The role of ethnicity and culture on functional status in children with spina bifida.
OBJECTIVE
Spina bifida is a common cause of pediatric disability and more prevalent in the Hispanic population. Significant health disparities exist in minority populations. Culturally adapted health interventions have been attempted in conditions such as pediatric asthma with improvement. This study aims to explore the influence of ethnicity and culture with regards to functional status and care satisfaction.


METHODS
Study participants were recruited from the Children's Hospital Colorado Spinal Defects Clinic. Demographics and past medical and surgical history were obtained via chart review. A questionnaire assessed ethnicity, acculturation, self-care, mobility, bowel and bladder function, and care satisfaction.


RESULTS
A total of 70 subjects with spina bifida were included in the statistical analysis. There was no difference in PEDI self-care and mobility scores between ethnicities. The Hispanic group had higher urinary incontinence rates, higher percentage with bladder accidents, and lower satisfaction with bladder management. Regarding bowel function, the Hispanic group had lower satisfaction rates and a trend towards lower bowel continence.


CONCLUSIONS
Further work is needed to understand the social and cultural differences between Hispanic and Non-Hispanic children and their families that impact bowel and bladder continence and care satisfaction. Once identified, culturally sensitive interventions may be implemented that can alleviate these apparent health disparities.
Department of Pediatrics, Children's Hospital Colorado, Aurora, CO, USA.
Montida
M
Chowanadisai
Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado, Aurora, CO, USA.
Deeni L
DL
de la Rosa Perez
Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado, Aurora, CO, USA.
David A
DA
Weitzenkamp
Department of Urology, Children's Hospital Colorado, Aurora, CO, USA.
Duncan T
DT
Wilcox
Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado, Aurora, CO, USA.
Gerald H
GH
Clayton
Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado, Aurora, CO, USA.
Pamela E
PE
Wilson
D000293:Adolescent; D002648:Child; D005242:Fecal Incontinence / Q000150:complications / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000208:ethnology; D016135:Spinal Dysraphism / Q000150:complications / Q000208:ethnology*; D014549:Urinary Incontinence / Q000150:complications / Q000208:ethnology*; D055815:Young Adult
Hispanic; Non-Hispanic; Spina bifida; acculturation; bladder function; bowel; ethnicity; incontinence; myelomeningocele; satisfaction with care