Summary
BACKGROUND: The term "Gender medicine" is resounded throughout the land, but there are only a few studies in ophthalmology regarding this issue. Aim of our study was to evaluate gender-specific differences in cataract patients, the gained knowledge will help to better respond to the patients' need and to improve health care and social supply. METHODS: 300 consecutive cataract patients who were referred to the outpatient-department of the Department of Ophthalmology and Optometry, KH Hietzing, for initial consultation have been asked to fill out a questionnaire. Social/family support, maximum acceptable waiting time, patients' visual impairment (VF-14 score), education, profession and social status were evaluated. An ophthalmologic examination was performed and the best corrected visual acuity (BCVA) was obtained. RESULTS: 275 complete questionnaires were analysed. The mean age was 75.1 ± 9.6 (SD) years, 34.5% were male. Male patients were younger (73.5 ± 9.5 years, p = 0.053) than female patients. They had a significant better BCVA (0.63 ± 0.24 vs. 0.55 ± 0.22; p = 0.003) and a significant better VF-14 score (76.4 ± 22.2 vs. 68.8 ± 22.7; p = 0.009). Women were less likely to have social support (68% vs. 83%; p = 0.012), were more likely to have problems to show up for postoperative check-up (69.9% vs. 84.1%; p = 0.015) and were significantly more likely to live alone (58.4% vs. 19.5%; p < 0.001). CONCLUSIONS: Women have significant worse BCVA and VF-14 scores when they are referred for cataract-surgery. Lack of social supply could be the explaining factor for the longer waiting to decide for surgery. Organisation of familial or social support could help to admit these patients earlier and to minimize the risk of falls due to visual impairment.
Zusammenfassung
HINTERGRUND: Obwohl der Begriff "Gender Medizin" in aller Munde ist, gibt es im Bereich der Ophthalmologie nur wenige Studien zu diesem Thema. Ziel unserer Studie ist es, genderspezifische Unterschiede bei Katarakt-PatientInnen zu erheben, um mit dem gewonnenen Wissen besser auf die Bedürfnisse der PatientInnen eingehen zu können und somit die Versorgung der PatientInnen zu verbessern. METHODEN: 300 konsekutive PatientInnen, die in die Augenambulanz des KH Hietzing zur Erstvorstellung für die Kataraktoperation kamen, wurden gebeten, einen Fragebogen auszufüllen. Familiäre und/oder soziale perioperative Unterstützung, die maximal akzeptable Wartezeit und die subjektive Visusbeeinträchtigung (VF-14) wurden überprüft. Weiters wurden Bildungsgrad, sozialer Status und Familienstatus erfasst. Die PatientInnen wurden einer ophthalmologischen Untersuchung sowie einer Visusbestimmung unterzogen. ERGEBNISSE: 275 komplett beantwortete Fragebögen wurden ausgewertet. Das Durchschnittsalter der PatientInnen betrug 75,1 ± 9,6 (SD) Jahre, 34,5% davon waren Männer. Männliche Patienten waren mit durchschnittlich 73,5 ± 9,5 Jahren jünger als die Patientinnen (p = 0,053), hatten einen signifikant besseren Visus am besseren Auge (0,63 ± 0,24 vs. 0,55 ± 0,22; p = 0,003) und einen signifikant höheren VF-14 Score (76,4 ± 22,2 vs. 68,8 ± 22,7; p = 0,009). Frauen hatten signifikant seltener eine Versorgung zu Hause (68% vs. 83%; p = 0,012), konnten seltener zur postoperativen Kontrolle kommen (69,9% vs. 84,1%; p = 0,015) und lebten signifikant häufiger alleine zu Hause (58,4% vs. 19,5%; p < 0,001). SCHLUSSFOLGERUNG: Frauen kommen mit einem signifikant schlechteren Visus und stärker subjektiver Visusbeeinträchtigung (VF-14) zur Katarakt-Operation. Die mangelnde familiäre Unterstützung könnte als Erklärung für das längere Zuwarten der Patientinnen gewertet werden. Durch Organisation einer häuslichen Versorgung könnten diese Frauen einer schnelleren Operation zugeführt werden und damit die mit dem verminderten Sehvermögen verbundene Sturzgefahr minimiert werden.
