Gender Disparities in Palliative Care: Are Men More Reluctant Than Women?

Study Examines Gender Attitudes Toward Palliative Care in Terminal Cancer Patients

Understanding Palliative Care

A recent study published in the *Journal of Pain and Symptom Management* explores the different attitudes of men and women regarding the acceptance of palliative care during the terminal stages of cancer. Palliative care encompasses a multidisciplinary approach involving specialized medical and nursing interventions designed to alleviate pain and suffering in patients facing terminal illnesses. This form of care is typically recommended when healthcare providers determine that medical treatments alone will not cure or significantly benefit the patient at a specific disease stage.

Palliative care aims to enhance the overall quality of life for patients by managing pain and offering spiritual and social support. Additionally, professionals in this field provide counseling to patients and their families to help them cope with the stress and emotional challenges associated with terminal illnesses. A diverse team comprising physicians, nurses, physiotherapists, occupational therapists, and spiritual and motivational counselors delivers this essential care, particularly in advanced cancer stages where clinical interventions are ineffective.

Research Focus and Methodology

The authors of the study set out to investigate the hypothesis that men exhibit greater reluctance than women regarding palliative care related to cancer. Another objective was to evaluate the influence of educational background on patients’ attitudes toward accepting palliative care. The central hypothesis posited that individuals with lower educational attainment would demonstrate less receptiveness to such care.

The clinical trial, known as Values and Options in Cancer Care (VOICE), involved 383 patients with advanced cancers from the Rochester and Buffalo areas in New York, as well as Sacramento, California. The VOICE platform utilized a survey format, posing questions about patients’ preferences for palliative care when medical treatments were deemed ineffective. Responses were categorized into five groups: “definitely no,” “possibly no,” “unsure,” “possibly yes,” and “definitely yes.”

Additional variables considered in the analysis included age (under or over 65), educational background (college-educated vs. non-college-educated), aggressiveness of cancer (aggressive vs. non-aggressive), race (white vs. non-white), perceived financial strain (present vs. absent), and insurance status (no insurance or Medicaid vs. Medicare or private insurance). Marital status (married vs. single) and living arrangements (living alone vs. with others) were also incorporated into the study.

Key Findings

The study revealed that a significant majority (79.1%) of patients expressed a desire to receive palliative care. However, approximately 14.1% of patients were hesitant about accepting this form of care. Notably, the findings indicated that women were considerably more open to receiving palliative care compared to men, who were found to be more reluctant.

The authors suggested that societal norms, which often portray men as stoic in the face of adversity, might account for this disparity in attitudes. Interestingly, the study found no significant correlation between educational background and the willingness to accept palliative care.

The authors emphasized the potential benefits of educational initiatives to enhance acceptance of palliative care among men. Furthermore, they highlighted the importance of clinicians considering the patient’s gender when discussing available palliative care options.

Conclusion

This study contributes valuable insights into the gender differences in attitudes toward palliative care among cancer patients. The findings underscore the necessity for targeted educational efforts and gender-sensitive approaches in clinical practice to improve acceptance and utilization of palliative care services.

Written by Vinayak Khattar, Ph.D., M.B.A.

Reference

Saeed, F., Hoerger, M., Norton, S. A., Guancial, E., Epstein, R. M., & Duberstein, P. R. (2018). Preference for Palliative Care in Cancer Patients: Are Men and Women Alike? *J Pain Symptom Manage*, 56(1), 1-6 e1. doi:10.1016/j.jpainsymman.2018.03.014