University of Michigan Health System, Ann Arbor, Michigan 48109-5360, USA.
J Womens Health (Larchmt). 2012 Dec;21(12):1267-74. doi: 10.1089/jwh.2012.3650.
Morbidity and mortality for women with chronic obstructive pulmonary disease (COPD) are increasing, and little is known about gender differences in perception of COPD care.
Surveys were administered to a convenience sample of COPD patients to evaluate perceptions about symptoms, barriers to care, and sources of information about COPD.
Data on 295 female and 273 male participants were analyzed. With similar frequencies, women and men reported dyspnea and rated their health as poor/very poor. Although more women than men reported annual household income <$30,000, no significant gender differences in frequency of health insurance, physician visits, or ever having had spirometry were detected. In adjusted models (1) women were more likely to report COPD diagnostic delay (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.13-2.45, p=0.01), although anxiety (OR 1.83, 95% CI 1.10-3.06, p=0.02) and history of exacerbations (OR 1.60, 95% CI 1.08-2.37, p=0.01) were also significant predictors, (2) female gender was associated with difficulty reaching one's physician (OR 2.54, 95% CI 1.33-4.86, p=0.004), as was prior history of exacerbations (OR 2.25, 95% CI 1.21-4.20, p=0.01), and (3) female gender (OR 2.15, 95% CI 1.10-4.21, p=0.02) was the only significant predictor for finding time spent with their physician as insufficient.
Significant gender-related differences in the perception of COPD healthcare delivery exist, revealing an opportunity to better understand what influences these attitudes and to improve care for both men and women.
患有慢性阻塞性肺疾病(COPD)的女性的发病率和死亡率正在上升,而关于 COPD 护理方面的性别差异知之甚少。
对 COPD 患者进行了一项便利样本调查,以评估他们对症状、护理障碍以及 COPD 相关信息来源的看法。
对 295 名女性和 273 名男性参与者的数据进行了分析。女性和男性报告呼吸困难的频率相似,并将其健康状况评为差/极差。尽管报告年收入<$30,000 的女性多于男性,但在医疗保险、医生就诊或曾进行过肺功能检查的频率方面,男女之间没有显著的性别差异。在调整后的模型中:(1)女性更有可能报告 COPD 诊断延迟(比值比[OR] 1.66,95%置信区间[CI] 1.13-2.45,p=0.01),尽管焦虑(OR 1.83,95% CI 1.10-3.06,p=0.02)和加重史(OR 1.60,95% CI 1.08-2.37,p=0.01)也是显著的预测因素;(2)女性性别与难以联系到医生(OR 2.54,95% CI 1.33-4.86,p=0.004)以及既往加重史(OR 2.25,95% CI 1.21-4.20,p=0.01)相关;(3)女性性别(OR 2.15,95% CI 1.10-4.21,p=0.02)是唯一显著的预测因素,表明她们认为与医生相处的时间不够。
在 COPD 医疗服务提供方面,存在显著的与性别相关的差异,这揭示了一个机会,可以更好地了解是什么影响了这些态度,并改善男女患者的护理。