Susan Obore

Most patients with ovarian cancer are diagnosed when the disease is at an advanced stage. The symptoms and the surgery-induced loss of sexual and reproductive function have an impact on the health-related quality of life (HRQOL) of affected women. The present study described the HRQOL among women with ovarian cancer at Mulago Hospital, Kampala, Uganda. This was a case series involving 36 women with histologically confirmed ovarian cancer admitted to the gynecologic oncology unit at Mulago Hospital. Clinical and histologic characteristics were determined using an interviewer-administered questionnaire. The abbreviated version of the WHO Quality of Life instrument (WHOQOL-BREF) was used to assess quality of life. All patients had symptoms (mainly abdominal symptoms) before diagnosis and had previously sought medical care without being diagnosed. The majority (88.9%) had advanced disease (mainly serous epithelial tumors). Most patients were dissatisfied with their life and scored low on all HRQOL domains (physical, psychological, and social well-being; environment). The overall mean WHOQOL-BREF score was 27.5%; the score was lowest (mean 18.7%) in the psychological domain. All patients experienced symptoms before diagnosis and the majority presented with advanced disease. The quality of life was poor in all domains, with psychological well-being most affected.

Obstetric fistula is a debilitating birth injury that affects an estimated 2-3 million women globally, most in sub-Saharan Africa and Asia. The urinary and/or fecal incontinence associated with fistula affects women physically, psychologically and socioeconomically. Surgical management of fistula is available with clinical success rates ranging from 65-95 %. Previous research on fistula repair outcomes has focused primarily on clinical outcomes without considering the broader goal of successful reintegration into family and community. The objectives for this study are to understand the process of family and community reintegration post fistula surgery and develop a measurement tool to assess long-term success of post-surgical family and community reintegration. This study is an exploratory sequential mixed-methods design including a preliminary qualitative component comprising in-depth interviews and focus group discussions to explore reintegration to family and community after fistula surgery. These results will be used to develop a reintegration tool, and the tool will be validated within a small longitudinal cohort (n = 60) that will follow women for 12 months after obstetric fistula surgery. Medical record abstraction will be conducted for patients managed within the fistula unit. Ethical approval for the study has been granted. This study will provide information regarding the success of family and community reintegration among women returning home after obstetric fistula surgery. The clinical and research community can utilize the standardized measurement tool in future studies of this patient population.