Do gender differences affect the doctor-patient interaction during consultations in general practice? Results from the INTERMEDE study

被引:48
|
作者
Schieber, Anne-Cecile [1 ,2 ,3 ]
Delpierre, Cyrille [1 ]
Lepage, Benoit [1 ,2 ]
Afrite, Anissa [4 ]
Pascal, Jean [3 ,5 ]
Cases, Chantal [6 ]
Lombrail, Pierre [7 ,8 ]
Lang, Thierry [1 ,2 ]
Kelly-Irving, Michelle [1 ]
机构
[1] INSERM UMR 1027, Toulouse, France
[2] Univ Toulouse 3, UMR1027, F-31062 Toulouse, France
[3] CHU Toulouse, Serv Epidemiol, Toulouse, France
[4] IRDES, Paris, France
[5] CHU Toulouse, Dept Informat Med, Toulouse, France
[6] INED, Paris, France
[7] Univ Paris 13, UPRES EA3412, Bobigny, France
[8] AP HP Hop Avicenne, Bobigny, France
关键词
Cardiovascular diseases; counselling; gender identity; healthcare disparities; physicians; physician-patient relation; primary care; PRIMARY-CARE PATIENTS; PHYSICIAN GENDER; CARDIOVASCULAR-DISEASE; PREVENTIVE CARE; CONCORDANCE; COMMUNICATION; OUTCOMES; WEIGHT; RISK; PRACTITIONER;
D O I
10.1093/fampra/cmu057
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective. The aim of the study was to ascertain whether disagreement between GPs and patients on advice given on nutrition, exercise and weight loss is related to patient-doctor gender discordance. Our hypothesis is that a patient interacting with a physician of the same gender may perceive more social proximity, notably on health care beliefs and may be more inclined to trust them. Methods. The analysis used the Intermede project's quantitative data collected via mirrored questionnaires at the end of the consultation. Multilevel logistic regressions were carried out to explore associations between patient-doctor gender discordance and their disagreement on advice given during the consultation adjusted on patients' and physicians' characteristics. The sample consists of 585 eligible patients and 27 GPs. Results. Disagreement on advice given on nutrition was observed less often for female concordant dyads: OR = 0.25 (95% CI = 0.08-0.78), and for female doctors-male patients dyads: OR = 0.24 (95% CI = 0.07-0.84), taking the male concordant dyads as reference. For advice given on exercise, disagreement was found less often for female concordant dyads OR = 0.38 (95% CI = 0.15-0.98) and an interdoctor effect was found (P < 0.05). For advice given on weight loss, the probability of disagreement was significantly increased (OR: 2.87 95% CI = 1.29-6.41) when consultations consisted of female patient and male GP. Conclusion. Patient-doctor gender concordance/discordance is associated with their agreement/disagreement on advice given during the consultation. Physicians need to be conscious that their own demographic characteristics and perceptions might influence the quality of prevention counseling delivered to their patients.
引用
收藏
页码:706 / 713
页数:8
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