Abstract
Introduction: For myocardial infarction (MI), in-hospital lethality is still significantly higher in women than in men. Medical guidelines and nursing expert standards include recommendations for gender-sensitive care, but it is unknown how these are implemented in health care practice. It is hypothesized that there is a discrepancy between evidence-based GSC+ guidelines and expert standards and their implementation in practice. The HeartGap project, which is funded by the German Innovation Fund, investigates influencing factors and whether a gap exists between evidence and the reality of care. Who is it for? All genders can benefit from an increase of GSC+.
Methods: The current state of GSC+ in cardiology is examined through a mixed-methods research design, including a scoping review and qualitative and quantitative surveys from the perspectives of nurses, clinicians, and patients. We included the patient's and stakeholder's perspective into the study to ensure public involvement in addition to the healthcare professionals' perspective. From the analysis and triangulation of research results, recommendations are derived to implement GSC+ sustainably in everyday healthcare. The focus of this poster will be on the results of the scoping review and qualitative survey. The scoping review investigated measures for the sustainable implementation of GSC+ and identified existing barriers and challenges. Additionally, results from 12 qualitative focus group interviews conducted between February 2023 and October 2023 in six hospitals of varying sizes and levels of care in Lower Saxony and North Rhine-Westphalia, Germany, involving nurses and doctors, will be presented.
Results: During the review, identified measures to promote the implementation of GSC+ were clustered into 14 dimensions. Besides hospital-specific factors, external factors such as universities and training institutions influence the success of the implementation of GSC+. The dimensions of "Education" and "Research and Science" captured the majority of measures. As the review included international studies in English and German, the measures identified relate to the global level therefore benefit an international audience.
In qualitative interviews, it was observed that barriers to implementing more GSC+ primarily exist in temporal and financial aspects. Furthermore, the importance and urgency of GSC+ are not universally recognized among healthcare providers. Supporting factors include an increase in scientific evidence, educational offerings, more awareness of the topic, policy directives, and practical implementation recommendations.
Summary: In the HeartGap project, disparities between expectations regarding gender-sensitive medical guidelines/expert standards in hospitals and their actual implementation are investigated. Despite existing guidelines for gender-sensitive care (GSC+), obstacles impede the implementation. The implementation should occur at an interdisciplinary level and in a holistic approach, as all genders benefit from GSC+. The next steps are to conduct the quantitative study in 2024. After the evaluation, all data will be triangulated and recommendations for action for the implementation of more GSC+ at German and international levels will be derived.