Gender-Sensitive Study of Personal Attitudes and Expectations Toward Post-Acute-Rehabilitation

Background In a large-scale project supported by the German Pension Insurance, factors influencing access to post-acute-rehabilitation were investigated. In a previous study, diagnosis was shown to be a decisive factor, but different attitudes and expectations with regard to therapeutic intervention were also revealed. The aim of this study is to analyze these expectations for gender-sensitive differences and to evaluate them in the context of the application process. Methods For this exploratory observational cross-sectional study, data collection (2014-2016) occurred in three acute care hospitals. Individuals aged 18-65 years who were treated for rehabilitation-related diagnoses were included. Questionnaire-based sociodemographic data as well as rehabilitation goals, wishes, and function-related information were collected. For this purpose, partly standardized survey instruments were used. The evaluation was carried out both descriptively and by means of univariate and multivariate binary logistic regression analyses. Results There are gender-sensitive attitudes and expectations towards post-acute-rehabilitation. While women were significantly more likely to report psychological distress and its influences on their illness in all corresponding questions, men rated their physical health-related quality of life and independence in daily functions significantly better (p<0.001 and p=0.029, respectively. In the combined analysis, applications from male subjects with older age showed a significantly higher approval rate (p=0.031 and p<0.001, respectively). Regardless of any sub-items, there was no gender-sensitive difference in the approval rate of Rehabilitation. Conclusion Female and male subjects show different attitudes and expectations towards post-acute-rehabilitation. A purely biological distinction in terms of gender ("sex") does not adequately explain these differences. However, the distinction in "gender", which includes cultural conventions, role models, and behaviors, can more accurately explain this through environmental and family-related factors. Incorporating these differences into therapy planning and implementation may contribute to better therapy outcomes and should be the subject of further research. Further development of the application documents is necessary to take a holistic view of patients.