title: Patients' understanding of pelvic floor disorders:  what women want to know.
abstract: OBJECTIVE
  To assess the effect of initial visit with a specialist on disease understanding in women with pelvic floor disorders.
  
  
  METHODS
  Women with referrals or chief complaints suggestive of urinary incontinence or pelvic organ prolapse were recruited from an academic urology clinic. The patients completed a Test of Functional Health Literacy in Adults and scripted interview sessions before and after a physician encounter. Physician's treatment plans were standardized based on diagnosis and were explained using models. Interview transcripts were analyzed using qualitative grounded theory methodology.
  
  
  RESULTS
  Twenty women with pelvic floor disorders (urinary incontinence or pelvic organ prolapse) were recruited and enrolled in this pilot study. The mean age was 60.5 years (range, 31-87 years) and most of the women were white, with a college degree or beyond. Test of Functional Health Literacy in Adults scores indicated adequate to high levels of health literacy. Preliminary themes before and after the physician encounter were extracted from interviews, and 2 main concepts emerged. First, after the initial physician's visit, knowledge of their diagnosis and the ability to treat their symptoms relieved the patients' concerns related to misunderstandings of the severity of their disease, Second, the patients tended to focus on treatment and had difficulty grasping certain diagnostic terms. This resulted in good understanding of treatment plans despite an inconsistent understanding of diagnosis.
  
  
  CONCLUSIONS
  Our findings demonstrated a significant effect of the initial physician's visit on the patients' understanding of their pelvic floor disorder. Despite the variation in diagnostic recall after the physician encounter, the patients had a good understanding of treatment plans. This served to increase perceived control and adequately relieve patients' fears.
authors.affiliation: Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, 99 La Cienega Blvd, 307 Beverly Hills, CA 90211, USA.
authors.forename: Krista
authors.initials: K
authors.lastname: Kiyosaki
authors.forename: A Lenore
authors.initials: AL
authors.lastname: Ackerman
authors.forename: Stephanie
authors.initials: S
authors.lastname: Histed
authors.forename: Claudia
authors.initials: C
authors.lastname: Sevilla
authors.forename: Karyn
authors.initials: K
authors.lastname: Eilber
authors.forename: Sally
authors.initials: S
authors.lastname: Maliski
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Rogers
authors.forename: Jennifer
authors.initials: J
authors.lastname: Anger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D007407:Interviews as Topic; D011939:Mental Recall; D008875:Middle Aged; D010353:Patient Education as Topic; D056887:Pelvic Organ Prolapse / Q000175:diagnosis* / Q000628:therapy*; D010817:Physician-Patient Relations; D010865:Pilot Projects; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000628:therapy*