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Comparison of gender differences in predictors of psychological distress in parents of children with cancer
GENDERMEDICINE
Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan Objective: To examine the secular trend in sex ratios of live b i r t h a n d fetal d e a t h from 1899 to 2003 in Japan. M e t h o d s : Annual male a n d female live births and fetal deaths data were obtained directly from the Vital Statistics in Japan. The ratio of male/female live births was defined as live b i r t h sex ratio, a n d male/female ratio of fetal deaths was calculated as sex ratio of fetal death. J o i n p o i n t regression analysis was used to detect long-term changes in the sex ratio over time. Results: Between 1899 a n d 2003, the trend of sex ratio of births was marked by three significant shifts. The joinpoints occurred in 1910 a n d 1971. Beginning in 1911, the trend increased b y 0.04% per year for nearly five decades. After 1971, the sex ratio of births began to decrease annually by ~0.03% per year. Trend analysis for sex ratio in fetal deaths showed 3 significant joinpoints in 1955, 1964, a n d 1976. A significant increase was observed since 1964. C o n c l u s i o n : Our study confirmed a decrease in sex ratio for births a n d a significant increase in sex ratio for fetal deaths in the recent three decades. The increase in sex ratio of fetal d e a t h m i g h t be due to great i m p r o v e m e n t s in obstetric care a n d a n increasing availability of perinatal diagnosis since the 1970s. This increasing trend in sex ratio of fetal d e a t h m a y have influenced the decrease in sex ratio of births in Japan. 87
Comparison of Gender Differences in Predictors of Psychological Distress in Parents of Children with Cancer C h a o - H s i n g Yeh
88
Evaluation of Second Curettage in Reduction of Persistent Mole M a h v a s h Zargar; Sara Masihi; a n d M o g h g a n Barati
Imam Hospital, Ahvaz, Khouzestan, Iran I n t r o d u c t i o n : Suction curettage is the preferred method for evacuation of H.mole. About 20% of molar pregnancy have risk of lxophoblastic neoplasia. One cause of persistent high level of BHCG may be residual trophoblastic tissue in uterus. The purpose of this study is evaluation of the need to perform a second curettage in H.mole to reduce risk of persistency. M a t e r i a l & Methods: In this case control study 124 patients after rout~m workup were assigned in 2 groups. In fire study group after primary suction curettage, we performed an ullxasonograghy and second curettage o n the next day under following conditions: echogenic area in uterine cavity, endometrial thicMmss above 10 ram, or irregular endometrium. Routine suction curettage has been performed for control group. All patients have been followed by serum BHCG. Results: The mean age, gravity, and other risk factors in b o t h groups were similar. In the study group, 55% of cases had empty uterus and 45% had residual tissue in ultrasound study. Overall persistent rate in the study group was 25% (8% in normal sonograghy, and 17% in second curettage group with abnormal sonograghy). In the conlxol group persistent rate was 34%. Conclusion: This study showed that patients who did not have residual tissue after first curettage were low risk for persistent diseases and in w h o m second curettage was performed because of residual tissue persistency was reduced by this procedure. 89
Chang Gung University, Kwei-San, Tao-Yuen, Taiwan
Gender in Medical Communication
B a c k g r o u n d : Reports published over the last few decades present contradictory findings about the psychological distress and coping patterns of parents whose children have cancer. Aims: Gender differences of parental predictors (including parenting distress, illness severity, the style of coping responses) of psychological distress (including anxiety, depression, and somatization) experienced by Taiwanese mothers and fathers (164 couples) whose children were undergoing treatment for cancer were investigated. Method: Structural equation modeling was used to analyze the predictors of psychological distress between mothers and fathers whose child had cancer. It hypothesizes that social support, parenting slxess, and coping style directly effect psychological distress; and that coping style also serves as an indirect mediator from social support and parenting stress to psychological distress. Results: The findings indicate that the different modelings were supported for b o t h mothers and fathers; although it was with different magnitude. For mothers, the relationships of social support and parenting stress to psychological distress appear to be mediated through coping style, with no path among social support, problem-focused, and emotion-focused coping was calculated. For fathers, the relationship of social support and parenting stress to psychological distress appears to be mediated through coping style without the path relation between problem-focused coping and psychological distress. Conclusions: Tiffs finding indicates the need for a thorough psychiatric consultation at the time of diagnosis for children who have cancer and their families. Ongoing psychosocial support and education should have been integral components of the treatment program when relapse occurred.
