December 18, 2003
Women's health care needs healing communication
WEST LAFAYETTE, Ind. - Despite advances in medicine and technology, some of women's most basic health care needs are not being met, says a Purdue University health communication expert.
"Many women suffer tremendous anxiety about their annual gynecological exams," says Marifran Mattson, an associate communication professor who studies health communication issues such as privacy and safety. "The anxiety is preventing women from receiving the best care possible, and many women who seek care regularly are not pleased with their visits. Patient education is key to alleviating anxiety associated with these vulnerable visits because it inspires women to be more confident in demanding that their individuality be respected and their input be considered."
Mattson teamed with Maria Brann, an assistant professor of communication studies at West Virginia University and a former Purdue graduate student, to survey 79 women, ages 18-71, about their annual exams, which screen for cancer and other health problems. The women were asked if they share concerns about their care with their gynecologists, and if they do, how do gynecologists react to their concerns. Unlike previous research, the surveys asked women to describe gynecological visits in their own words, rather than rating them on a scale.
The results of their study are published in the chapter "Reframing Communication During Gynecological Exams," which appears in the book "Gender in Applied Communication Contexts." The book was published in November. Their research also suggests that gynecologists reevaluate how they communicate with patients in order to improve the delivery of health care. Almost two-thirds of the women surveyed expressed some concern about visiting a gynecologist, including the gynecologist's gender. Mattson and Brann's study agrees with previous research that shows the fear associated with women's exams is often connected to being examined by a male doctor.
"Interestingly, older women did not have a preference for the gender of their gynecologist, and that can be attributed to women not growing up with a choice," Mattson says. "However, younger women prefer female doctors. But even though we think of female gynecologists as more perceptive to our needs and concerns, we need to remember they are trained in a male-dominated medical system."
In the 1800s the health care system became more male-dominated when woman-to-woman care, such as midwifery, was excluded from mainstream care. As medical science evolved, physicians, most of whom were men, were trained to treat medical conditions rather than the individual patient, Mattson says.
Other reasons keeping women from their annual exams include feelings of discomfort, embarrassment and personal intrusion, as well as the fear of finding a problem such as cancer, Brann says.
Women who schedule annual exams expressed difficulty sharing these concerns with their doctor. The majority of women reported they did not share their feelings because they "found doctors to be uncaring and patronizing."
The women who do share their concerns said some physicians laughed or told the patient to just relax. Their research also shows that women want better communication with their doctors, but they are not willing or comfortable sharing their concerns.
"The focus should be on the well-being of the patient, and the goal of any health care interaction should be on maintaining a caring relationship," Brann says. "Because there are two parties involved in the relationship, both should be responsible for creating that relationship. Physicians need to see women as people who experience real anxieties, not just illnesses. And patients need to start, or continue, being assertive when addressing such concerns with their gynecologists."
Gynecologists can improve their communication skills by making eye contact and avoid being condescending, Brann says. Patients should demand more time with their doctor to share concerns and ask questions about their health care.
"A woman's dignity must be maintained throughout the examination, especially considering the vulnerable position that women are in when they go the gynecologist," Mattson says. "A genuine relationship between a patient and physician is created and maintained through communication. Improved communications may help alleviate the anxiety women experience before, during and after exams. When a woman knows that her gynecologist cares for her, she feels comfortable expressing herself, and that empowers women to be active in seeking health care and contributing to the decision making in their care."
Writer: Amy Patterson-Neubert, (765) 494-9723, firstname.lastname@example.org
Sources: Marifran Mattson, (765) 494-7596, email@example.com
Maria Brann, (304) 293-3905, Maria.Brann@mail.wvu.edu
Purdue News Service: (765) 494-2096; firstname.lastname@example.org
Marifran Mattson, an associate professor of health communication, studied women's concerns about gynecological exams. Mattson teamed with Maria Brann, an assistant professor of communication studies at West Virginia University and a former Purdue graduate student, to survey 79 women, ages 18-71, about their concerns regarding women's exams. The results of their study are published in the chapter "Reframing Communication During Gynecological Exams," which appears in the book "Gender in Applied Communication Contexts." The book was published in November. (Purdue News Service photo/David Umberger)
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