Hibbard J H, Pope C R
Soc Sci Med. 1983;17(3):129-37. doi: 10.1016/0277-9536(83)90246-0.
The study investigates illness orientation as a factor which may account for sex differences in the utilization of medical care. First, sex differences in the way symptoms are perceived, evaluated and acted upon (illness orientation) are analyzed. Then gender role factors which may account for sex differences in illness orientation are examined. Finally, the degree to which gender role factors and illness orientation account for sex differences in medical care utilization are assessed. The study population includes 1648 adults between the ages of 18 and 59. Medical record data covering 7 years of outpatient services are linked with survey data on the respondents. The findings show that while females are more likely to perceive symptoms than males, there is no apparent sex difference in a tendency to adopt the sick role when ill. In addition, results indicate that gender role factors such as level and type of role responsibility and concern with health are related to female though not male symptom reports. Illness orientation variables are related to rates of medical utilization for both sexes. However, it is primarily the perception of symptoms and an interest and concern with health which contributes to sex differences in utilization rates. When examining respondents who report either a very low or very high number of symptoms, sex differences in utilization rates fall below statistical significance.
该研究调查了患病取向这一因素,它可能是医疗服务利用方面性别差异的原因。首先,分析了在症状的感知、评估和应对方式(患病取向)上的性别差异。然后,研究了可能导致患病取向性别差异的性别角色因素。最后,评估了性别角色因素和患病取向对医疗服务利用性别差异的影响程度。研究对象包括1648名年龄在18岁至59岁之间的成年人。涵盖7年门诊服务的病历数据与受访者的调查数据相关联。研究结果表明,虽然女性比男性更有可能感知症状,但患病时采用病人角色的倾向没有明显的性别差异。此外,结果表明,诸如角色责任的水平和类型以及对健康的关注等性别角色因素与女性而非男性的症状报告有关。患病取向变量与两性的医疗利用率都有关系。然而,主要是症状的感知以及对健康的兴趣和关注导致了利用率的性别差异。在检查报告症状数量非常少或非常多的受访者时,利用率的性别差异低于统计学显著性。