Fullard Michelle E, Dafoe Ashley, Shelton Erika, Kern Drew S, Matlock Dan D, Morris Megan A
Department of Neurology, University of Colorado, Aurora, Colorado, USA.
Adult & Child Center for Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Mov Disord Clin Pract. 2025 Apr;12(4):453-463. doi: 10.1002/mdc3.14284. Epub 2024 Dec 18.
Women make up only 23% to 30% of recipients for deep brain stimulation (DBS) surgery for Parkinson's disease (PD), a discrepancy that is not accounted for by differences in disease incidence. One of the many factors that may contribute to this gap includes gender differences in decision-making.
The aim was to explore how women and men approach the decision for DBS in terms of informational needs, weighing risks and benefits, and decision-making.
Semistructured interviews were conducted with 33 participants with PD who had undergone DBS evaluation within the past 3 years. Data were analyzed using content analysis.
Sixteen women and 17 men participated in interviews. We identified 4 key themes. First, information sources were similar between women and men, and they valued hearing personal experiences. Second, the motivations for DBS surgery were often very personal. Third, the decision-making process occurred over time, sometimes years. Fourth, although many expressed fear of brain surgery, trust in the surgeon helped many overcome this fear. Women overall had less support than men during decision-making and after surgery. Women also placed greater value on talking to other women who had undergone DBS, although they had a hard time finding these women. Men, on the contrary, were less often worried about support and valued numerical information when weighing risks and benefits.
We found gender differences in information needs, support, motivating factors, and how patients weighed risks and benefits. These differences can be used to inform educational tools and counseling for DBS.
在帕金森病（PD）的脑深部电刺激（DBS）手术接受者中，女性仅占23%至30%，这种差异无法用疾病发病率的差异来解释。造成这一差距的众多因素之一包括决策中的性别差异。
旨在探讨男性和女性在信息需求、权衡风险与益处以及决策方面如何做出DBS决策。
对33名在过去3年内接受过DBS评估的PD患者进行了半结构化访谈。采用内容分析法对数据进行分析。
16名女性和17名男性参与了访谈。我们确定了4个关键主题。首先，男性和女性的信息来源相似，他们重视听取个人经历。其次，DBS手术的动机往往非常个人化。第三，决策过程历经时间，有时长达数年。第四，尽管许多人表示害怕脑部手术，但对医生的信任帮助许多人克服了这种恐惧。总体而言，女性在决策过程中和手术后得到的支持比男性少。女性也更重视与接受过DBS手术的其他女性交流，尽管她们很难找到这些女性。相反，男性较少担心支持问题，在权衡风险和益处时更看重数字信息。
我们发现了在信息需求、支持、激励因素以及患者如何权衡风险和益处方面的性别差异。这些差异可用于为DBS的教育工具和咨询提供参考。
