title: Psychosocial implications of tubal ligation in a rural health district: a phenomenological study.
abstract: BACKGROUND
  Tubal ligation is the most popular family planning method worldwide. While its benefits, such as effectiveness in protecting against pregnancies, minimal need for long-term follow-up and low side-effects profile are well documented, it has many reported complications. However, to date, these complications have not been described by residents in Congo. Therefore, the study aimed at exploring the experience of women who had undergone tubal ligation, focusing on perceptions of physical, psychological and contextual experiences of participants.
  
  
  METHODS
  This qualitative study used a semi-structured questionnaire in a phenomenological paradigm to collect data. Fifteen participants were purposefully selected among sterilized women who had a ligation procedure performed, were aged between 30 and 40 years, and were living within the catchment area of the district hospital. Data were collected by two registered nurses, tape-recorded, and transcribed verbatim. Reading and re-reading cut and paste techniques, and integration were used to establish codes, categories, themes, and description.
  
  
  RESULTS
  Diverse and sometimes opposite changes in somatic symptoms, psychological symptoms, productivity, ecological relationships, doctor-client relationships, ethical issues, and change of life style were the major problem domains.
  
  
  CONCLUSIONS
  Clients reported conflicting experiences in several areas of their lives after tubal sterilization. Management, including awareness of the particular features of the client, is needed to decrease the likelihood of psychosocial morbidity and/or to select clients in need of sterilization.
authors.affiliation: Department of Family Médecine, Université de Goma, Goma, 2 Avenue Himbi, Congo P,O, Box 204 Goma, Congo. mukobelwalutalap@yahoo.com
authors.forename: Prosper M
authors.initials: PM
authors.lastname: Lutala
authors.forename: Jannie F
authors.initials: JF
authors.lastname: Hugo
authors.forename: Levi N
authors.initials: LN
authors.lastname: Luhiriri
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003223:Congo; D003906:Developing Countries; D004526:Efficiency; D005260:Female; D006167:Guilt; D006801:Humans; D007398:Interpersonal Relations; D008599:Menstruation Disturbances / Q000209:etiology; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012423:Rural Health; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000523:psychology*