Abstract

Gender-specific differences in the description of ehest pain: some results of a transdisciplinary cardiologic-linguistic investigation Chest pain can be caused by many different diseases ranging from trivial muscle pain to acute myocardial infarction. lf ehest pain is due to coronary heart disease, a prompt diagnosis is important regarding survival and quality of !ife. Since laboratory investigations like ECG or blood tests are only of limited value to confirm or exclude a coronary cause of ehest pain, the clinical history is very important. Gender differences, found in diagnosis and therapy of coronary heart disease, suggest that also the clinical history and the description of ehest pain may be different between female and male patients. Therefore, the aim of this prospective transdisciplinary cardiologic-linguistic study was to assess if cause- and gender-specific differences exist in the description of ehest pain in patients admitted to a cardiac unit. Out of a total number of 82 interviews, 24 interviews were selected and subject to a narrative analysis. The qualitative linguistic analysis showed strong gender differences in both self presentation as a patient and description of pain. Male patients presented themselves as well informed about their illness( es), as actively pain-managing in order to treat it, as eo-operative, and as interested in the detection and diagnosis of the causes of pain. In addition, male patients observed their pain extensively, took it seriously, stressed the importance of treating it and produced very concrete pain descriptions. On the other hand, female patients tended towards an emotional self-description and presented themselves as prevailingly pain enduring in a passive, accepting way delegating its treatrnent to the expert system. They focused primarily on psycho-social strain and did not show interest in the clarification of the causes of pain. Furthermore, women played down their suffering from pain, did not describe it as serious and debased it. The women's pain descriptions were diffuse, they gave no symptomatic pain descriptions and made meta-communicative comments on the impossibility of pain description.