Differences in Symptom Distress Based on Gender and Palliative Care Designation Among Hospitalized Patients

Abstract

Purpose: To explore patient-reported symptom distress in relation to documentation of symptoms and palliative care designation in hospital inpatients. Design: This cross-sectional study analyzed data from 710 inpatients at two large hospitals in Sweden using the Edmonton Symptom Assessment Scale and the Memorial Symptom Assessment Scale. Chart reviews focused on nurses' and physicians' symptom documentation and palliative turning point. Methods: Descriptive statistics were calculated for all variables and provided summaries about the sample. Patients were grouped according to gender, age, palliative care designation, and symptom documentation. The t test and chisquare test were used to calculate whether symptom distress varied between groups. A two-way analysis of variance was conducted for multiple comparisons to explore the impact of gender and age on mean symptom distress. Findings: Females reported higher levels of symptom distress than did males related to pain, fatigue, and nausea. When comparing symptom distress between males and females with documentation pertaining to symptoms, there were significant differences implying that females had to report higher levels of symptom distress than males in order to have their symptoms documented. Conclusions: Females need to report higher levels of symptom distress than do males for healthcare professionals to identify and document their symptoms. It can be hypothesized that females are not receiving the same attention and symptom alleviation as men. If so, this highlights a serious inequality in care that requires further exploration. Clinical Relevance: Considering that common reasons why people seek health care are troublesome symptoms of illness, and that the clinical and demographic characteristics of inpatients are changing towards more advanced ages with serious illnesses, inadequate symptom assessment and management are a serious threat to the care quality.

Severe symptoms and very low quality-of-life among outpatients newly diagnosed with advanced cancer: data from a multicenter cohort study

“…Online Resources 4 and 5 indicated that tumor site and gender might be associated with patients' burden. In all, women had better POS scores but reported higher values for anxiety and fatigue than male patients which confirms results identified in other studies and underlines the need for a closer look at gender differences in future studies [28][29][30].…”

Health status and most distressing concerns at admission and discharge reported by patients cared for at an internal medical care ward

“…Women also reported lower values on EQ VAS at both admission and discharge compared with men. These differences are supported by similar findings where women reported higher symptom distress than men, and where women had to report more symptoms for the caregivers to document those . In another study, women reported higher levels of distress from experienced symptoms than men did .…”

Reflexionen und Analysen zu Geschlecht, Gender und Diversität in der Palliativmedizinischen Forschung – Wie können wir Intersektionalität in unserer wissenschaftlichen Praxis umsetzen?

“…In der Forschung zur Palliativversorgung werden beispielsweise Diskrepanzen in der Selbsteinschätzung und im Berichten von Symptomen und Problemen zwischen Patient*innen beschrieben. Daher ist anzunehmen, dass Frauen und Männer folglich auch nicht die gleiche Behandlung und Symptomlinderung erhalten [6]. Es konnte auch gezeigt werden, dass Männer zögern, über ihren eigenen bevorstehenden Tod [7] sowie den Tod ihres/r Partner*in zu sprechen und dass sie durch den Verlust eines/r Ehepartners*in stärker betroffen sind als Frauen [8].…”