Ethnic group and gender influence patients' treatment decisions

Ethnicity and gender influence patients' experiences in decision-making about treatment, but in different ways, according to a new study by Henry S. Perkins, MD, of the Center's Health Sciences Center. University of Texas and the Ecumenical Center for Religion and Health in San Antonio, Texas. This conclusion is reflected in an article in the July issue of Medical care, published in the Lippincott Portfolio by Wolters Kluwer.

In previous studies, researchers have discovered differences between the views of Hispanic, white and black American patients on end-of-life planning. This prompted a new badysis of patient data The preferences for decision making treatment and perceptions decision-making about treatment.

Patients in the study were 58 adults (aged 50 to 79 years) hospitalized for serious medical conditions such as heart or lung disease. The interviews focused on patients' preferences and perceptions of their involvement in decision-making, ranging from physician-controlled decisions to shared decisions (taken jointly by the physician and the patient or by the physician alone and the patient). only) to decisions controlled by the patient.

Sex, but not ethnic group, indicated patient decision-making The preferences. In all, 12 patients preferred decisions controlled by the doctor; 31, one or the other type of shared decision-making; and 15 decisions made under the control of the patient.

However, in most ethnic groups, most men preferred physician-controlled decisions (with or without patient involvement), while most women preferred decisions controlled by the patient (with or without physician involvement). ). Dr. Perkins and his colleagues badume that men "may be resigned (or relieved) to see doctors making health decisions for them," while women "may want considerable responsibility" in taking care of themselves. their own decisions about health care.

On the other hand, the ethnic group and the bad together indicated the decision-making perceptions. Many patients of all ethnicities and genders have been seen by the doctor alone and by the patient alone on different occasions. But for Hispanics, about equal numbers of men and women have done, for whites, more men than women, and for blacks, more women than women. # 39; men. Dr. Perkins and colleagues note that, unexpectedly, "no respondent perceived the decision-making shared by the physician and the patient together".

In addition, the ethnic group, but not the bad, indicated matches between patients' preferences and perceptions of decision-making. Matches occur twice as often in Whites than in Hispanics or Blacks.

Dr. Perkins and colleagues concluded that neither ethnic group nor gender has a dominant global influence on patients' preferences and perceptions of decision-making. Each factor plays a distinct role but of equal importance.

"Whenever direct patient surveys fail," write the researchers, an awareness of these distinct roles "may indicate patients' current preferences and perceptions of their participation in decision-making." But they also warn that "matching these preferences and perceptions, especially for minority patients, remains difficult."