Revista Internacional de Saúde Mental e Psiquiatria

COPING MECHANISMS OF PATIENTS SUFFERING FROM VESICOVAGINAL FISTULA (VVF) IN SOUTH-EAST NIGERIA

David Nwoba Nweke, Nicodemus Okwudili Obayi, Christian Nweke Eze and Silas Okey Ewah

Background: Vesico- Vaginal Fistula (VVF) is an abnormal communication between the woman’s urinary bladder and the vagina leading to continuous leakage of urine through the vagina. Adjustment difficulties have been reported frequently in association with highly stigmatized and discriminated illnesses; subjects afflicted with VVF may have difficulties in coping. Aim: Assess the Coping Mechanisms in women with Vesico-Vaginal Fistula (VVF) in South East, Nigeria; determine the sociodemographic profile of the participants with VVF and find out the relationship between their socio-economic profile and their coping mechanisms.

Method: Descriptive survey design was used in this study. A total of 100 women with Vesico-Vaginal Fistula (VVF) and another 100 Women of Childbearing Age (WCA) without VVF were selected through a non-probability sampling technique. Consecutive and consenting participants with VVF that met the inclusion criteria were recruited from the National Obstetric Fistula Centre, Abakaliki, South-East Nigeria. They were interviewed using the modified version of the Mental Adjustment to Cancer scales to measure coping, in five sub-scales: Fighting Spirit (FS), Hopelessness/Helplessness (HH), Anxious Preoccupation (AP), Fatalism (FA) and Avoidance (AV). A socio-demographic and clinical history questionnaire was also used to assess the socio-demographic and clinical characteristics of the participants. Data collected were analyzed using the Statistical Package for Social Sciences (SPSS) version 17.

Results: The study revealed that VVF subjects have a significantly higher fighting spirit and anxious pre-occupation compared with WCA subjects. They also have more emotional distress. In the socio-demographic variables, participants with VVF compared with controls were more likely to be in polygamous marriages (χ2=48.42, p=0.0001) and to be separated or divorced after the onset of their illness (χ2=26.67, p=0.0001) while WCA were more likely to be educated (χ2=83.02, p=?0.0001). WCA reported a statistically significant greater level of social support compared with VVF respondents (χ2=93.54, p=0.001).

Conclusion: Chronic ailments tend to break down innate coping mechanisms. A strong fighting spirit will enhance a positive coping mechanism. There is a need for good social support in cases of chronic ill-health. Mental health support should be extended to this category of patients as this will make the sufferers bear the problem with positive coping. Public enlightenment on the need for moral and psycho-social support for women with VVF is advised.