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Gender differences in descriptions of angina symptoms and health problems immediately prior to angiography: the ACRE study

Philpott, S.; Boynton, P.; Feder, G.; Hemingway, H.; (2001) Gender differences in descriptions of angina symptoms and health problems immediately prior to angiography: the ACRE study. Social Science and Medicine , 52 (10) pp. 1565-1575. 10.1016/S0277-9536(00)00269-0.

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Abstract

Although the prevalence of angina in women is increasing, women are less likely than men to undergo invasive management of coronary disease. Gender differences in language use may contribute to disparities in management, since the diagnosis of angina relies on a patient's description of their symptoms. This study set out to investigate whether gender differences exist in the language used when describing angina symptoms and perceived health problems at the time of angiography, which might influence the rate of subsequent revascularisation. Content analysis was used to analyse written accounts of ‘symptoms and health problems’ in 200 (96 female) patients randomly selected within age strata who were undergoing coronary angiography for chronic stable angina in the Appropriateness of Coronary Revascularisation (ACRE) study. Written free text was coded into seven categories: pain location (chest or arm and throat, neck or jaw); pain character; breathlessness; other symptoms; effects on lifestyle; symptom attributions; and patient discourses (‘story’ or ‘factual’). Women described more throat, neck or jaw pain than men among those with low physical functioning (p=0.06), in the presence of coronary artery disease (p=0.04) and in those who were not subsequently revascularised (p=0.05). Women also gave more accounts than men of breathlessness and other symptoms, but there was little evidence for gender differences in the use of ‘factual’ discourses. We conclude that from the time of angiography, gender differences in language use do exist and description of angina pain may influence subsequent revascularisation. Further research is necessary to investigate the nature and consequences of gender differences in language use at this and earlier stages in the referral process.

Type: Article
Title: Gender differences in descriptions of angina symptoms and health problems immediately prior to angiography: the ACRE study
DOI: 10.1016/S0277-9536(00)00269-0
Publisher version: http://dx.doi.org/10.1016/S0277-9536(00)00269-0
Language: English
Keywords: Gender differences, angina, coronary artery disease, symptom accounts
UCL classification: UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Epidemiology and Public Health
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Primary Care and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/6534
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