ArticlesAdvance Care Planning: Does Patient Gender Make a Difference?
Section snippets
Methods
As we described in a prior article,7 this hypothesis-generating study used a purposive sampling of 58 Mexican American, European American, and African American inpatients aged 50 to 79 and recruited at either a private community hospital or a public teaching hospital in San Antonio, Texas. All subjects actively suffered from at least one of 10 common internal medicine diagnoses. Sixty-two percent had either congestive heart failure or angina. A validated algorithm classified subjects by ethnic
Results
The 58 subjects included 14 male and 12 female Mexican Americans, 7 male and 11 female European Americans, and 7 male and 7 female African Americans. Within each ethnic group, the genders were similar by age, number of screening diagnoses, religion, and educational level but differed by marital status, occupational group,26 and employment status (Table 1). The genders for European Americans also differed by the Duncan Socioeconomic Index,27 and the genders for Mexican Americans and African
Discussion
Ethnic culture surely shapes patients' attitudes about end-of-life care.28 Gender subcultures within ethnic culture probably also play a role. Although we studied in depth just 3 American ethnic cultures, our data suggest that most or all such cultures may share certain core attitudes about end-of-life care. While embracing those core attitudes, each American ethnic culture may hold other attitudes distinctive to that culture. Similarly, while embracing such ethnically distinctive attitudes,
Acknowledgements
Melissa Heinz Bennett, MPH, and Lucille Quinn conducted the interviews; Cynthia M. A. Geppert, MD, PhD, and Adelita Gonzales, RN, helped code transcripts; and Kathryn E. Artnek, RN, PhD, reviewed subjects' medical records. Susan Bagby, Andrew K. Diehl, MD, and D. Krysten James, BBA, made helpful suggestions about earlier drafts.
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2021, Journal of Pain and Symptom ManagementCitation Excerpt :Because several education program on end-of-life care have recently been implemented,34,35 our results suggests that family doctors in Japan need to improve the practice of eliciting and discussing their patients' opinions and preferences regarding EOL treatment and care. We found that men of all age groups were less likely to have EOLD than women, which is consistent with some previous studies.11,12,36,37 Health-care providers should be aware of these trends and encourage men to engage in EOLD.
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2020, Journal of Pain and Symptom ManagementCitation Excerpt :However, our female participants were less likely than their male counterparts to report death preparedness, likely because females experience death and dying in a more contextual and relational manner than males.36 When considering and preparing for their EOL, women place more emphasis on family dynamics, involvement, burden, and economics than men.37 These factors predispose female patients to worry about risking financial sufficiency, being a burden to their family, and about their family's preparation for and ability to cope with their death/dying, making them less likely to report death preparedness than male patients.
The Mexican-American Medical Treatment Effectiveness Research Center, the Aging Research and Education Center, the Office of the Medical Dean, and the Medical Ethics Research and Education Fund, all from The University of Texas Health Science Center at San Antonio, supported this project in part.