Siddiqui Nazema Y, Ammarell Natalie, Wu Jennifer M, Sandoval Juan S, Bosworth Hayden B
From the *Department of Obstetrics and Gynecology and †School of Nursing, Duke University Medical Center, Durham; ‡Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill; and §Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center; Departments of Medicine, Psychiatry, and School of Nursing, Duke University Medical Center, Durham, NC.
Female Pelvic Med Reconstr Surg. 2016 Sep-Oct;22(5):340-5. doi: 10.1097/SPV.0000000000000286.
Fewer than half of women with urinary incontinence (UI) seek care for their condition. Our objective was to qualitatively assess the themes surrounding treatment-seeking behaviors.
We conducted 12 focus groups with women and, using purposive sampling, we stratified by racial or ethnic group (white, black, Latina) and by UI frequency. All sessions were transcribed and coded for common themes. Comparative thematic analysis was used to describe similarities and differences among groups.
In total, 113 (39 white, 41 black, and 33 Latina) community-dwelling women participated in focus groups. There were no differences in treatment-seeking themes between groups with different UI frequency. However, certain themes emerged when comparing racial/ethnic groups. Women from all groups shared experiences of embarrassment and isolation because of UI, which were impediments to care seeking. White and black women described discussions with close friends or family that led to normalization of symptoms and prevented care seeking. Latina women maintained more secrecy about UI and reported the longest delays in seeking care. Women articulated a higher likelihood of seeking care if they had knowledge of treatment options, but white women were more likely to seek UI-related knowledge compared with black or Latina women. Physician communication barriers were identified in all groups.
Despite similar experiences, there are different perceptions about care seeking among white, black, and Latina women. Culturally relevant educational resources that focus on a range of treatment options may improve knowledge and thus improve care-seeking behaviors in women with UI.
患有尿失禁(UI)的女性中,寻求治疗的人数不到一半。我们的目的是定性评估围绕寻求治疗行为的主题。
我们对女性进行了12个焦点小组访谈,并采用目的抽样法,按种族或族裔群体(白人、黑人、拉丁裔)以及尿失禁频率进行分层。所有访谈都进行了转录,并对共同主题进行编码。采用比较主题分析来描述各群体之间的异同。
共有113名(39名白人、41名黑人、33名拉丁裔)社区居住女性参与了焦点小组访谈。不同尿失禁频率的群体在寻求治疗的主题上没有差异。然而,在比较种族/族裔群体时出现了某些主题。所有群体的女性都因尿失禁而有尴尬和孤立的经历,这成为寻求治疗的障碍。白人和黑人女性描述了与亲密朋友或家人的讨论,这些讨论使症状正常化并阻碍了寻求治疗。拉丁裔女性对尿失禁更为保密,并报告寻求治疗的延迟时间最长。如果女性了解治疗选择,她们表示寻求治疗的可能性更高,但与黑人或拉丁裔女性相比,白人女性更有可能寻求与尿失禁相关的知识。所有群体都发现了医生沟通障碍。
尽管经历相似,但白人、黑人和拉丁裔女性在寻求治疗方面存在不同看法。关注一系列治疗选择的具有文化相关性的教育资源可能会提高知识水平,从而改善尿失禁女性的寻求治疗行为。