Gender differences in the evolution of illness understanding among patients with advanced cancer

Kalen Fletcher, Holly G. Prigerson, Elizabeth Paulk, Jennifer Temel, Esme Finlay, Lisa Marr, Ruth McCorkle, Lorna Rivera, Francisco Munoz, Paul K. Maciejewski

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Background Patient understanding of advanced metastatic disease is central to decisions about care near death. Prior studies have focused on gender differences in communication style rather than on illness understanding. Objectives To evaluate gender differences in terminal illness acknowledgement (TIA), understanding that the disease is incurable and the advanced stage of the disease. To evaluate gender differences in patients' reports of discussions of life expectancy with oncology providers and its effect on differences in illness understanding. Methods Coping with Cancer 2 patients (N = 68) were interviewed before and after a visit with their oncology providers to discuss scan results. Results At the prescan interview, there were no statistically significant gender differences in patient measures of illness understanding. At the postscan interview, women were more likely than men to recognize that their illness was incurable (Adjusted Odds Ratio, [AOR] = 5.29; P = .038), know that their cancer was at an advanced stage (AOR = 6.38; P = .013), and report having had discussions of life expectancy with their oncologist (AOR = 4.77; P = .021). Controlling discussions of life expectancy, women were more likely than men to report that their cancer was at an advanced stage (AOR = 9.53; P = .050). Controlling for gender, discussions of life expectancy were associated with higher rates of TIA (AOR = 4.65; P = .036) and higher rates of understanding that the cancer was incurable (AOR = 4.09; P = .085). Conclusions Due largely to gender differences in communication, women over time have a better understanding of their illness than men. More frequent discussions of life expectancy should enhance illness understanding and reduce gender differences.

Original languageEnglish (US)
Pages (from-to)126-132
Number of pages7
JournalJournal of Supportive Oncology
Volume11
Issue number3
DOIs
StatePublished - Sep 1 2013

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Gender differences in the evolution of illness understanding among patients with advanced cancer'. Together they form a unique fingerprint.

  • Cite this

    Fletcher, K., Prigerson, H. G., Paulk, E., Temel, J., Finlay, E., Marr, L., McCorkle, R., Rivera, L., Munoz, F., & Maciejewski, P. K. (2013). Gender differences in the evolution of illness understanding among patients with advanced cancer. Journal of Supportive Oncology, 11(3), 126-132. https://doi.org/10.12788/j.suponc.0007