Exploring downstream effects of gender roles in healthcare decision-making and relationships within systems: A cross-sectional analysis of openness to treatment in pediatric headache

J Psychosom Res. 2024 Apr:179:111611. doi: 10.1016/j.jpsychores.2024.111611. Epub 2024 Feb 15.

Abstract

Objective: Socio-culturally defined identity factors present significant and often understudied influences on the experience, management, and treatment of chronic pain. For instance, there exist societal narratives about how males and females are expected to experience and express pain. Such gender roles may impact youth and caregiver openness to individual multidisciplinary treatments for pediatric headache.

Methods: In this cross-sectional study, participants (N = 1087 youth/caregiver dyads, Mage = 14.5 years, 71% female, 97% cisgender, 77% White) completed a series of questionnaires, including Openness to Headache Treatment (OHT), upon presenting for initial multidisciplinary evaluation of chronic headache. Pearson correlations, independent samples t-tests and hierarchical regressions were used to analyze potential gender differences in youth and caregiver openness, as well as its relationships with pain-related and psychological factors.

Results: Overall, female youth and their caregivers were more open to headache treatment, broadly and for individual interventions, when compared to male counterparts. Caregiver distress related to their child's headaches (i.e., fear and avoidance) was significantly correlated with openness in female youth and their caregivers, but not males.

Conclusion: Gendered patterns in healthcare decision-making in youth and caregivers provide insight on individual, societal, and systemic gender bias.

Keywords: Caregiver-child relationship; Chronic pain; Family system; Gender roles; Healthcare system; Pediatric headache; Pediatric pain; Provider-patient relationship.

MeSH terms

  • Adolescent
  • Caregivers / psychology
  • Child
  • Chronic Pain*
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Female
  • Gender Role*
  • Headache / therapy
  • Humans
  • Male
  • Sexism