Gender sensitivity and its implementation in inpatient cardiology: a mixed-methods study of patient and healthcare professional perspectives
4 affiliations
- 1Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School , ,
- 2Institute for Gender Health , ,
- 3Department of Internal Medicine/ Gender- and Sex-Specific Medicine, Medical Faculty University Hospital Magdeburg Otto von Guericke , ,
- 4Figus—Research Institute for Health- and System Design , ,
Abstract
Background: Gender-sensitive personalized care (GSC+) is a core component of people-centered healthcare and health equity. Evidence from cardiovascular research demonstrates relevant sex- and gender-related differences in symptom presentation, diagnostics, treatment response, and outcomes. These differences are increasingly acknowledged in clinical practice guidelines and nursing expert standards. However, despite growing integration into guideline recommendations, translation into routine clinical practice remains inconsistent. Empirical data integrating both patient and healthcare professional perspectives on guideline-based gender-sensitive care are still limited.
Methods: This exploratory mixed-methods study synthesizes findings from the German health services research project HeartGap (funding number: 01VSF22030; DRKS00031317). The study comprised (1) a scoping review on measures, facilitators, and barriers to implementing GSC+, (2) qualitative expert interviews and focus groups with physicians and nurses, and (3) nationwide surveys with physicians (n = 155), nurses (n = 111), and cardiology inpatients (n = 390). Gender sensitivity among healthcare professionals was assessed using the Nijmegen Gender Awareness in Medicine Scale (N-GAMS), alongside measures of perceived implementation of GSC+. Patient perspectives were analyzed descriptively and using multivariate regression models.
Results: Healthcare professionals demonstrated moderate to high gender sensitivity (physicians: M = 3.95, SD = 0.73; nurses: M = 3.46, SD = 0.76). Perceived implementation of GSC+ was substantially lower, particularly among physicians (M = 2.45, SD = 0.59), compared with nurses (M = 2.91, SD = 0.81) and patients (M = 3.04, SD = 0.65). Higher gender sensitivity did not correspond with higher perceived implementation, indicating a disconnect between attitudes and practice. Although guideline-based knowledge on sex- and gender-related aspects was moderate to high, its translation into routine clinical practice remained limited. Patients evaluated GSC+ positively and reported comparatively low additional needs. Across methods, structural constraints, insufficient operationalization of guideline recommendations, and limited institutional embedding emerged as key barriers.
Conclusion: Organizational, structural, and systemic barriers were consistently identified across study components as relevant factors associated with implementation gaps in GSC+ rather than by negative attitudes or lack of awareness among healthcare professionals. Strengthening the evidence base, operationalizing gender-sensitive recommendations, and embedding GSC+ into organizational routines and education are essential to advance people-centered, equitable, and safe cardiology care.
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BibTeX
@article{sgraja2026gender,
title = {{Gender sensitivity and its implementation in inpatient cardiology: a mixed-methods study of patient and healthcare professional perspectives}},
author = {Sophia Sgraja and Judith Mollenhauer and Martina Kloepfer and Ute Seeland and Clarissa Kurscheid and Volker E. Amelung},
journal = {Frontiers in global women's health},
year = {2026},
month = oct,
doi = {10.3389/fgwh.2026.1871546},
url = {https://europepmc.org/article/PMC/PMC13719549},
note = {CC BY},
}
RIS
TY - JOUR
TI - Gender sensitivity and its implementation in inpatient cardiology: a mixed-methods study of patient and healthcare professional perspectives
AU - Sophia Sgraja
AU - Judith Mollenhauer
AU - Martina Kloepfer
AU - Ute Seeland
AU - Clarissa Kurscheid
AU - Volker E. Amelung
PY - 2026
DA - 2026/10/16
JO - Frontiers in global women's health
DO - 10.3389/fgwh.2026.1871546
UR - https://europepmc.org/article/PMC/PMC13719549
AB - Background: Gender-sensitive personalized care (GSC+) is a core component of people-centered healthcare and health equity. Evidence from cardiovascular research demonstrates relevant sex- and gender-related differences in symptom presentation, diagnostics, treatment response, and outcomes. These differences are increasingly acknowledged in clinical practice guidelines and nursing expert standards. However, despite growing integration into guideline recommendations, translation into routine clinical practice remains inconsistent. Empirical data integrating both patient and healthcare professional perspectives on guideline-based gender-sensitive care are still limited. Methods: This exploratory mixed-methods study synthesizes findings from the German health services research project HeartGap (funding number: 01VSF22030; DRKS00031317). The study comprised (1) a scoping review on measures, facilitators, and barriers to implementing GSC+, (2) qualitative expert interviews and focus groups with physicians and nurses, and (3) nationwide surveys with physicians (n = 155), nurses (n = 111), and cardiology inpatients (n = 390). Gender sensitivity among healthcare professionals was assessed using the Nijmegen Gender Awareness in Medicine Scale (N-GAMS), alongside measures of perceived implementation of GSC+. Patient perspectives were analyzed descriptively and using multivariate regression models. Results: Healthcare professionals demonstrated moderate to high gender sensitivity (physicians: M = 3.95, SD = 0.73; nurses: M = 3.46, SD = 0.76). Perceived implementation of GSC+ was substantially lower, particularly among physicians (M = 2.45, SD = 0.59), compared with nurses (M = 2.91, SD = 0.81) and patients (M = 3.04, SD = 0.65). Higher gender sensitivity did not correspond with higher perceived implementation, indicating a disconnect between attitudes and practice. Although guideline-based knowledge on sex- and gender-related aspects was moderate to high, its translation into routine clinical practice remained limited. Patients evaluated GSC+ positively and reported comparatively low additional needs. Across methods, structural constraints, insufficient operationalization of guideline recommendations, and limited institutional embedding emerged as key barriers. Conclusion: Organizational, structural, and systemic barriers were consistently identified across study components as relevant factors associated with implementation gaps in GSC+ rather than by negative attitudes or lack of awareness among healthcare professionals. Strengthening the evidence base, operationalizing gender-sensitive recommendations, and embedding GSC+ into organizational routines and education are essential to advance people-centered, equitable, and safe cardiology care.
SN - 2673-5059
ER -