Sexism Interacts with Patient-Physician Gender Concordance in Influencing Patient Control Preferences: Findings from a Vignette Experimental Design.

Dario Monzani,Silvia Francesca Maria Pizzoli,Manuela Cattelan,Luca Bailo,Luca Pancani,Laura Vergani,Chiara Messori,Gabriella Pravettoni,Giulia Marton,Ketti Mazzocco

doi:10.1111/aphw.12193

Abstract

BackgroundPatient preferences regarding their involvement in shared treatments decisions is fundamental in clinical practice. Previous evidences demonstrated a large heterogeneity in these preferences. However, only few studies have analysed the influence of patients’ individual differences, contextual and situational qualities, and their complex interaction in explaining this variability.MethodsWe assessed the role of the interaction of patient’s sociodemographic and psychological factors with a physician’s gender. Specifically, we focused on patient gender and attitudes toward male or female physicians. One hundred fifty‐three people participated in this randomised controlled study and were randomly assigned to one of two experimental conditions in which they were asked to imagine discussing their treatment with a male and a female doctor.ResultsAnalyses showed an interplay between attitude towards women and the gender of patients and doctors, explaining interindividual variability in patient preferences.ConclusionsIn conclusion, patients’ attitudes toward the physicians’ gender constitutes a relevant characteristic that may influence the degree of control patients want to have and the overall patient‐physician relationship.

Highlights

A good patient–physician relationship has a positive impact on clinical outcomes, while fostering information exchange and active participation of patients in medical decision-making (Cooper-Patrick, 1999; Coulter, 1997; Kaplan, Greenfield, & Ware, 1989; Little et al, 2001; Okunrintemi et al, 2017; Riedl & Sch€ußler, 2017)
These results indicate multiple and complex interactions between people’s hostile sexism, physicians’ gender, and people’s gender in influencing preferences for the active role, while the effect of interaction between people’s hostile sexism and physicians’ gender on the preferences for the active-collaborative role does not depend on people’s gender
The interaction was significant for the active role and the active-collaborative role. These results indicate that the interaction between people’s benevolent sexism and physicians’ gender that explains control preferences for the active role and the active-collaborative role differs between men and women

Summary

Introduction

A good patient–physician relationship has a positive impact on clinical outcomes, while fostering information exchange and active participation of patients in medical decision-making (Cooper-Patrick, 1999; Coulter, 1997; Kaplan, Greenfield, & Ware, 1989; Little et al, 2001; Okunrintemi et al, 2017; Riedl & Sch€ußler, 2017). The pivotal role of the patient–physician relationship has been stressed by the patient-centered approach, a significant new perspective within the healthcare setting that has occurred in recent decades (Arnaboldi, Oliveri, & Pravettoni, 2015; Gorini, Mazzocco, & Pravettoni, 2013) This new paradigm points out the relevance of good communication between patients and healthcare providers as well as of the benefit of including patient preferences in the medical decision-making process (Bailo, Guiddi, Vergani, Marton, & Pravettoni, 2019; Deber, 1994; Hashim, 2017; King & Hoppe, 2013; Strull, Lo, & Charles, 1984; Vick & Scott, 1998).

Methods

Results

Conclusion