Heart Patients Want More From Their Doctors

Survey finds many think their physicians should give them better guidance

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HealthDay Reporter

FRIDAY, Jan. 23, 2004 (HealthDayNews) -- Many heart patients want more guidance from their doctors, a new survey finds.

Women were especially dissatisfied with the information they did get, says Dr. Donna E. Stewart and her colleagues at the University of Toronto. To arrive at that conclusion, the researchers tallied up responses from 522 people who had been hospitalized for a heart attack or unstable angina. The survey results appear in the January/February issue of Psychosomatic Medicine.

"I think we can do a better job of having material available for patients to take home, and tell them to call or bring any questions with them to their next appointment," Stewart says.

Many patients assume a passive role when talking to their doctors and don't ask for all the information they want, adds Dr. Sharon Sweede, former chairwoman of the Commission on Public Health of the American Academy of Family Physicians. Also, doctors are often too pressed for time to answer questions as fully as patients would like. The doctors "are reimbursed for 'doing something,' not for talking with patients," she says.

"In my experience, women ask more questions only when encouraged to do so," Sweede says. "Men ask more often for what they want, but also don't want much information. They often bring their wives along to ask questions."

She suggests it's up to doctors to encourage their patients to ask more questions and learn interviewing techniques that would draw out concerns.

The survey results certainly seem to suggest that approach is needed.

Six months after the heart patients returned home, they completed a survey that measured how well-informed they felt about their cardiac condition and topics on which they wanted more information. Six months after that, the subjects answered another survey that asked about their satisfaction with their medical care and which health-care providers had best met their needs for more information.

In the first survey, the patients' mean score for the amount of information they wanted was 4.3 on a scale of 1-5, with 5 being as much information as possible. There was no difference between the sexes.

But when asked about the amount of information they'd actually received, the mean rating from men was 3.7, compared with a mean of 3.5 from women, a statistically significant difference that suggests men were happier than the women on that point.

In the 12-month survey, men were 30 percent more likely than women to report they got helpful information about their test results from their family physicians, and 23 percent more likely to say those physicians had given them information on cardiac rehabilitation.

When it came to topics on which patients felt they hadn't received enough information, the top five for men and women alike were future treatment choices, how their families could support their lifestyle changes, the future course of their condition, the role of each type of doctor in treatment, and cardiac rehabilitation. However, men said they wanted more information on how their illness affected sexual function, while women desired more information on angina and hypertension.

Men and women who felt better-informed were more satisfied with their health care, felt more in control and less depressed, and were more likely to follow good health habits such as exercising more, smoking less and engaging in cardiac rehabilitation.

Many patients also indicated their doctors frequently made their health-care decisions for them despite their wish to have a role in those decisions. Here again, there was no difference between the sexes.

These findings suggest that recovering heart patients feel "only moderately well-informed" about their condition, and they want more information than they're getting on many topics, Stewart says.

They also reflect a gender gap in expectations when it comes to receiving information from health-care providers and making decisions.

"Women in general endorse statements such as, 'I want all the information possible about my condition,' while men endorse statements indicating they're satisfied with less information," Stewart says.

Women also seem to prefer making their health-care decisions on their own or in partnership with their physicians, while men more often say they trust their doctors to do the right thing.

More information

Johns Hopkins Bayview Medical Center has more information on heart health. The American Heart Association also has lifestyle tips for heart patients.

SOURCES: Donna E. Stewart, M.D., professor and chairwoman, Department of Women's Health, University Health Network and University of Toronto; Sharon Sweede, M.D., staff physician, JFK Alcohol and Drug Abuse Treatment Center, Black Mountain, N.C., and immediate past chairman, Commission on Public Health, American Academy of Family Physicians; January/February 2004, Psychosomatic Medicine

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