Stewart Donna E, Abbey Susan E, Shnek Zachary M, Irvine Jane, Grace Sherry L
University Health Network Women's Health Program, University of Toronto, Ontario, Canada.
Psychosom Med. 2004 Jan-Feb;66(1):42-8. doi: 10.1097/01.psy.0000107006.83260.12.
This study examined gender differences in health information needs and decisional preferences after an acute ischemic coronary event (ICE).
Patients with ICE, recruited in 12 coronary intensive care units, completed a questionnaire on demographic, disease-related, and psychosocial topics. Six and 12 months later, they completed mailed follow-up questionnaires.
Nine hundred six patients completed the baseline questionnaire, 541 (69%) completed the 6-month questionnaire, and 522 (64%) completed the 12-month questionnaire after hospital discharge. Men reported significantly more information received and greater satisfaction with healthcare practitioners meeting their information needs. Women wanted more information than men concerning angina and hypertension. Men wanted more information about sexual function and reported receiving more information about the role of each doctor, test results, treatments, cardiac rehabilitation, and how their families could support their lifestyle changes. Patients who reported receiving more information reported less depressive symptomatology and greater self-efficacy, healthcare satisfaction, and preventive health behaviors. Although most patients of both sexes preferred a shared decision-making role with their physician, the majority felt their doctor had made the main decisions.
Patients after ICE, especially women, reported receiving much less information than they wanted from all health professionals. Most patients wanted a shared or autonomous treatment decision-making role with their doctor, but only a minority experienced this. Clinicians must do better, because meeting patients' information needs and respecting their decisional preferences are shown to be associated with better self-efficacy, satisfaction, and health-promoting behavior.
本研究调查了急性缺血性冠状动脉事件(ICE)后患者在健康信息需求和决策偏好方面的性别差异。
从12个冠心病重症监护病房招募ICE患者,完成一份关于人口统计学、疾病相关及社会心理主题的问卷。6个月和12个月后,他们完成邮寄的随访问卷。
906名患者完成了基线问卷,541名(69%)完成了6个月问卷,522名(64%)在出院后完成了12个月问卷。男性报告收到的信息显著更多,对满足其信息需求的医护人员满意度更高。女性比男性想要更多关于心绞痛和高血压的信息。男性想要更多关于性功能的信息,并报告收到了更多关于每位医生的职责、检查结果、治疗、心脏康复以及家人如何支持其生活方式改变的信息。报告收到更多信息的患者抑郁症状更少,自我效能感、医疗满意度和预防性健康行为更高。尽管大多数男女患者都希望与医生共同参与决策,但大多数人觉得主要决策是由医生做出的。
ICE后的患者,尤其是女性,报告称从所有医疗专业人员那里获得的信息比他们想要的少得多。大多数患者希望与医生共同或自主做出治疗决策,但只有少数人能如愿。临床医生必须做得更好,因为满足患者的信息需求并尊重他们的决策偏好与更好的自我效能感、满意度和健康促进行为相关。