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Patients’ Understanding of Pelvic Floor Disorders: What Women Want to Know

Kiyosaki, Krista BA*†; Ackerman, A. Lenore MD, PhD; Histed, Stephanie MD; Sevilla, Claudia MD; Eilber, Karyn **; Maliski, Sally RN, PhD; Rogers, Rebecca G. MD§; Anger, Jennifer MD, MPH*

Female Pelvic Medicine & Reconstructive Surgery: May/June 2012 - Volume 18 - Issue 3 - p 137–142
doi: 10.1097/SPV.0b013e318254f09c
Original Articles
Journal Club

Objective: To assess the effect of initial visit with a specialist on disease understanding in women with pelvic floor disorders.

Methods: Women with referrals or chief complaints suggestive of urinary incontinence or pelvic organ prolapse were recruited from an academic urology clinic. The patients completed a Test of Functional Health Literacy in Adults and scripted interview sessions before and after a physician encounter. Physician’s treatment plans were standardized based on diagnosis and were explained using models. Interview transcripts were analyzed using qualitative grounded theory methodology.

Results: Twenty women with pelvic floor disorders (urinary incontinence or pelvic organ prolapse) were recruited and enrolled in this pilot study. The mean age was 60.5 years (range, 31–87 years) and most of the women were white, with a college degree or beyond. Test of Functional Health Literacy in Adults scores indicated adequate to high levels of health literacy. Preliminary themes before and after the physician encounter were extracted from interviews, and 2 main concepts emerged. First, after the initial physician’s visit, knowledge of their diagnosis and the ability to treat their symptoms relieved the patients’ concerns related to misunderstandings of the severity of their disease, Second, the patients tended to focus on treatment and had difficulty grasping certain diagnostic terms. This resulted in good understanding of treatment plans despite an inconsistent understanding of diagnosis.

Conclusion: Our findings demonstrated a significant effect of the initial physician’s visit on the patients’ understanding of their pelvic floor disorder. Despite the variation in diagnostic recall after the physician encounter, the patients had a good understanding of treatment plans. This served to increase perceived control and adequately relieve patients’ fears.

Twenty women with pelvic floor disorder (urinary incontinence or pelvic organ prolapse) were recruited and enrolled in a pilot study assessing the effect of initial visit with a specialist on understanding their disease. The findings demonstrated a significant effect of the initial physician’s visit on the patients understanding of their pelvic floor disorder.

From the *Department of Urology, Department of Surgery, Cedars-Sinai Medical Center; †Department of Urology; ‡School of Nursing, David Geffen School of Medicine, University of California, Los Angeles, CA; and §Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM.

Reprints: Jennifer Anger, MD, MPH, Urological Research, Cedars-Sinai Medical Center, 99 La Cienega Blvd, 307 Beverly Hills, CA 90211. Email: angerj@cshs.org.

Funded by a Patient-Oriented Research Career Development Award 1 K23 DK080227-01 (JTA), American Recovery and Reinvestment Act (ARRA) Supplement 5K23DK080227-03 (JTA) from the National Institute of Diabetes and Digestive and Kidney Diseases.

Dr Rogers has received unrestricted grant funding from Pfizer and serves as the DSMB chair for the TRANSFORM trial sponsored by American Medical Systems.

The authors declare that they have nothing to disclose.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins