Spanish-Speaking Latinas with Pelvic Floor Disorders: Understanding the Misunderstood.

Abstract

Introduction and hypothesis: Challenges to providing care to Spanish-speaking Latinas with pelvic floor disorders (PFDs) are well studied. Limited data exist on patient and provider perspectives on the unique challenges in providing language-discordant care. Our study was aimed at highlighting these challenges and providing evidence-based recommendations on how to optimize the care of these women.

Methods: Both Spanish-speaking patients with PFDs and non-Spanish speaking providers at the University of South Florida were recruited for this study. Interviews were conducted by a single bilingual interviewer. Topics included providers' experiences, specifically barriers, when caring for Spanish-speaking Latinas, and patients' experiences, focusing on differences between Spanish and non-Spanish speaking providers, while receiving care for PFDs. All interviews were analyzed using grounded theory qualitative methods.

Results: Thirteen interviews were conducted, 7 Spanish-speaking Latinas with PFDs and 6 non-Spanish-speaking urogynecology providers. Qualitative analysis yielded three major themes noted by both patients and providers: cultural stigma, barriers influencing care, and behavioral adaptations to language discordance. Concepts identified from these themes included: generational shame and embarrassment, aversion to treatment, interpreter use barriers, lack of resources, accommodation between patient and provider, and time constraints. Culturally competent recommendations were made based on study findings and review of the literature to improve care of Spanish-speaking Latinas.

Conclusions: This study highlights common themes experienced by both patients and their non-Spanish-speaking providers caring for Spanish-speaking Latinas. The study provides recommendations and implementable strategies that can improve care and help providers to build a stronger therapeutic relationship with Spanish-speaking Latinas.