Development of a culturally specific assessment tool for pelvic organ prolapse in a Mayan population

Abstract

Pelvic organ prolapse is a common condition that can significantly affect a woman's life, including her sexual, urinary, and social functioning. In Guatemala, anecdotal evidence suggests that the daily activities of Mayan women contribute to and worsen the degree of pelvic organ prolapse. The objective of this research was to develop a culturally specific assessment tool to better evaluate how pelvic organ prolapse affects the daily activities of Mayan women in rural Guatemala. A survey was created entitled a Culturally Specific Assessment Tool for Pelvic Organ Prolapse (CSAT-POP). The survey was administered to a 19 Mayan women with various degrees of pelvic organ prolapse in Montellano, Guatemala. Participants were asked using a Likert scale about how their pelvic organ prolapse affected their ability to perform 7 culturally specific activities of daily living. The survey was administered through an on-site interpreter who translated the CSAT-POP into Spanish and Quiché. Nineteen women were assessed using the CSAT-POP. Their mean age was 49.2 ± 28 years, and the median parity was 6.8 children (range 1-11). Three culturally specific activities: performing vigorous activities, gathering wood, and carrying water, were identified as the activities most impacted by pelvic organ prolapse. Of the participants, 15-20% were unable to perform these activities on a daily basis. However, preparing food, washing clothes, and caring for children were the activities reported by women with pelvic organ prolapse which required the least amount of assistance. The CSAT-POP identified several activities specific to the rural Mayan community in Guatemala which are difficult to perform with pelvic organ prolapse. By using culturally specific activities of daily living, the CSAT-POP allowed for more relevant assessment, identification, and treatment of women with pelvic organ prolapse in Guatemala.