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Article
Gender differences in the evolution of illness understanding among patients with advanced cancer
Women’s and Gender Studies Faculty Publication Series
  • Kalen Fletcher, Center for Psychosocial Epidemiology and Outcomes Research
  • Holly G. Prigerson, McGraw/Patterson Center for Population Sciences
  • Elizabeth Paulk, University of Texas Southwestern Medical Center at Dallas
  • Jennifer Temel, Harvard Medical School
  • Esme Finlay, University of New Mexico, Albuquerque, NM
  • Lisa Marr, University of New Mexico, Albuquerque, NM
  • Ruth McCorkle, Smilow Cancer Hospital at Yale
  • Lorna Rivera, University of Massachusetts Boston
  • Francisco Munoz, Pomona Valley Hospital Medical Center
  • Paul K. Maciejewski, Center for Psychosocial Epidemiology and Outcomes Research
Document Type
Article
Publication Date
9-1-2013
Disciplines
Abstract
Background Patient understanding of advanced metastatic disease is central to decisions about care near death. Prior studies have focused on gender differences in communication style rather than on illness understanding. Objectives To evaluate gender differences in terminal illness acknowledgement (TIA), understanding that the disease is incurable and the advanced stage of the disease. To evaluate gender differences in patients’ reports of discussions of life expectancy with oncology providers and its effect on differences in illness understanding. Methods Coping with Cancer 2 patients (N = 68) were interviewed before and after a visit with their oncology providers to discuss scan results. Results At the prescan interview, there were no statistically significant gender differences in patient measures of illness understanding. At the postscan interview, women were more likely than men to recognize that their illness was incurable (Adjusted Odds Ratio, [AOR] = 5.29; P = .038), know that their cancer was at an advanced stage (AOR = 6.38; P = .013), and report having had discussions of life expectancy with their oncologist (AOR = 4.77; P = .021). Controlling discussions of life expectancy, women were more likely than men to report that their cancer was at an advanced stage (AOR = 9.53; P = .050). Controlling for gender, discussions of life expectancy were associated with higher rates of TIA (AOR = 4.65; P = .036) and higher rates of understanding that the cancer was incurable (AOR = 4.09; P = .085). Conclusions Due largely to gender differences in communication, women over time have a better understanding of their illness than men. More frequent discussions of life expectancy should enhance illness understanding and reduce gender differences.
Comments

Published in The Journal of Supportive Oncology. v.11(3): 126-32. DOI: 10.12788/j.suponc.0007.

Community Engaged/Serving
No, this is not community-engaged.
Citation Information
Kalen Fletcher, Holly G. Prigerson, Elizabeth Paulk, Jennifer Temel, et al.. "Gender differences in the evolution of illness understanding among patients with advanced cancer" (2013)
Available at: http://works.bepress.com/lorna_rivera/17/