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Literatur
Hochleitner M (2008) Gender Medicine. Ringvorlesung an der Medizinischen Universität Innsbruck, Wien
Fischman RJW, JG; Koenig BA (1999) The use of "sex" and "gender" to define and characterize meaningful differences between man and women in National Institutes of Health
Bird CE, Rieker PP (1999) Gender matters: an integrated model for understanding men's and women's health. Soc Sci Med 48: 745–755 DOI S027795369800402X [pii]
Risberg G, Hamberg K, Johansson EE (2006) Gender perspective in medicine: a vital part of medical scientific rationality. A useful model for comprehending structures and hierarchies within medical science. BMC Med 4: 20
Daly C, Clemens F, Lopez Sendon JL, Tavazzi L, Boersma E, Danchin N, Delahaye F, Gitt A, Julian D, Mulcahy D, Ruzyllo W, Thygesen K, Verheugt F, Fox KM (2006) Gender differences in the management and clinical outcome of stable angina. Circulation 113: 490–498
Ruiz MT, Verbrugge LM (1997) A two way view of gender bias in medicine. J Epidemiol Community Health 51: 106–109
Hamberg K, Risberg G, Johansson EE, Westman G (2002) Gender bias in physicians' management of neck pain: a study of the answers in a Swedish national examination. J Womens Health Gend Based Med 11: 653–666
Herold AH, Riker AI, Warner EA, Woodard LJ, Brownlee HJ Jr, Pencev D, Oldenski RJ, Brady PG (1997) Evidence of gender bias in patients undergoing flexible sigmoidoscopy. Cancer Detect Prev 21: 141–147
Richter-Mueksch S, Zehetmayer M, Radner W, Kaider A, Velikay-Parel M (2001) Influence of sex, visual acuity, and systemic disease on delayed presentation for cataract surgery in Austria. J Cataract Refract Surg 27: 1999–2005
Monestam E, Wachtmeister L (1998) Cataract surgery from a gender perspective – a population based study in Sweden. Acta Ophthalmol Scand 76: 711–716
Suominen-Taipale AL, Martelin, T, Koskinen S, Holmen J, Johnsen R (2006) Gender differences in health care use among the elderly population in areas of Norway and Finland. BMC Health Services Research 6: 1–9
Verbrugge LM (1989) The twain meet: empirical explanations of sex differences in health and mortality. J Health Soc Behav 30: 282–304
Macintyre S (1993) Gender differences in the perceptions of common cold symptoms. Soc Sci Med 36: 15–20
Sweeting H (1995) Reversals of fortune? Sex differences in health in childhood and adolescence. Soc Sci Med 40: 77–90
Macintyre S, Pritchard C (1989) Comparisons between the self-assessed and observer-assessed presence and severity of colds. Soc Sci Med 29: 1243–1248
Verbrugge LM (1988) Unveiling higher morbidity for men. Social Structures and Human Lives 1: 138–160
Macintyre S, Hunt K, Sweeting H (1996) Gender differences in health: are things really as simple as they seem? Soc Sci Med 42: 617–624
Rabady S, Rebhandl E (2004) Allgemeinmedizin. In: Rieder A, Lohff B (Hrsg) Gender Medizin. Geschlechtsspezifische Aspekte für die klinische Praxis. Springer, Wien, pp 13–30
Flaherty J, Richman J (1989) Gender differences in the perception and utilization of social support: theoretical perspectives and an empirical test. Soc Sci Med 28: 1221–1228
Barnett RC, Davidson H, Marshall NL (1991) Physical symptoms and the interplay of work and family roles. Health Psychol 10: 94–101
Hibbard JH, Pope CR (1987) Women's roles, interest in health and health behavior. Women Health 12: 67–84
Vécsei-Marlovits PV, Weingessel B, Gnad H (2008) Wer beeinflusst die Entscheidung zur Katarakt-Chirurgie? Spektrum Augenheilkd 22 (3): 153–157
Weingessel B, Richter-Mueksch S, Weingessel A, Gnad H, Vécsei-Marlovits PV (2008) Tagesklinische Katarakt-Chirurgie – attraktiv für PatientInnen? Spektrum Augenheilkd 22 (3): 148–152
Gilhotra JS, Mitchell P, Ivers R, Cumming RG (2001) Impaired vision and other factors associated with driving cessation in the elderly: the Blue Mountains Eye Study. Clin Exp Ophthalmol 29: 104–107
Ivers RQ, Cumming RG, Mitchell P (2002) Visual impairment and risk of falls and fracture. Inj Prev 8: 259
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Weingessel, B., Steinböck, S. & Vécsei-Marlovits, P. Sind Frauen bei der Katarakt-Operation benachteiligt?. Spektrum Augenheilkd. 23, 265–269 (2009). https://doi.org/10.1007/s00717-009-0342-9
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DOI: https://doi.org/10.1007/s00717-009-0342-9