ABSTRACT
Aims: To investigate women’s perceptions of miscarriage and its complications. Study Design: A qualitative design was used with data collected through semistructured interviews. Place and Duration of Study: Gynaecology ward of the Queen Elizabeth Central Hospital, Blantyre, Malawi, during February and March 2012. Methodology: Sample: We included 30 patients (aged between 18 and 39) admitted to the gynaecology ward for surgery following miscarriage. Inclusion criteria were: (a) diagnosis of miscarriage (b) aged over 18. Semi-structured interviews were conducted through a translator and lasted an average of 30 minutes (range 14 – 46minutes). Results: 14 of the women interviewed knew what a miscarriage was. Perceived causes included contraceptives, prohibited medicines, hard labour, stress, HIV, malaria, witchcraft, traditional medicines, lack of child spacing and abuse by their male partners. Women obtained knowledge from their own experience of miscarriage and through the shared experiences of female family members and friends. Women were found to have concerns about death from miscarriage; facing stigmatising attitudes of community and health workers; and the treatment they would receive in hospital, particularly the surgical procedure. Conclusions: The women had poor knowledge of the causes and symptoms of miscarriage. They were concerned about the treatment that they would receive in the hospital and how their miscarriage would be perceived by both the hospital staff and within their communities. Women who have miscarriages should be encouraged to discuss this with female friends and relatives to improve knowledge on miscarriage and help dispel the stigma surrounding it. Providing information on the treatment they would receive whilst in hospital may help to allay women’s concerns. Incorporating education about miscarriage into the school syllabus may help to improve women’s awareness and understanding.
ABSTRACT
A crença de que medicamentos à base de plantas são isentos de riscos à saúde faz parte da bagagem cultural da população afeita ao seu uso: "o que vêm da terra não faz mal". No entanto, o potencial tóxico, as características específicas do usuário, a possibilidade de contaminação e a falta de regulamentação constituem fatores de risco para a ocorrência de reações adversas, intoxicações e outras complicações decorrentes de seu uso. Foram realizadas entrevistas semi-estruturadas junto a 20 raizeiros (vendedores de ervas "in natura") na cidade de Diadema/SP. Foram relatados 40 casos de problemas relacionados ao uso de 22 espécies de plantas medicinais. As espécies mais citadas foram Luffa operculata - buchinha (7 casos), Senna alexandrina - sene (4 casos) e Paullinia cupana - guaraná (3 casos). Dentre os sinais e sintomas relatados, os mais freqüentes foram relacionados ao sistema nervoso central, problemas gastrointestinais e cardiovasculares. Os entrevistados também relataram um caso de aborto relacionado ao uso de S. alexandrina e três casos de óbito após a ingestão do chá do fruto de L. operculata. O caráter "natural" das plantas medicinais não é sinônimo de ausência de riscos para a população usuária. É necessária a implantação de políticas de fitofarmacovigilância eficientes, a fim de tornar o consumo mais racional e, deste modo, minimizar os riscos à população usuária.
Traditionally, medicinal herbs have been considered gentle and harmless because of their natural origin: "natural and therefore free of risks". However, toxic potential, various consumer-related factors (such as age, disease factors, pregnancy, etc), contamination, and lack of regulation concerning quality control are some of the risk factors deemed to be associated with herbal adverse reactions, poisonings and other complications. Over a 7-month period, semi-structured interviews were carried out with 20 "raizeiros" (traditional healers) in Diadema/SP. We found 40 unexpected events related to 22 species of medicinal herbs. The most frequent species reported were Luffa operculata - "buchinha" (7 reports), Senna alexandrina - "sene" (4 reports) and Paullinia cupana - "guaraná" (3 reports). Among the adverse events, the most frequent signs and symptoms reported involved the central nervous, gastrointestinal and cardiovascular systems. They also reported one case of abortion (related with S. alexandrina) and three deaths related with L. operculata. Adverse events that result from "natural" medicines are relatively uncommon, but they certainly occur more often than acknowledged. Medicinal plants are traditionally considered as innocuous, but as commercially available medicinal products they require sanitary surveillance in order to identify their risks, to give them a legal status, to evaluate their efficacy and to ascertain their safety.
ABSTRACT
Qualitative research has gained greater attention in medical research, but it might seem to be unscientific because qualitative and quantitative research methods are grounded in different paradigm.<BR>In this article, we introduce three major qualitative research methods frequently used in studies of patient-doctor communications: 1) in-depth interviews; 2) focus group interviews and, 3) semi-structured interviews.<BR>Each qualitative research method has different or common advantages and disadvantages, and which methods should be used depends on the study objectives. Qualitative research and quantitative research are complementary: while quantitative research explains the prevalence or variation of an issue, qualitative research explains the reasons or processes of that prevalence or variation. Combination of the two methods enables the gathering of more comprehensive and explanatory results.