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University Health Network Women’s Health Program (D.E.S., S.E.A., S.L.G.) and Credit Valley Hospital (Z.M.S.), University of Toronto; and University Health Network (J.I.), York University, Toronto, Canada.
Address correspondence and reprint requests to Donna E. Stewart, MD, FRCPC, Lillian Love Chair of Women’s Health, University Health Network, 657 University Avenue, ML 2-004, Toronto, Ontario, M5G 2N2, Canada. E-mail: donna.stewart{at}uhn.on.ca
OBJECTIVE: This study examined gender differences in health information needs and decisional preferences after an acute ischemic coronary event (ICE).
METHODS: Patients with ICE, recruited in 12 coronary intensive care units, completed a questionnaire on demographic, disease-related, and psychosocial topics. Six and 12 months later, they completed mailed follow-up questionnaires.
RESULTS: Nine hundred six patients completed the baseline questionnaire, 541 (69%) completed the 6-month questionnaire, and 522 (64%) completed the 12-month questionnaire after hospital discharge. Men reported significantly more information received and greater satisfaction with healthcare practitioners meeting their information needs. Women wanted more information than men concerning angina and hypertension. Men wanted more information about sexual function and reported receiving more information about the role of each doctor, test results, treatments, cardiac rehabilitation, and how their families could support their lifestyle changes. Patients who reported receiving more information reported less depressive symptomatology and greater self-efficacy, healthcare satisfaction, and preventive health behaviors. Although most patients of both sexes preferred a shared decision-making role with their physician, the majority felt their doctor had made the main decisions.
CONCLUSIONS: Patients after ICE, especially women, reported receiving much less information than they wanted from all health professionals. Most patients wanted a shared or autonomous treatment decision-making role with their doctor, but only a minority experienced this. Clinicians must do better, because meeting patients’ information needs and respecting their decisional preferences are shown to be associated with better self-efficacy, satisfaction, and health-promoting behavior.
Key Words: information, • decisional preferences, • gender, • ischemic cardiac events.
Abbreviations: BDI = Beck Depression Inventory;; CICU = coronary intensive care unit;; ICE = ischemic coronary event;; MI = myocardial infarction;; PIP = perception of information provision.
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