Lewandowski Michał J, Kurnikowski Amelie, Vanek Lenka, Bretschneider Philipp, Schwaiger Elisabeth, Krenn Simon, Hödlmoser Sebastian, Gauckler Philipp, Pirklbauer Markus, Horn Sabine, Brunner Maria, Zitt Emanuel, Kirsch Bernhard, Windpessl Martin, Aringer Ida, Wiesholzer Martin, Ritschl Valentin, Stamm Tanja, Jauré Allison, Hecking Manfred
Clinical Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Department of Internal Medicine, Brothers of Saint John of God Eisenstadt, Eisenstadt, Austria.
Kidney360. 2025 Feb 1;6(2):227-235. doi: 10.34067/KID.0000000594. Epub 2024 Oct 2.
Women felt vulnerable and felt that their housework obligations may interfere with CKD treatment, especially dialysis. Women felt they were good at protecting their health, whereas men might expect help from others and live in denial when confronted with advanced CKD.
CKD affects more women than men worldwide; however, men comprise most patients who receive KRT. We aimed to describe the perspectives of patients and their caregivers regarding gender disparities in CKD.
Semi-structured interviews were conducted with 45 patients with CKD (20 women) and 14 caregivers (12 women) from seven clinics in Austria. The interviews were analyzed thematically.
Five themes were identified in this study. Participants perceived that women were disadvantaged and vulnerable (silent and intimidated, single mother predicament, impeded access to care and support because of socioeconomic disadvantage, had to fend for themselves); fulfilling gender roles and norms (primarily responsible for childcare, pressure to perform well as homemakers, put others' needs before their own, encouraging husband's treatment adherence); and protecting their own health (self-disciplined, vigilant, confronted health challenges, advocated for their needs). Men were seen to place the onus of care on others (expected help from family, relied on others for decisions). Both men and women experienced a disease-related identity crisis and distress (women: impaired body image, mental distress; men: denial and self-destruction, emasculated by sickness).
Women with CKD felt vulnerable and were inclined to fulfill gender norms and responsibilities as caregivers, but were also vigilant about protecting their own health. Men tended to be reluctant to accept CKD and appeared to depend on others for disease management. Better awareness and addressing these concerns can inform strategies to minimize gender disparities in access to care and outcomes in CKD.
女性感到脆弱，认为她们的家务责任可能会干扰慢性肾脏病（CKD）的治疗，尤其是透析治疗。女性觉得自己善于保护健康，而男性可能期望得到他人帮助，面对晚期CKD时则不愿承认病情。
在全球范围内，CKD对女性的影响大于男性；然而，接受肾脏替代治疗（KRT）的患者大多数是男性。我们旨在描述患者及其照护者对CKD中性别差异的看法。
对来自奥地利7家诊所的45例CKD患者（20名女性）和14名照护者（12名女性）进行了半结构式访谈。对访谈进行了主题分析。
本研究确定了五个主题。参与者认为女性处于不利和脆弱地位（沉默和受恐吓、单身母亲困境、因社会经济劣势而难以获得护理和支持、不得不自力更生）；履行性别角色和规范（主要负责照顾孩子、作为家庭主妇有表现出色的压力、将他人需求置于自身之前、鼓励丈夫坚持治疗）；以及保护自己的健康（自律、警惕、面对健康挑战、主张自己的需求）。男性则将护理责任推给他人（期望家人帮助、依靠他人做决定）。男性和女性都经历了与疾病相关的身份危机和痛苦（女性：身体形象受损、精神痛苦；男性：否认和自我毁灭、因疾病而 emasculated）。
患有CKD的女性感到脆弱，倾向于履行作为照护者的性别规范和责任，但也警惕保护自己的健康。男性往往不愿接受CKD，在疾病管理方面似乎依赖他人。更好地认识和解决这些问题可以为减少CKD护理可及性和治疗结果方面的性别差异提供策略依据。
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