Urogynecology and Pelvic Reconstructive Surgery, Tufts Medical Center, Boston, MA, USA.
Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, Chicago, IL, USA.
Int Urogynecol J. 2023 Oct;34(10):2557-2564. doi: 10.1007/s00192-023-05574-6. Epub 2023 Jun 7.
The objective was to evaluate whether younger age was associated with noncare-seeking behavior among Asian Americans with pelvic floor symptoms, and secondarily, to explore multilevel factors that may contribute to noncare-seeking behavior in this population.
We performed a concurrent mixed methods study and heterogeneously sampled Asian Americans with urinary incontinence, urgency-frequency, vaginal bulge, or anal incontinence. We stratified the participants into two groups, care seekers vs noncare seekers. Using Anderson's model as the main framework, we administered validated questionnaires and conducted semi-structured interviews to explore factors associated with care-seeking behaviors.
Seventy-eight surveys and 20 interviews were completed and analyzed. Most participants reported urinary leakage (67%), followed by urinary urgency-frequency (50%), anal incontinence (18%), and vaginal bulge (17%). The mean age of the study cohort was 46.1 ± 16.2 years. We found noncare seekers to be younger and with an increased proportion of lifetime spent in the USA than care seekers. When controlling for age, proportion of lifetime spent in the USA, symptom severity, and individual-level resources, both younger age and increased proportion of lifetime spent in USA remained independently associated with noncare-seeking behavior. From qualitative data, we found that noncare seekers often experienced anti-Asian racism across workplace, neighborhoods, and health care settings. Additionally, noncare seekers also reported symptom minimization and decreased self-efficacy when coping with their pelvic floor symptoms.
We found that one's age and proportion of lifetime spent in the USA may affect the extent of exposure to anti-Asian racism that is associated with symptom minimization, increased perceived barrier, and noncare-seeking behavior.
本研究旨在评估年龄较小是否与亚裔美国人出现盆底症状时不寻求医疗护理有关，其次，探讨可能导致该人群不寻求医疗护理的多层次因素。
我们进行了一项同期混合方法研究，并对患有尿失禁、尿急-频、阴道膨出或肛门失禁的亚裔美国人进行了异质抽样。我们将参与者分为两组，即寻求护理者和不寻求护理者。我们使用安德森模型作为主要框架，为参与者提供了经过验证的问卷，并进行了半结构化访谈，以探讨与寻求护理行为相关的因素。
完成并分析了 78 份调查和 20 份访谈。大多数参与者报告有尿漏（67%），其次是尿急-频（50%）、肛门失禁（18%）和阴道膨出（17%）。研究队列的平均年龄为 46.1±16.2 岁。我们发现不寻求护理者比寻求护理者更年轻，且一生中在美国的时间比例更高。在控制年龄、一生中在美国的时间比例、症状严重程度和个体资源后，年龄较小和一生中在美国的时间比例增加仍然与不寻求护理行为独立相关。从定性数据中，我们发现不寻求护理者在工作场所、社区和医疗保健环境中经常经历反亚裔种族主义。此外，不寻求护理者还报告说，在应对盆底症状时，他们会症状最小化和自我效能感降低。
我们发现，一个人的年龄和一生中在美国的时间比例可能会影响他们接触与症状最小化、增加感知障碍和不寻求护理行为相关的反亚裔种族主义的程度。
