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Communication Between Physicians and Spanish-Speaking Latin American Women With Pelvic Floor Disorders: A Cycle of Misunderstanding?

Sevilla, Claudia BS*; Wieslander, Cecilia K. MD; Alas, Alexandriah N. MD; Dunivan, Gena C. MD§; Khan, Aqsa A. MD*; Maliski, Sally L. RN, PhD; Rogers, Rebecca G. MD§; Anger, Jennifer Tash MD, MPH

Female Pelvic Medicine & Reconstructive Surgery: March/April 2013 - Volume 19 - Issue 2 - p 90–97
doi: 10.1097/SPV.0b013e318278cc15
Original Articles
Journal Club

Objective: This study aimed to assess the effect of the initial visit with a specialist on disease understanding among Spanish-speaking women with pelvic floor disorders.

Methods: Spanish-speaking women with referrals suggestive of urinary incontinence (UI) and/or pelvic organ prolapse (POP) were recruited from public urogynecology clinics. Patients participated in a health literacy assessment and interview before and after their physician encounter. All interviews were analyzed using Grounded Theory qualitative methods.

Results: Twenty-seven women with POP (n = 6), UI (n = 11), and POP/UI (n = 10) were enrolled in this study. The mean age was 55.5 years, and most women had marginal levels of health literacy. From our qualitative analysis, 3 concepts emerged. First, was that patients had poor understanding of their diagnosis before and after the encounter regardless of how extensive the physician’s explanation or level of Spanish-proficiency. Second, patients were overwhelmed with the amount of information given to them. Lastly, patients ultimately put their trust in the physician, relying on them for treatment recommendations.

Conclusions: Our findings emphasize the difficulty Spanish-speaking women with low health literacy have in understanding information regarding pelvic floor disorders. In this specific population, the physician has a major role in influencing patients’ treatment decisions and helping them overcome fears they may have about their condition.

We found barriers to communication between physicians and Spanish-speaking Latin American women with pelvic floor disorders.

From the *Department of Urology, UCLA David Geffen School of Medicine, Los Angeles; †Department Obstetrics and Gynecology, Olive View-UCLA Medical Center, Sylmar; ‡Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA; §Departments of Obstetrics and Gynecology and Surgery, University of New Mexico Health Sciences Center, Albuquerque, NM; ∥UCLA School of Nursing; and ¶Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA.

Reprints: Jennifer T. Anger, MD, MPH, Department of Surgery, Cedars-Sinai Medical Center, 99 N La Cienega Blvd, Suite 307, Beverly Hills, CA 90211. E-mail:

Supported by an NIDDK Career Development Award 1-K23-DK080227-01 (Dr Anger).Dr Rebecca G. Rogers serves as the DSMB chair for the TRANSFORM trial sponsored by American Medical Systems.

The other authors have declared they have no conflicts of interest.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins