Racial/Ethnic Differences in Women’s Experiences with Symptomatic Uterine Fibroids: a Qualitative Assessment

• Published in: Journal of racial and ethnic health disparities 2017-04, Vol.4 (2), p.178-183
• Main Authors: Sengoba, Katherine S., Ghant, Marissa S., Okeigwe, Ijeoma, Mendoza, Gricelda, Marsh, Erica E.
• Format: Article
• Language: English
• Subjects: Adult; African Americans; Asian Americans; Attitude to Health - ethnology; Aversion; Clinical outcomes; Coders; Cultural differences; Data analysis; Data collection; Education; Epidemiology; Ethnic differences; Ethnic factors; Ethnic Groups; Ethnicity; European Continental Ancestry Group; Family income; Female; Fibroids; Grounded Theory; Health disparities; Health education; Health insurance; Health literacy; Healthcare Disparities - ethnology; Hispanic Americans; Humans; Hysterectomy; Insurance Coverage; Insurance, Health; Intervention; Interviews; Kappa coefficient; Leiomyoma - therapy; Medicine; Medicine & Public Health; Middle Aged; Minority & ethnic groups; Organizations; Patient Satisfaction - ethnology; Public health; Qualitative Research; Quality of Life Research; Race; Social Inequality; Social Structure; Socioeconomic Factors; Uterine Myomectomy; Uterine Neoplasms - therapy; Uterus; White people; Women
• ISSN: 2197-3792; 2196-8837
• DOI: 10.1007/s40615-016-0216-1

Objective The purpose of this study is to determine racial/ethnic differences in treatment experiences and expectations among women with fibroids. Methods Sixty women with symptomatic uterine fibroids completed semi-structured interviews, demographic surveys, and a health literacy assessment. Participants were recruited from community-based organizations and health care organizations. Data from interviews were analyzed using a grounded theory approach. Three coders identified major themes and subthemes. Results The kappa ( κ ) among coders was 0.94. The mean age of participants was 43.0 ± 6.8 (mean ± SD). A total of 61.7 % of subjects were African-American (AAW), 25.0 % were non-Hispanic White (WW), 8.3 % were Hispanic (HW), and 5.0 % were Asian (ASW). When considering treatment options, AAW were more likely to want a permanent intervention. They were also more likely to demonstrate an aversion toward conventional treatments. Of the women who received a surgical intervention, AAW were also more likely to have had a difficult recovery and to be dissatisfied with their treatment. Finally, AAW disproportionately expressed concern regarding financial challenges. Conclusions AAW have high treatment expectations, have more financial obstacles, and are less satisfied with their treatment outcomes than women of other racial/ethnic groups. Our findings suggest a need to create targeted patient interventions and education to ameliorate these disparities in experience.