Abstract
This study analyses gender differences in the complexity observed in palliative home care through a multicentre longitudinal observational study of patients with advanced disease treated by palliative home care teams in Catalonia (Spain). We used the HexCom model, which includes six dimensions and measures three levels of complexity: high (non-modifiable situation), medium (difficult) and low. Results: N = 1677 people, 44% women. In contrast with men, in women, cancer was less prevalent (64.4% vs. 73.9%) (p < 0.001), cognitive impairment was more prevalent (34.1% vs. 26.6%; p = 0.001) and professional caregivers were much more common (40.3% vs. 24.3%; p < 0.001). Women over 80 showed less complexity in the following subareas: symptom management (41.7% vs. 51,1%; p = 0.011), emotional distress (24.5% vs. 32.8%; p = 0.015), spiritual distress (16.4% vs. 26.4%; p = 0.001), socio-familial distress (62.7% vs. 70.1%; p = 0.036) and location of death (36.0% vs. 49.6%; p < 0.000). Men were more complex in the subareas of “practice” OR = 1.544 (1.25–1.90 p = 0.000) and “transcendence” OR = 1.52 (1.16–1.98 p = 0.002). Observed complexity is related to male gender in people over 80 years of age. Women over the age of 80 are remarkably different from their male counterparts, showing less complexity regarding care for their physical, psycho-emotional, spiritual and socio-familial needs.
Highlights
There is currently a certain consensus that, beyond the vital prognosis or the disease, the backbone of palliative care should be the level of care complexity required by the person with advanced disease [1]
We explore the role of gender in the process of defining the complexity of each case
Our objectives were to analyse differences by gender in the complexity of patients registered by a home palliative care team and describe the role of age in these differences
Summary
There is currently a certain consensus that, beyond the vital prognosis or the disease, the backbone of palliative care should be the level of care complexity required by the person with advanced disease [1]. Complexity emerges from the interdependence between those elements involved in each case, yielding non-linearity, blurriness and chaoticity [2]. This means that complexity goes beyond the needs of independent physical, psychological, social and spiritual domains, and includes how patients interact with their families and professionals and how services respond to their needs [3,4]. The complexity and uniqueness of each patient and each situation calls for an open and multiple approach, bearing in mind that the application of conventional approaches—such as reductionism and compartmentalisation—can be potentially counterproductive [5].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Environmental Research and Public Health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