Elisabeth Z e m p l ; B e n e d i c t Martina2; Joerg Leuppi3; Patricia F a r a h m a n d 4 ; M i c h e l a Ceschil; M a r j a m Stuerchler2; a n d A n n e l i e s H a e c k i - B u h o f e r 4
$68
1Institute of Social and Preventive Medicine, University Basel, Switzerland; 2Department ofllnternal Medicine, University Hospital, Basel, Switzerland; 3Division oflPneumology, University Hospital, Basel, Switzerland; and 4Department of German, University Basel, Switzerland B a c k g r o u n d a n d Aim: There is evidence t h a t patient a n d physician gender have a n impact o n c o m m u n i c a t i o n in medical visits (Hall 1998, v a n d e n Brink-Muinen 1998, Roter 2002) a n d o n medical decisions (Wenger 1993, C h a p m a n 2001). This study investigates the role of gender for c o m m u nicative b e h a v i o u r of physicians a n d of patients seeking care for dyspnea, b y means of a n interdisciplinary approach involving linguistics, epidemiology a n d internal medicine. M e t h o d s : A b o d y of 96 medical discourses (medical history of 74 female a n d 54 male patients, taken by 14 female a n d 21 male physicians) have b e e n audio-registered. Standardised assessment of clinical a n d demographic information. Definition of a set of linguistic categories p o i n t i n g to "gendered speech," based o n theoretical a n d empirical work. Online coding with the Roter Interaction Analysessystem. Genderedness of c o m m u n i c a t i o n is analysed according to physician a n d p a t i e n t gender, a n d to gender constellations. Determinants of gendered speech is studied by means of negative b i n o m i n a l regression models. Results: The most frequently observed categories of genderedness differ between patients a n d physicians. While in bivariate analysis, significant differences are seen in several categories
Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan Objective: To examine the secular trend in sex ratios of live b i r t h a n d fetal d e a t h from 1899 to 2003 in Japan. M e t h o d s : Annual male a n d female live births and fetal deaths data were obtained directly from the Vital Statistics in Japan. The ratio of male/female live births was defined as live b i r t h sex ratio, a n d male/female ratio of fetal deaths was calculated as sex ratio of fetal death. J o i n p o i n t regression analysis was used to detect long-term changes in the sex ratio over time. Results: Between 1899 a n d 2003, the trend of sex ratio of births was marked by three significant shifts. The joinpoints occurred in 1910 a n d 1971. Beginning in 1911, the trend increased b y 0.04% per year for nearly five decades. After 1971, the sex ratio of births began to decrease annually by ~0.03% per year. Trend analysis for sex ratio in fetal deaths showed 3 significant joinpoints in 1955, 1964, a n d 1976. A significant increase was observed since 1964. C o n c l u s i o n : Our study confirmed a decrease in sex ratio for births a n d a significant increase in sex ratio for fetal deaths in the recent three decades. The increase in sex ratio of fetal d e a t h m i g h t be due to great i m p r o v e m e n t s in obstetric care a n d a n increasing availability of perinatal diagnosis since the 1970s. This increasing trend in sex ratio of fetal d e a t h m a y have influenced the decrease in sex ratio of births in Japan. 87
Comparison of Gender Differences in Predictors of Psychological Distress in Parents of Children with Cancer C h a o - H s i n g Yeh
88
Evaluation of Second Curettage in Reduction of Persistent Mole M a h v a s h Zargar; Sara Masihi; a n d M o g h g a n Barati
Imam Hospital, Ahvaz, Khouzestan, Iran I n t r o d u c t i o n : Suction curettage is the preferred method for evacuation of H.mole. About 20% of molar pregnancy have risk of lxophoblastic neoplasia. One cause of persistent high level of BHCG may be residual trophoblastic tissue in uterus. The purpose of this study is evaluation of the need to perform a second curettage in H.mole to reduce risk of persistency. M a t e r i a l & Methods: In this case control study 124 patients after rout~m workup were assigned in 2 groups. In fire study group after primary suction curettage, we performed an ullxasonograghy and second curettage o n the next day under following conditions: echogenic area in uterine cavity, endometrial thicMmss above 10 ram, or irregular endometrium. Routine suction curettage has been