Sex and Gender Interactions in the Lives of Patients with Spondyloarthritis in Spain: A Quantitative-qualitative Study.

OBJECTIVE: To illustrate the experiences and contextual support perceived by men and women with spondyloarthritis (SpA) in relation to their demanding productive and reproductive roles. METHODS: A quantitative-qualitative study of 96 men and 54 women with SpA was conducted at the Alicante University General Hospital, in a Spanish Mediterranean city, from March 2013 to February 2014. Descriptive and qualitative content analyses compared working lives and family/partner relationships of male and female patients. RESULTS: Working life: both women (55.6%) and men (51.04%) were similarly affected, but women had worse disease activity (5.4 vs 4.0, p = 0.01) and less antitumor necrosis factor-α therapy (56.7% vs 77.6%, p < 0.05). Different patterns were found by gender: women mostly practiced presenteeism whereas men practiced absenteeism, women took antiinflammatories prior to work and men after work, employers suggested more frequently the beneficial actions for men, and some women withdrew permanently from the labor market. Family/partner relationships: women were more affected (57.4%) than men (41.7%), with worse results for diagnostic delay (11.2 vs 6.4 yrs, p = 0.02), disease activity (5.8 vs 3.6, p < 0.001), and physical function (5.2 vs 3.8, p = 0.02). Gender role conflicts emerged, with women developing strategies to face compulsory housework whereas men avoided them; women regretted neglecting their children and men not sharing leisure activities with them. CONCLUSION: Our study highlights the vital complexity in which patients with SpA are immersed, especially for women in a country where a mix of new and traditional gender roles coexist. Awareness of its existence is crucial when professionals strive to provide healthcare focused on their well-being in addition to medical therapy.

[A gender perspective analysis of perception and practices in coronary disease in women from northern México]. / Análisis con perspectiva de género sobre percepción y prácticas en enfermedad coronaria en mujeres en el norte de México.

OBJECTIVE: To analyze the perception of coronary risk and health care practices in a group of Mexican women, from a gendered perspective. MATERIALS AND METHODS: Mixed methods: survey of 140 women; nine in-depth interviews to women with coronary disease; eight semi-structured interviews to physicians. ANALYSIS: proportions contrast for quantitative data; and procedures of grounded theory for qualitative information. RESULTS: More than 50% of women don't know their coronary risk and how to reduce it. Despite having information about heart disease, vulnerable women with chest pain sought medical attendance less than non-vulnerable women (p=0.0l); and are blamed by physicians. Women consider they lack sufficient information about how to reduce the risk of coronary disease, and blame themselves when ill. CONCLUSIONS: There are vulnerability conditions in women that modulate a low perception of their being at risk, and the scarcity of health care practices.

Análisis con perspectiva de género sobre percepción y prácticas en enfermedad coronaria en mujeres en el norte de México / A gender perspective analysis of perception and practices in coronary disease in women from northern México

Resumen: Objetivo: Analizar la percepción de riesgo coronario y prácticas de cuidados de un grupo de mujeres mexicanas, desde una perspectiva de género. Material y métodos: Estudio realizado de septiembre de 2013 a diciembre de 2014 en el estado de Sonora, México. Diseño mixto: encuesta a 140 mujeres. Análisis: contraste de proporciones; nueve entrevistas en profundidad a mujeres con enfermedad coronaria; ocho entrevistas semiestructuradas a médicos. Aplicación de técnicas de la teoría fundamentada. Resultados: Más de 50% desconoce su riesgo y cómo reducirlo. Mujeres informadas vulnerables con dolor de pecho buscan menos atención médica que las no vulnerables p=0.01 y son responsabilizadas por parte del personal médico sobre su enfermedad. Las mujeres consideran que están desinformadas sobre cómo reducir el riesgo de enfermedad coronaria; sin embargo, se culpabilizan por enfermar. Conclusiones: Las condiciones de vulnerabilidad de las mujeres modulan una baja percepción de riesgo coronario y mínimas prácticas de cuidados.

Abstract: Objective: To analyze the perception of coronary risk and health care practices in a group of Mexican women, from a gendered perspective. Materials and methods: Mixed methods: survey of 140 women; nine in-depth interviews to women with coronary disease; eight semi-structured interviews to physicians. Analysis: proportions contrast for quantitative data; and procedures of grounded theory for qualitative information. Results: More than 50% of women don't know their coronary risk and how to reduce it. Despite having information about heart disease, vulnerable women with chest pain sought medical attendance less than non-vulnerable women (p=0.0l); and are blamed by physicians. Women consider they lack sufficient information about how to reduce the risk of coronary disease, and blame themselves when ill. Conclusions: There are vulnerability conditions in women that modulate a low perception of their being at risk, and the scarcity of health care practices.