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首页> 外文期刊>Journal of women’s health >Patient-centered care: The influence of patient and resident physician gender and gender concordance in primary care
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Patient-centered care: The influence of patient and resident physician gender and gender concordance in primary care

机译：以患者为中心的护理：患者和住院医师性别和性别一致性在初级保健中的影响

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Background: Patient-centered care (PCC) is thought to significantly influence the process of care and its outcomes and has been identified as part of a comprehensive strategy for improving our nation's healthcare delivery system. Patient and physician gender, as well as gender concordance, may influence the provision of PCC. Methods: Patients (315 women, 194 men) were randomized to care by primary care resident physicians (48 women, 57 men). Sociodemographic information, history of health risk behaviors (tobacco use, alcoholism, and obesity), and self-reported global pain and health status were collected before the first visit. That visit and subsequent patient visits to the primary care physician (PCP) were videotaped during the year-long study period. PCC was measured by coding all videotapes using a modified version of the Davis Observation Code. Results: No significant gender differences in PCC were found between the male and female patients; however, female physicians provided increased PCC to their patients. The greatest amount of PCC was seen in the female patient-female physician gender dyad. Regression analyses, controlling for other patient variables, confirmed that female concordant dyads were associated with a greater amount of PCC. There was no significant relationship for the male patient-male physician concordance (vs. disconcordance). Conclusions: These findings highlight the influence of gender in the process of care and provision of PCC. Gender concordance in female patient-female physician dyads demonstrated significantly more PCC. Further research in other clinical settings using other measures of PCC is needed. A public mandate to provide care that is patient-centered has implications for medical education.
机译：背景：以患者为中心的护理（PCC）被认为会极大地影响护理过程及其结果，并且已被确定为改善我国医疗服务体系的综合战略的一部分。患者和医生的性别以及性别一致性可能会影响PCC的提供。方法：患者（315名女性，194名男性）由初级护理住院医师随机分配（48名女性，57名男性）。在第一次访问之前，收集了社会人口统计学信息，健康风险行为的历史记录（吸烟，酗酒和肥胖）以及自我报告的总体疼痛和健康状况。在为期一年的研究期内，对患者的访问以及随后对初级保健医生（PCP）的访问进行了录像。通过使用戴维斯观测代码的修改版本对所有录像带进行编码来测量PCC。结果：男性和女性患者之间在PCC中均未发现明显的性别差异。但是，女医生为患者提供了更多的PCC。 PCC量最大的是女性患者-女性医师性别二元组。对其他患者变量进行控制的回归分析证实，女性一致的二元组与大量PCC相关。男性患者与男性医生之间的一致性（与discorcordance相比）没有显着关系。结论：这些发现突出了性别在护理和提供PCC过程中的影响。女性患者-女性医师二元组中的性别一致性显示出更多的PCC。需要使用其他PCC措施在其他临床环境中进行进一步研究。提供以患者为中心的医疗服务的公共任务对医学教育产生了影响。

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