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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