Older women's health priorities and perceptions of care delivery: results of the WOW health survey

BackgroundAs women get older, their health priorities change. We surveyed a sample of older Canadian women to investigate what health priorities are of concern to them, their perceptions about the care delivered to address these priorities and the extent to which priorities and perceptions of care differ across age groups and provinces.MethodsThe WOW (What Older women Want) cross-sectional health survey was mailed in October 2003 to 5000 community-dwelling women aged 55–95 years from 10 Canadian provinces. Women were asked questions on 26 health priorities according to the World Health Organization''s International Classification of Functioning, Disability and Health, and their perceptions of whether these priorities were being addressed by health care providers through screening or counselling. Differences in priorities and perceptions of care delivery were examined across age groups and provinces.ResultsThe response rate was 52%. The mean age of the respondents was 71 (standard deviation 7) years. The health priorities identified most frequently by the respondents were preventing memory loss (88% of the respondents), learning about the side effects of medications (88%) and correcting vision impairment (86%). Items least frequently selected were counselling about community programs (28%), counselling about exercise (33%) and pneumonia vaccination (33%). Up to 97% of the women recalled being adequately screened for heart disease and stroke risk factors, but as little as 11% reported receiving counselling regarding concerns about memory loss or end-of-life issues. Women who stated that specific priorities were of great concern or importance to them were more than twice as likely as those who stated that they were not of great concern or importance to perceive that these priorities were being addressed: osteoporosis (odds ratio [OR] 2.6, 95% confidence interval [CI] 2.1–3.2), end-of-life care (OR 2.6, 95% CI 2.0–3.4), anxiety reduction (OR 2.2, 95% CI 1.8–2.6), fall prevention (OR 2.1, 95% CI 1.6–2.7), stroke (OR 2.1, 95% CI 1.4–3.0), depression (OR 2.1, 95% CI 1.7–2.7) and urinary incontinence (OR 2.1, 95% CI 1.7–2.5). The respondents'' perceptions of care delivery varied across age groups and provinces.InterpretationAccording to the perceptions of surveyed women, health care providers are addressing many, but not all, of their health concerns, especially those that are of great concern or importance to these women.As women''s life expectancy increases, physicians are confronted with the challenge of treating an elderly population that is predominantly female and has a variety of health priorities and needs. Older women face functional, psychological and social difficulties in addition to health-related conditions. One solution to align care more closely with women''s health priorities is to practise patient-centred care, whereby clinical decision-making is focused primarily on the priorities and preferences of individual patients.^1,2,3 Data on older women''s health priorities are scarce,^4,5,6 and understanding the gamut of their concerns is important for directing patient-centred, priority-driven agendas. The WOW — What Older women Want — health survey was conducted to determine health priorities of older Canadian women and the extent to which women perceive that their priorities are being addressed by health care professionals.