The patient was a 32-year-old woman who presented with infertility secondary to uterine didelphys. Hysteroscopic metroplasty was chosen as the corrective surgical procedure for this anatomical defect. During the surgical repair, the patient developed a massive air embolism (MAE) leading to hypotension, arrhythmia, and cardiogenic shock. Resuscitation was started by placing the patient in the right-side up position, and emplacement of central venous catheter, but it was unsuccessful. The decision was then made to bypass the patient's cardiopulmonary system to effectively treat the MAE. Cannulation was done via femoral vein and artery. During cardiopulmonary bypass (CPB), the MAE was quickly eliminated, oxygen saturation was normalized, and the patient was hemodynamically stabilized. The surgical repair was successfully completed and the patient was decannulated and recovered without any incident.
Background
Human papillomavirus is the most common cause of sexually transmitted diseases. Various studies report that positive human papillomavirus diagnosis results in psychosexual issues for the infected and reduces their quality of life. However, the adaptation of the infected has not been addressed yet. The present study aims to identify the process by which individuals infected with human papillomavirus adapt to their disease.
Method
This is a qualitative work of research with a grounded theory design. The setting of the study was the skin clinic of Shahid Faghihi Hospital in Shiraz. The participants consisted of 27 individuals: 18 patients, 3 doctors, 2 counselors, and 4 spouses of patients. The subjects were selected via purposeful and theoretical sampling method until data saturation was reached. Data were collected through face-to-face, in-depth, semi-structured interviews from April 2019 to December 2020. The collected data were analyzed using Corbin and Strauss’s method (2015) and MAXQDA 2018.
Results
The theory which emerged from the data was “trying to maintain resilience in the absence of psychological security.” Analysis of data showed the main concern of participants in adapting to their diagnosis with human papillomavirus was “life stress”. “Stigma and ignorance” was found to be a contextual condition and “paradox in support” was an intervening condition in the patients’ adaptation. The patients’ action/interaction responses to their main concern in the context in question were “emotional confrontation” and “maintaining resilience.” The outcome was “oscillation between tension and tranquility.”
Conclusion
The present study explains the process by which patients with human papillomavirus adapt to their condition. Identification of the concerns of patients with human papillomavirus and the factors which affect their adaptation can help healthcare policy-makers and providers develop effective support plans in order to increase patients’ quality of life. Early interventions, e.g. counseling care providers to modify their behaviors toward alleviating the psychosexual tension of the infected, can facilitate the adaptation of the infected and decrease the consequences of the infection for them.
Graphical Abstract
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