Spanish-speaking Latina women with PFDs are heavily influenced by their culture and lack of knowledge of the disease process which produces feelings of shame, fear and isolation. These patients avoid discussions regarding their symptoms, and ultimately delay care and treatment until their condition is very advanced. As a result, Latina women bear a disproportionate burden of symptomatic pelvic floor disorders (PFDs) compared with other racial/ethnic groups. Disparities have been identified across the continuum of care for diagnosis, treatment and surgical outcomes. This study assessed the knowledge, attitude, behaviors and beliefs in Spanish-speaking Latina women with PFDs to begin to understand the reasons underlying these disparities.

Spanish-speaking women with pelvic organ prolapse (POP) and/or mixed urinary incontinence (MUI) were recruited from a public Urogynecology specialty clinic in Los Angeles. Two focus groups (n=18) were conducted by a Spanish-speaking moderator. Topics addressed knowledge and cultural beliefs about PFDs, concerns regarding symptoms, determinants of seeking care, self-perception and relationships with partners. The focus group transcripts were qualitatively analyzed using Grounded Theory methodology.

Several themes emerged from our analysis and were grouped into three categories: knowledge and beliefs, personal responses to symptom onset, and behavioral responses to symptom onset. With regards to knowledge and beliefs, stereotypes and cultural barriers inhibit Latina women from openly discussing their symptoms; however, these women voiced a strong desire for change at both the community and personal level to increase awareness about PFDs. For example, cultural barriers and stereotypes regarding PFDs exist and include Latina women being raised to not speak about personal health problems snd the perception that PFDs are normal part of aging. Additionally, women were overall frustrated by the general lack of knowledge about the management of their conditions. Personal responses to symptom onset included an undesirable emotional response, barriers to seek help, and changes in self-perception. The behavioral response to symptom onset ultimately impacted personal relationships, as well as resulted in delays in seeking care and varied treatment choices.

Spanish-speaking Latina women with PFDs are heavily influenced by their culture and lack of knowledge of the disease process which produces feelings of shame, fear and isolation. As a result, these patients avoid discussions regarding their symptoms, and ultimately delay care and treatment until their condition is very advanced. The Latina women in our focus groups were motivated and empowered to change stereotypes regarding the disease

More public awareness is needed, specifically in the Latino community, to help educate women that it is normal and healthy to talk about PFDs.