The Relationship between Self-Fulfilling Prophecies and Social Reintegration among Obstetric Fistula Patients of Different Repair Status at St. Joseph Kitovu Hospital, Uganda.

Abstract

Background: Obstetric fistula is a debilitating childbirth injury. Patients live in despair and self-stigmatize. Studies highlight beliefs and perceptions about the cause of the disease and how it can be cured. Experiences among both treated and untreated patients are also discussed vastly but there is limited information on negative perceptions and beliefs among obstetric fistula patients towards their spouses, families, and communities and how these affect social reintegration. This study determined the relationship between self-fulfilling prophecies and social reintegration among obstetric fistula patients in different repair categories. Methods: A cross-sectional mixed-methods survey was done among the obstetric fistula patients (n=398) at St. Joseph Kitovu Hospital in Uganda. Also, 12 key informants participated. A semi-structured questionnaire and an in-depth interview were used to get data from the patients. The interviews covered patients ’ expectations and beliefs on reacceptance, interaction, self-satisfaction and comfort with others. The hypothesis: “ there was a significant relationship between self-fulfilling prophecies and social reintegration among obstetric fistula patients in different repair categories” was tested by Pearson chi-square at a 95% confidence interval. Results: Accordingly, 51.5%, 14.4% and 9.0% of the 398 participants felt that their spouses, communities, and parents respectively would not reaccept them. Again, 33.6% were not satisfied with their lives and 47.7% felt uncomfortable around others. A major difference was observed in the relationship between their self-perceived stigma, sense of loss, self-worth, achievement, the expectation of reacceptance, perception of others’ attitudes towards them, labeling, moods, self-satisfaction, comfort with others and social reintegration. A relationship with the patients’ repair category was noted across all variables: P-values less than 0.001 at a 95% confidence interval. Conclusion: A relationship was found between the patient’s negative beliefs, perceptions, and social reintegration. Negative beliefs and expectations could be transformed into positive ones through the promotion of personal hygiene and comprehensive counseling.