在2014年和2017年尤其高。在新教妇女中很高。在中等均等的妇女中,在城市地区和寡妇中,但在两次以上堕胎的女性中更高。在高均等女性中,它与教育水平呈负相关。
结论:为了帮助患有瘘管的妇女达到或接近她们想要的孩子数量,我们的研究结果表明,(1)对孩子有高欲望的女性需要咨询;(2)人类,材料,应提供在刚果民主共和国消除瘘管病所需的财政资源;(3)应对医务人员和护理人员进行充分和有效的培训,以尽量减少对瘘管病妇女进行不成功手术的次数。
BACKGROUND: Studies on fertility desires among
fistula patients in the Democratic Republic of Congo (DRC) have been conducted on fewer patients. Furthermore, these studies have adopted a univariate descriptive approach. This study aims to examine the determinants of fertility desires among patients with
fistula in the DRC.
METHODS: This cross-sectional study included women aged 15-49 whose fistulas were repaired by the Panzi Hospital mobile team in seven DRC regions between 2013 and 2018. Univariate and bivariate descriptive analyses were performed using the frequency distribution table and the chi-square test. Adjusted odds ratios with their 95 confidence intervals from logistic regression were used to analyze factors associated with fertility desire after
fistula repair. All analyses were stratified by parity level for all women aged 15-49 and 20-34 years.
RESULTS: Of the 1,646 women aged 15-49 and 808 aged 20-34, 948 (57.6%) and 597 (73.8%), respectively, wanted to have children after
fistula repair. Among women aged 15-49 and 20-34 years, the desire to have children was parity-specific. It was negatively associated with age at all parity levels. In women with low parity, the desire for children was significantly negatively associated with a high number of surgeries, abortions, and fistula duration. It tended to decrease with time, but was particularly high in 2014 and 2017. It was high among the Protestant women. Among medium-parity women, it was significantly lower in urban areas and among widows, but higher among women who had more than two abortions. Among high-parity women, it was negatively associated with education level.
CONCLUSIONS: To help women with
fistula achieve or approach their desired number of children, our findings suggest that (1) counseling is needed for women with a high desire for children; (2) the human, material, and financial resources needed to eliminate fistula in the DRC should be made available; and (3) medical and nursing staff should be sufficiently and effectively trained to minimize the number of unsuccessful surgeries performed on women with fistula.