performed for control group. All patients have been followed by serum BHCG. Results: The mean age, gravity, and other risk factors in b o t h groups were similar. In the study group, 55% of cases had empty uterus and 45% had residual tissue in ultrasound study. Overall persistent rate in the study group was 25% (8% in normal sonograghy, and 17% in second curettage group with abnormal sonograghy). In the conlxol group persistent rate was 34%. Conclusion: This study showed that patients who did not have residual tissue after first curettage were low risk for persistent diseases and in w h o m second curettage was performed because of residual tissue persistency was reduced by this procedure. 89
Chang Gung University, Kwei-San, Tao-Yuen, Taiwan
Gender in Medical Communication
B a c k g r o u n d : Reports published over the last few decades present contradictory findings about the psychological distress and coping patterns of parents whose children have cancer. Aims: Gender differences of parental predictors (including parenting distress, illness severity, the style of coping responses) of psychological distress (including anxiety, depression, and somatization) experienced by Taiwanese mothers and fathers (164 couples) whose children were undergoing treatment for cancer were investigated. Method: Structural equation modeling was used to analyze the predictors of psychological distress between mothers and fathers whose child had cancer. It hypothesizes that social support, parenting slxess, and coping style directly effect psychological distress; and that coping style also serves as an indirect mediator from social support and parenting stress to psychological distress. Results: The findings indicate that the different modelings were supported for b o t h mothers and fathers; although it was with different magnitude. For mothers, the relationships of social support and parenting stress to psychological distress appear to be mediated through coping style, with no path among social support, problem-focused, and emotion-focused coping was calculated. For fathers, the relationship of social support and parenting stress to psychological distress appears to be mediated through coping style without the path relation between problem-focused coping and psychological distress. Conclusions: Tiffs finding indicates the need for a thorough psychiatric consultation at the time of diagnosis for children who have cancer and their families. Ongoing psychosocial support and education should have been integral components of the treatment program when relapse occurred.
Elisabeth Z e m p l ; B e n e d i c t Martina2; Joerg Leuppi3; Patricia F a r a h m a n d 4 ; M i c h e l a Ceschil; M a r j a m Stuerchler2; a n d A n n e l i e s H a e c k i - B u h o f e r 4
$68
1Institute of Social and Preventive Medicine, University Basel, Switzerland; 2Department ofllnternal Medicine, University Hospital, Basel, Switzerland; 3Division oflPneumology, University Hospital, Basel, Switzerland; and 4Department of German, University Basel, Switzerland B a c k g r o u n d a n d Aim: There is evidence t h a t patient a n d physician gender have a n impact o n c o m m u n i c a t i o n in medical visits (Hall 1998, v a n d e n Brink-Muinen 1998, Roter 2002) a n d o n medical decisions (Wenger 1993, C h a p m a n 2001). This study investigates the role of gender for c o m m u nicative b e h a v i o u r of physicians a n d of patients seeking care for dyspnea, b y means of a n interdisciplinary approach involving linguistics, epidemiology a n d internal medicine. M e t h o d s : A b o d y of 96 medical discourses (medical history of 74 female a n d 54 male patients, taken by 14 female a n d 21 male physicians) have b e e n audio-registered. Standardised assessment of clinical a n d demographic information. Definition of a set of linguistic categories p o i n t i n g to "gendered speech," based o n theoretical a n d empirical work. Online coding with the Roter Interaction Analysessystem. Genderedness of c o m m u n i c a t i o n is analysed according to physician a n d p a t i e n t gender, a n d to gender constellations. Determinants of gendered speech is studied by means of negative b i n o m i n a l regression models. Results: The most frequently observed categories of genderedness differ between patients a n d physicians. While in bivariate analysis, significant differences are seen in several categories