出现心力衰竭症状患者的医生信息检索行为——医生和患者的性别有影响吗？

Physicians' information seeking behavior in patients presenting with heart failure symptoms - Does gender of physician and patient matter?

作者信息

Koens Sarah, Marx Gabriella, Gras Colette, Scherer Martin, Lüdecke Daniel, von dem Knesebeck Olaf

机构信息

Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Department of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Patient Educ Couns. 2020 May 31. doi: 10.1016/j.pec.2020.05.022.

DOI:10.1016/j.pec.2020.05.022

PMID:32611486

Abstract

OBJECTIVE

To examine differences in the anamnesis in heart failure patients by patient and physician gender.

METHODS

A factorial experimental design with video vignettes was applied. While the dialog of an initial encounter because of heart failure symptoms was identical in all videos, patients, played by professional actors, differed in terms of gender (male/female), age (55 years/75 years) and Turkish migration history (no/yes). After viewing the video, 128 physicians (50 % female) were asked if they wanted to ask additional questions (yes/no) and if so, what they wanted to ask (open ended). A coding frame was conducted for the open ended question.

RESULTS

Compared to male physicians, female physicians more often said they wanted to ask additional questions, especially about psychosocial aspects. Physicians, particularly female physicians, wanted to ask male patients more often about lifestyle aspects compared to female patients.

CONCLUSION

Although the dialog was identical in all videos, some variations in the anamnestic approach regarding physician and patient gender were identified. This is in contrast to current heart failure guidelines that recommend a detailed anamnesis in all patients presenting themselves with heart failure symptoms.

PRACTICE IMPLICATIONS

Primary care physicians should reflect how possible gender stereotypes may influence their anamnestic behavior.

摘要

目的

按患者和医生的性别，研究心力衰竭患者既往史的差异。

方法

采用带有视频短片的析因实验设计。虽然所有视频中因心力衰竭症状进行初次问诊的对话相同，但由专业演员扮演的患者在性别（男/女）、年龄（55岁/75岁）和土耳其移民史（无/有）方面存在差异。观看视频后，询问128名医生（50%为女性）是否想问额外问题（是/否），如果是，想问什么（开放式问题）。针对开放式问题制定了编码框架。