Quality of Life and Associated Factors Among Women With Obstetric Fistula in Ethiopia

Abstract Background: The physical, emotional and social suffering associated with continuous leakage of urine has a profound impact on women quality of life. The aim of this study was to assess quality of life and associated factors among obstetric fistula patients in Ethiopia, has a significant role for further intervention. Objective: To assess quality of life and associated factors among obstetric fistula patients in Ethiopia, 2017. Methods: In this cross-sectional study, 289 women with obstetric fistula were recruited for interviews, using the systematic random sampling technique. The World Health Organization Quality of Life – Brief (WHOQOL-BREF) Version was used to assess quality of life. The Jacob perceived stigma scale and the Oslo-3 social support instruments were used to assess the factors. We computed simple and multiple linear regression analysis to assess factors associated with quality of life. P-value <0.05 was declared statistically significant.Result: Of 289 women studied, only 12.1% felt satisfied with their general state of health and quality of life. In the physical health domain, the mean quality of life score was 40.78±.78. In the psychological domain, the mean quality of life score was 39.96±.82. In the social and environmental domain, the mean quality of life score was 32.9±.95, 36.45±.8 respectively. Duration of incontinence (unstandard β=-3.8,95% CI(-6.95,-.62), patients coming for surgical procedure (β=-4.4, 95% CI(-7.64,-1.2), poor social support(β= -6.14, 95%CI (-8.8,-3.4), Co-morbid anxiety(β= -4, 95% CI (-7,-1.1) and depression(β=-9.2, 95% CI (-12,-6.4) were negatively associated with physical domain of quality of life. Co-morbid anxiety (β= -11,95% CI (-14.8,-7.3), employment(β= 9.1,95%CI(.5, 17.6), number of children(β= 2.1,95%CI(.8, 3.4), and depression(β= -6.3,95%CI(-9.7,-2.9) were associated with a psychological domain. Duration of incontinence (β=-8.1,95%CI(-12.82,-3.4), poor social support(β= -7.8(-12,-3.6), patients coming for surgical procedure (β= -12,95%CI(-17.4,-6.4) and co-morbid anxiety(β= -9.2,95%CI(-13.8, 4.5) were negatively associated with social domain of quality of life. Number of children present (β=2.4,95%CI(.82, 3.6), and poor social support(β= -5.5,95%CI(-9.5,-1.5) were significantly associated with an environmental domain of quality of life. Conclusion and recommendation: Co-morbid depression and anxiety, poor social support, duration of urine incontinence, employment, number of children, and duration of hospital stay were factors significantly associated with domains of QOL. Treating co-morbid depression and anxiety, strong social support and controlling urine incontinence is necessary to increase women’s domain of quality of life.