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影响低收入、服务不足患者管理心血管疾病能力的社会心理问题中的性别差异。

Gender differences in psychosocial issues affecting low-income, underserved patients' ability to manage cardiovascular disease.

机构信息

The George Washington University Medical Center, School of Public Health and Health Services, Department of Health Policy, Center for Health Care Quality, Washington, DC 20037, USA.

出版信息

Womens Health Issues. 2010 Sep;20(5):308-15. doi: 10.1016/j.whi.2010.05.006.

Abstract

RESEARCH OBJECTIVE

This paper examines the psychosocial challenges that interfere with low-income, underserved patients' ability to manage cardiovascular disease (CVD) and seeks to explore the differences in how men and women manifest these issues.

STUDY DESIGN

We convened 33 focus group discussions with low-income, underserved heart patients in 10 U.S. communities. Using content analysis, we identified key psychosocial issues that illustrate the psychosocial barriers patients experience as they manage their illness and analyzed these issues by gender to uncover differences in coping and self-management.

PRINCIPAL FINDINGS

We identified eight factors that represent the most frequently cited psychosocial issues by participants: 1) depression; 2) fear; 3) anger; 4) disease stress; 5) financial stress; 6) social isolation; 7) burden to family and friends; and 8) social supports. For the most part, men and women characterized psychosocial problems very differently. Among the eight themes identified, four emerged as dominant themes among women participants and three emerged among male participants. One factor, depression, was a prevalent theme for both men and women.

CONCLUSION

This study suggests that low-income, underserved women and men experience gender-specific psychosocial problems that interfere with their ability to manage their disease. Programs and interventions to improve the psychosocial issues related to CVD, particularly for low-income underserved populations, may be more effective if they are designed to address the unique ways in which women and men experience their illnesses.

摘要

研究目的

本文研究了低收入、服务不足的患者在管理心血管疾病(CVD)方面存在的心理社会挑战,并试图探讨男性和女性表现出这些问题的差异。

研究设计

我们在美国 10 个社区召集了 33 次低收入、服务不足的心脏病患者焦点小组讨论。我们使用内容分析方法,确定了体现患者在管理疾病过程中所经历的心理社会障碍的关键心理社会问题,并按性别分析了这些问题,以揭示应对和自我管理方面的差异。

主要发现

我们确定了八项因素,这些因素代表了参与者最常提到的心理社会问题:1)抑郁;2)恐惧;3)愤怒;4)疾病压力;5)经济压力;6)社会孤立;7)对家庭和朋友的负担;8)社会支持。在大多数情况下,男性和女性对心理社会问题的描述非常不同。在所确定的八个主题中,有四个主题是女性参与者的主要主题,三个主题是男性参与者的主要主题。一个因素,即抑郁,是男性和女性共同存在的一个普遍主题。

结论

这项研究表明,低收入、服务不足的女性和男性经历着与他们管理疾病能力相关的特定于性别的心理社会问题。为了改善与 CVD 相关的心理社会问题,特别是为了低收入、服务不足的人群,相关项目和干预措施如果能够针对女性和男性体验疾病的独特方式,可能会更加有效。

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