Experiences of surgical continence management approaches for cloacal anomalies: a qualitative analysis based on 6 women.
OBJECTIVE
The aim of this qualitative study was to gain insight into health care experiences of young women diagnosed with cloacal anomalies, with a special focus on continence management.


METHODS
Qualitative analysis of one-to-one interviews.


METHODS
A tertiary center for congenital anomalies of the urogenital tract in London.


METHODS
Six women aged 16 to 24 with cloacal anomalies.


METHODS
Tape-recorded one-to-one semi-stuctured interviews with a skilled interviewer.


METHODS
The taped interviews were transcribed and analyzed verbatim using interpretative phenomenological analysis according to the research question. Organizing themes across all of the accounts were identified.


RESULTS
Two organizing themes concerning our research interests are summarized. The first theme Personal Agency in the Hands of Experts focuses on the interviewees' appreciation of their life-saving surgical care and their involvement in treatment decisions. The second theme Compromises and Trade-Offs focuses on what it was like to live with the more traditional versus the more advanced continence methods. Reliability emerged as a key priority in terms of continence treatment outcome. Gratitude may have interfered with the women's honest communications during treatment decision and evaluation consultations.


CONCLUSIONS
A more developed approach to communication about the complex interventions proposed, founded on a nuanced understanding of users perspectives, can enhance informed decision making about continence management approaches. Despite these specific gaps, the interviewees were appreciative of their care and optimistic about life.
University College London Hospitals, London, UK. Electronic address: lih-mei.liao@uclh.nhs.uk.
L-M
LM
Liao
Norfolk and Suffolk Foundation Trust, Ipswich, UK.
E
E
Baker
Department of Psychology, University of East London, UK.
M E
ME
Boyle
University College London Hospitals, London, UK.
C R J
CR
Woodhouse
University College London Hospitals, London, UK.
S M
SM
Creighton
D000223:Adaptation, Psychological; D000293:Adolescent; D002988:Cloaca / Q000002:abnormalities*; D005242:Fecal Incontinence / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D005260:Female; D058015:Health Communication; D006801:Humans; D010358:Patient Participation; D017060:Patient Satisfaction; D036301:Qualitative Research; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D014564:Urogenital Abnormalities / Q000150:complications* / Q000523:psychology / Q000601:surgery; D055815:Young Adult
ACE; Clinical psychology; Cloacal anomalies; Communication; Mitrofanoff; Treatment preferences; User experiences