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Sex and Gender Bias as a Mechanistic Determinant of Cardiovascular Disease Outcomes. Can J Cardiol 2022; 38:1865-1880. [PMID: 36116747 DOI: 10.1016/j.cjca.2022.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/21/2022] [Accepted: 09/11/2022] [Indexed: 12/14/2022] Open
Abstract
Defined as a prejudice either for or against something, biases at the provider, patient, and societal level all contribute to differences in cardiovascular disease recognition and treatment, resulting in outcome disparities between sexes and genders. Provider bias in the under-recognition of female-predominant cardiovascular disease and risks might result in underscreened and undertreated patients. Furthermore, therapies for female-predominant phenotypes including nonobstructive coronary artery disease and heart failure with preserved ejection fraction are less well researched, contributing to undertreated female patients. Conversely, women are less likely to seek urgent medical attention, potentially related to societal bias to put others first, which contributes to diagnostic delays. Furthermore, women are less likely to have discussions around risk factors for coronary artery disease compared with men, partially because they are less likely to consider themselves at risk for heart disease. Provider bias in interpreting a greater number of presenting symptoms, some of which have been labelled as "atypical," can lead to mislabelling presentations as noncardiovascular. Furthermore, providers might avoid discussions around certain therapies including thrombolysis for stroke, and cardiac resynchronization therapy in heart failure, because it is incorrectly assumed that women are not interested in pursuing options deemed more invasive. To mitigate bias, organizations should aim to increase the visibility and involvement of women in research, health promotion, and clinical and leadership endeavours. More research needs to be done to identify effective interventions to mitigate sex and gender bias and the resultant cardiovascular outcome discrepancies.
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Shen F, Huang H, Li L. Effects of symptom clusters on quality of life mediated by self‐efficacy among individuals with myasthenia gravis: A structural equation modelling analysis. J Clin Nurs 2022. [DOI: 10.1111/jocn.16569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/24/2022] [Accepted: 10/04/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Fan Shen
- Department of Neurology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
- School of Nursing, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Hai‐Shan Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Ling Li
- Department of Neurology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
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Nazali MIM, Razali S, Ariaratnam S, Ahmad Y, Nawawi H. The 2019 Universiti Teknologi MARA, Malaysia Staff Survey: Determining the Level and Predictors of Quality of Life. Front Psychiatry 2021; 12:705018. [PMID: 34434129 PMCID: PMC8380962 DOI: 10.3389/fpsyt.2021.705018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/01/2021] [Indexed: 11/14/2022] Open
Abstract
Experiencing good quality of life (QOL) among university staff is extremely crucial to ensuring academic excellence; however, there are limited data on factors that contribute to QOL among university staff. This study aims to determine the level and the predictors for good QOL among university staff. The consenting participants were selected using a stratified sampling method. Participants who had fulfilled the selection criteria were provided with socio-demographic, medical illness, job factor, and family background questionnaires. QOL and psychological well-being (depression, anxiety, and stress) were assessed using the World Health Organization Quality of Life brief version (WHOQOL-BREF) and Depression, Anxiety, and Stress Scale (DASS-21) questionnaires, respectively. A total of 278 staff (mean ± SD age: 38.84 ± 7.85 years, 44.2% males, 82.7% married) had participated in this study. This study found that participants had low QOL in the domains of physical health [P-QOL] (11.2%), psychological health [PSY-QOL] (9.7%), social relationships [SR-QOL] (19.1%), and environment [E-QOL] (14.4%). The predictors of P-QOL were depression, medical illness, and number of dependents, while those of PSY-QOL were work promotion, depression, medical illness, and number of dependents. Additionally, the predictors of SR-QOL were campus location, depression, and work promotion, while those of E-QOL were age, level of education, depression, work promotion, and medical illness. Depression significantly affected all domains of QOL. Younger participants without medical illness and those with tertiary level of education had increased odds of having good QOL. Participants having dependents without work promotion and employed in suburban areas had decreased odds of having good QOL. The relevant authority should be identified and then assist staff with difficulties to ensure the staff benefited from having a good QOL.
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Affiliation(s)
- Mohd Izwan Mat Nazali
- Department of Psychiatry, Faculty of Medicine, Selangor Campus, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Selangor Campus, Universiti Teknologi MARA, Shah Alam, Malaysia.,Institute for Pathology, Laboratory, and Forensic Medicine (I-PPerForM), Shah Alam, Malaysia
| | - Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Cawangan Selangor, Kampus Selayang, Shah Alam, Malaysia
| | - Yuhaniz Ahmad
- School of Quantitative Sciences, Universiti Utara Malaysia, Changlun, Malaysia
| | - Hapizah Nawawi
- Institute for Pathology, Laboratory, and Forensic Medicine (I-PPerForM), Shah Alam, Malaysia.,I-PPerForM (Institute of Pathology, Forensic and Laboratory Medicine) and Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
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Luque B, Castillo-Mayén R, Cuadrado E, Gutiérrez-Domingo T, Rubio SJ, Arenas A, Delgado-Lista J, Pérez Martínez P, Tabernero C. The Role of Emotional Regulation and Affective Balance on Health Perception in Cardiovascular Disease Patients According to Sex Differences. J Clin Med 2020; 9:E3165. [PMID: 33007817 PMCID: PMC7599936 DOI: 10.3390/jcm9103165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 11/17/2022] Open
Abstract
One of the challenges of aging is the increase of people with chronic diseases, such as cardiovascular disease (CVD). Men and women experience the disease differently. Therefore, it has an impact on how CVD is treated and its outcomes. This research analyzed the relationship between psychosocial variables and health promotion among cardiovascular patients, paying special attention to sex differences. A longitudinal study with cardiovascular patients (747 in phase 1 (122 women) and 586 in phase 2 (83 women)) was carried out. Participants were evaluated based on their sociodemographic characteristics, affective balance, regulatory negative affect self-efficacy, stress and anxiety regulation strategies, and perceived global health. Results showed that men presented significantly higher scores in positive affect, affective balance, and self-efficacy to regulate negative emotions, while women presented significantly higher scores in negative affect and the use of passive strategies to cope with stressful situations. Regression analyses showed that all psychological variables studied in phase 1 were significant predictors of health perception in phase 2. According to the results, it is necessary to include strategies to improve cardiovascular health through education and emotional regulation, with a gender focus.
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Affiliation(s)
- Bárbara Luque
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Psychology, University of Córdoba, 14071 Córdoba, Spain
| | - Rosario Castillo-Mayén
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Psychology, University of Córdoba, 14071 Córdoba, Spain
| | - Esther Cuadrado
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Psychology, University of Córdoba, 14071 Córdoba, Spain
| | - Tamara Gutiérrez-Domingo
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Psychology, University of Córdoba, 14071 Córdoba, Spain
| | - Sebastián J. Rubio
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Didactics of Experimental Sciences, University of Córdoba, 14071 Cordoba, Spain
| | - Alicia Arenas
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Social Psychology, University of Seville, 41018 Seville, Spain
| | - Javier Delgado-Lista
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofía University Hospital, 14004 Córdoba, Spain
- Department of Medicine (Medicine, Dermatology and Otorhinolaryngology), University of Córdoba, 14004 Cordoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28007 Madrid, Spain
| | - Pablo Pérez Martínez
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofía University Hospital, 14004 Córdoba, Spain
- Department of Medicine (Medicine, Dermatology and Otorhinolaryngology), University of Córdoba, 14004 Cordoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28007 Madrid, Spain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Instituto de Neurociencias de Castilla y León (INCYL), University of Salamanca, 37007 Salamanca, Spain
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