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黑人和西班牙裔女性对下尿路症状治疗及家庭干预的看法。

Black and Hispanic Women's Views on LUTS Treatment and a Home-Based Intervention.

作者信息

Brown Oluwateniola, Serrano Eloisa, Geynisman-Tan Julia, Simon Melissa, Griffith James W, Kenton Kimberly

机构信息

From the Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine.

Department of Medical Social Science, Northwestern University.

出版信息

Urogynecology (Phila). 2025 May 30. doi: 10.1097/SPV.0000000000001699.

Abstract

OBJECTIVE

This study aimed to examine facilitators and barriers to treatment for lower urinary tract symptoms among care-seeking Black and Hispanic women and to explore perspectives on "SUPPORT," a self-directed, 8-week, home-based intervention combining education, bladder retraining, pelvic floor muscle training, and cognitive behavior therapy.

STUDY DESIGN

This was a qualitative observational study. We recruited a convenience sample of care-seeking women with lower urinary tract symptoms who self-identified as Black race or Hispanic ethnicity and were English or Spanish speaking. We conducted focus groups in the participants' primary language. Two authors analyzed the focus group transcripts using modified grounded theory techniques.

RESULTS

We enrolled 27 participants and conducted 7 focus groups. There were 13 non-Hispanic Black and 14 Hispanic participants. The mean ± SD age of the cohort was 49 ± 14 years. Barriers reported by both Black and Hispanic participants included (1) unfamiliarity with treatment options and negative perceptions of procedural treatments, (2) unsatisfactory interactions with the health care team, (3) travel distance for treatment, and (4) resources. Barriers distinct to Spanish-speaking and Black participants were inadequate interpreter services and feeling blocked from accessing care by clinic staff, respectively. Facilitators of treatment included (1) patient-centered clinical environments, (2) streamlined financial assistance services, and (3) shared treatment decision making. Most participants found the SUPPORT intervention concept promising for reducing psychosocial stress related to lower urinary tract symptoms and potentially overcoming various barriers to treatment.

CONCLUSION

Participants reported multilevel barriers to lower urinary tract treatments. The concept of the SUPPORT intervention was acceptable to participants and may overcome barriers to treatment.

摘要

目的

本研究旨在探讨寻求治疗的黑人和西班牙裔女性下尿路症状治疗的促进因素和障碍,并探讨对“支持”的看法,这是一种为期8周的自我指导的家庭干预措施,结合了教育、膀胱再训练、盆底肌肉训练和认知行为疗法。

研究设计

这是一项定性观察性研究。我们招募了一个方便样本,即寻求治疗的有下尿路症状的女性,她们自我认定为黑人或西班牙裔,且说英语或西班牙语。我们用参与者的母语进行焦点小组讨论。两位作者使用改良的扎根理论技术分析焦点小组记录。

结果

我们招募了27名参与者并进行了7次焦点小组讨论。有13名非西班牙裔黑人参与者和14名西班牙裔参与者。该队列的平均年龄±标准差为49±14岁。黑人和西班牙裔参与者报告的障碍包括:(1)对治疗选择不熟悉以及对程序性治疗的负面看法;(2)与医疗团队的互动不令人满意;(3)治疗的出行距离;(4)资源。讲西班牙语的参与者和黑人参与者特有的障碍分别是口译服务不足和感觉被诊所工作人员阻碍获得治疗。治疗的促进因素包括:(1)以患者为中心的临床环境;(2)简化的经济援助服务;(3)共同的治疗决策。大多数参与者发现“支持”干预概念有望减轻与下尿路症状相关的心理社会压力,并可能克服各种治疗障碍。

结论

参与者报告了下尿路治疗的多层次障碍。“支持”干预概念为参与者所接受,并可能克服治疗障碍。

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