Alas Alexandriah N, Dunivan Gena C, Wieslander Cecelia K, Sevilla Claudia, Barrera Biatris, Rashid Rezoana, Maliski Sally, Eilber Karen, Rogers Rebecca G, Anger Jennifer Tash
From the *Department of Gynecology, Cleveland Clinic Florida, Weston, FL; †Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM; ‡Department of Obstetrics and Gynecology, Olive View Medical Center; §Department of Urology, UCLA David Geffen School of Medicine; ∥Department of Urology, Cedars-Sinai Medical Center; and ¶Department of Nursing, UCLA School of Nursing, Los Angeles, CA.
Female Pelvic Med Reconstr Surg. 2016 Nov/Dec;22(6):460-466. doi: 10.1097/SPV.0000000000000315.
The objective of this study was to compare perceptions and barriers between Spanish-speaking and English-speaking women in public and private hospitals being treated for pelvic organ prolapse (POP).
Eight focus groups, 4 in English and 4 in Spanish, were conducted at 3 institutions with care in female pelvic medicine and reconstructive surgery. Standardized questions were asked regarding patients' emotions to when they initially noticed the POP, if they sought family support, and their response to the diagnosis and treatment. Transcripts were analyzed using grounded theory qualitative methods.
Thirty-three women were Spanish-speaking and 25 were English-speaking. Spanish speakers were younger (P = 0.0469) and less likely to have a high school diploma (P < 0.0001) than English speakers. Spanish-speaking women had more concerns that the bulge or treatments could lead to cancer, were more resistant to treatment options, and were less likely to be offered surgery. Women in the private hospital desired more information, were less embarrassed, and were more likely to be offered surgery as first-line treatment. The concept emerged that patient care for POP varied based on socioeconomic status and language and suggested the presence of disparities in care for underserved women with POP.
The discrepancies in care for Spanish-speaking women and women being treated at public hospitals suggest that there are disparities in care for POP treatment for underserved women. These differences may be secondary to profit-driven pressures from private hospitals or language barriers, low socioeconomic status, low health literacy, and barriers to health care.
本研究的目的是比较在公立和私立医院接受盆腔器官脱垂（POP）治疗的讲西班牙语和讲英语的女性之间的认知和障碍。
在3家提供女性盆底医学和重建手术护理的机构进行了8个焦点小组讨论，其中4个用英语，4个用西班牙语。针对患者最初注意到POP时的情绪、是否寻求家庭支持以及她们对诊断和治疗的反应提出了标准化问题。使用扎根理论定性方法分析记录。
33名女性讲西班牙语，25名讲英语。讲西班牙语的女性比讲英语的女性更年轻（P = 0.0469），拥有高中文凭的可能性更小（P < 0.0001）。讲西班牙语的女性更担心肿块或治疗会导致癌症，对治疗方案更抗拒，接受手术的可能性更小。私立医院的女性希望获得更多信息，不那么尴尬，更有可能被提供手术作为一线治疗。出现了这样一种概念，即对POP的患者护理因社会经济地位和语言而异，这表明在为服务不足的POP女性提供护理方面存在差异。
对讲西班牙语的女性和在公立医院接受治疗的女性的护理差异表明，在为服务不足的女性提供POP治疗方面存在差异。这些差异可能是由于私立医院的利润驱动压力、语言障碍、社会经济地位低、健康素养低以及医疗保健障碍所致。
