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Communication Barriers Among Spanish-Speaking Women With Pelvic Floor Disorders: Lost in Translation?

Khan, Aqsa A. MD*; Sevilla, Claudia MD*; Wieslander, Cecilia K. MD; Moran, Meghan B. PhD; Rashid, Rezoana BS§; Mittal, Brita BS*; Maliski, Sally L. RN, PhD*; Rogers, Rebecca G. MD; Anger, Jennifer T. MD, MPH§

Female Pelvic Medicine & Reconstructive Surgery: May/June 2013 - Volume 19 - Issue 3 - p 157–164
doi: 10.1097/SPV.0b013e318288ac1c
Original Articles

Objectives The purpose of our study was to evaluate barriers in communication and disease understanding among office staff and interpreters when communicating with Spanish-speaking women with pelvic floor disorders.

Methods We conducted a qualitative study to evaluate barriers to communication with Spanish-speaking women with pelvic floor disorders among office staff and interpreters. Sixteen office staff and interpreters were interviewed; interview questions focused on experiences with Spanish-speaking patients with pelvic floor disorders in the clinic setting. Interview transcripts were analyzed qualitatively using grounded theory methodology.

Results Analysis of the interview transcripts revealed several barriers in communication as identified by office staff and interpreters. Three major classes were predominant: patient, interpreter, and system-related barriers. Patient-related barriers included a lack of understanding of anatomy and medical terminology and inhibited discussions due to embarrassment. Provider-related barriers included poor interpreter knowledge of pelvic floor vocabulary and the use of office staff without interpreting credentials. System-related barriers included poor access to information. From these preliminary themes, an emergent concept was revealed: it is highly likely that Spanish-speaking women with pelvic floor disorders have poor understanding of their condition owing to multiple obstacles in communication.

Conclusions There are many levels of barriers to communications with Latin women treated for pelvic floor disorders, arising from the patient, interpreter, and the system itself. These barriers contribute to a low level of understanding of their diagnosis, treatment options, and administered therapies.

Barriers in communication with Latin women with pelvic floor disorders contribute to a low level of understanding of their diagnosis, treatment options, and administered therapies.

From the *University of California Los Angeles, Los Angeles, CA; †Olive View Medical Center, Sylmar, CA; ‡San Diego State University, San Diego, CA; §Cedars-Sinai Medical Center, Los Angeles, CA; and ∥University of New Mexico, Albuquerque, NM.

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

This work was funded by a National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Patient-Oriented Research Career Development Award (1 K23 DK080227, JTA) and an American Recovery and Reinvestment Act (ARRA) Supplement (5K23DK080227, JTA).

Dr Rebecca G. Rogers is 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 Lippincott Williams & Wilkins