Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA.
Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA.
J Racial Ethn Health Disparities. 2022 Aug;9(4):1184-1191. doi: 10.1007/s40615-021-01059-8. Epub 2021 May 19.
Uterine fibroids are non-cancerous neoplasms of the uterus. Women of color, including non-Hispanic Black/African American women and Hispanic/Latinas, have a higher uterine fibroid prevalence, incidence, and disease burden compared to non-Hispanic White women. Therefore, understanding ethnoracial factors in the diagnosis and treatment of uterine fibroids in women of color is critical. This study provides insight on the ethnoracial factors and cultural barriers experienced by women of color in the management and treatment of uterine fibroids.
Women were recruited via The Fibroid Foundation, a nonprofit that provides uterine fibroid support and education. Women who were interested completed an online screening survey. Eligible participants were interviewed via phone. Transcribed audio recordings were qualitatively analyzed using the principles of grounded theory.
Forty-seven women of reproductive age who were diagnosed with uterine fibroids and received U.S.-based care participated in a semi-structured interview exploring experiences with uterine fibroid diagnosis and management. Twenty-eight women self-identified as Black, Latina, or other ethnicity. Women of color reported fibroid symptoms that significantly disrupted their work and home life. Women of color also reported perceptions that their race/ethnicity impacted their uterine fibroid treatment, including negative interpersonal provider-patient interactions. These perceptions engendered feelings of skepticism towards the medical system based on historical injustices and/or their own negative experiences and led some to go without longitudinal care.
Cultural and familial factors have significant impact on uterine fibroid diagnosis and management. Greater attention to culturally sensitive care and potential bias reduction in the treatment of uterine fibroids should be a priority.
子宫肌瘤是子宫的非癌性肿瘤。与非西班牙裔白人女性相比，包括非西班牙裔黑人/非裔美国女性和西班牙裔/拉丁裔女性在内的有色人种女性的子宫肌瘤患病率、发病率和疾病负担更高。因此，了解有色人种女性子宫肌瘤诊断和治疗中的种族因素至关重要。本研究提供了关于有色人种女性在子宫肌瘤管理和治疗中经历的种族因素和文化障碍的见解。
通过非营利组织 The Fibroid Foundation 招募女性，该组织为子宫肌瘤提供支持和教育。有兴趣的女性完成了在线筛选调查。符合条件的参与者通过电话接受采访。使用扎根理论的原则对转录的音频记录进行定性分析。
47 名年龄在生育期的患有子宫肌瘤并接受美国医疗护理的女性参加了一项半结构式访谈，探讨了她们在子宫肌瘤诊断和管理方面的经历。28 名女性自我认同为黑人、拉丁裔或其他族裔。有色人种女性报告说，她们的子宫肌瘤症状严重扰乱了她们的工作和家庭生活。有色人种女性还报告说，她们的种族/族裔影响了她们的子宫肌瘤治疗，包括与提供者的负面人际互动。这些看法基于历史上的不公正和/或她们自己的负面经历，导致一些人对医疗系统产生怀疑，从而导致她们不去进行长期护理。
文化和家庭因素对子宫肌瘤的诊断和管理有重大影响。应该优先关注文化上敏感的护理，并在治疗子宫肌瘤方面减少潜在的偏见。
