The levels of self-efficacy among obstetric fistula patients in different repair categories at St. Joseph Kitovu Hospital, Uganda:

Abstract

Objective: The repair of obstetric fistula is possible and potentially addresses the physical ordeals, but the psycho-social afflictions with effect on patients’ self-efficacy may persist. Meanwhile, inadequate evidence exists regarding the levels of self-efficacy among patients in different repair categories, which incited this study. Methods: Data was collected and analyzed among the 402 participants at St. Joseph Kitovu Hospital Masaka, Uganda. 390 participants were involved in quantitative methods while 22 were involved in qualitative methods. Only obstetric fistula patients were involved in the quantitative study, 10 of them in a qualitative study. The other 12 were key informants who were included purposively. The patients were identified from the Urogynecology department surgical logbook, randomly sampled using SPSS 25.0, invited by phone calls and others identified through snowballing. Results: Among the patients, 192 had had repair of the fistula, of which 82.3% had been successful while 198 had not yet had fistula repair. The largest proportion (47.0%) was aged 19 to 29 years. The levels of self-efficacy among the patients included low, moderate and high. The larger proportion (60.26%) had a moderate level, 20.00% had a high level while 19.74% had a low level of self-efficacy. However, when Pearson correlation was done, the patients whose fistula had been repaired had a higher level of self-efficacy compared to those with unrepaired fistula with all the attributes of self-efficacy having P-values of <0.001 at a significant level of 0.05. Interviewees also reported that patients with repaired fistula generally have higher levels of self-efficacy compared to those whose fistulas are not yet repaired. Conclusion: Obstetric fistula patients may have low, moderate or higher levels of self- efficacy depending on the level of incontinence, repair status, and prior training in life skills. Therefore, targeted strategies aimed to reduce incontinence and promote wellbeing such as the repair of fistula, life skills training and counseling would improve the levels of self-efficacy henceforth enhance social rehabilitation and reintegration.