Advance care planning: Does patient gender make a difference?
Advance care planning: Does patient gender make a difference?
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DOI：
10.1097/00000441-200401000-00006
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发表时间：
2004-01-01
影响因子：
3.1
通讯作者：
Hazuda, HP
中科院分区：
文献类型：
--
作者：
Perkins, HS;Cortez, JD;Hazuda, HP
背景虽然它得到了很少的研究，性别可能会显着影响患者的态度提前护理计划。研究方法：我们询问了26名墨西哥裔美国人（14名男性，12名女性），18名欧洲裔美国人（7名男性，11名女性）和14名非洲裔美国人（7名男性，7名女性）住院患者对提前护理计划和死亡的态度。不同种族和性别的编码员对响应进行了独立、设盲的内容分析。结果：访谈确定了40个主题。五个，包括“预先指示（广告）提高病人的愿望将被遵循的机会”，所有3个种族群体的特点是两性。虽然没有单独的主题区分不同种族的性别，3元主题-或相关主题的集群。男性的临终愿望仅涉及功能结果，但女性的愿望也涉及其他因素。男子感到被卫生系统剥夺了权力，但妇女感到自己有了权力。男人害怕这个系统的伤害，但女人期待好处。每个种族群体都表现出独特的性别差异。例如，大多数墨西哥裔美国人宁愿死亡也不愿残疾，相信“医疗保健系统控制治疗”，不希望“徒劳的”生命支持。相比之下，大多数墨西哥裔美国妇女只表达了对生命支持以外的护理的愿望（特别是关于她们想在何时何地死去），相信广告“帮助工作人员了解...“愿”，“荣誉”。结论：在三个种族群体中观察到的两种性别的核心文化态度可能延伸到所有美国人。虽然核心态度可能支持许多美国人的提前护理计划，但卫生专业人员应考虑将其调整为其他种族和性别特定的态度。
Background. Although it has received little study, gender may significantly affect patients' attitudes about advance care planning. Methods: We asked 26 Mexican American (14 male, 12 female), 18 European American (7 male, 11 female), and 14 African American (7 male, 7 female) inpatients for their attitudes about advance care planning and dying. Coders of different ethnicities and genders performed independent, blinded content analyses of responses. Results: The interviews identified 40 themes. Five, including "Advance directives (ADs) improve the chances a patient's wishes will be followed," characterized both genders of all 3 ethnic groups. Although no individual themes distinguished the genders across ethnic groups, 3 meta-themes-or clusters of related themes-did. Men's end-of-life wishes addressed functional outcome alone, but women's wishes addressed other factors, too. Men felt disempowered by the health system, but women felt empowered. Men feared harm from the system, but women anticipated benefit. Each ethnic group expressed these gender differences uniquely. For example, most Mexican American men preferred death to disability, believed "the health care system controls treatment," and wanted no "futile" life support. In contrast, most Mexican American women expressed wishes only about care other than life support (especially about when and where they wanted to die), believed ADs "help staff know... (such) wishes," and trusted the system to "honor (written) ADs." Conclusion: Core cultural attitudes observed in both genders of 3 ethnic groups may extend to all Americans. Although core attitudes may support advance care planning for many Americans, health professionals should consider tailoring it to other, ethnic- and gender-specific attitudes.