Horizon 2020 SwafS-17-2016 The ethics of informed consent in novel treatment including a gender perspective Grant Agreement No: 741856 Project acronym: I-Consent Project title: Improving the guidelines of informed consent, including vulnerable populations, under a gender perspective Deliverable D1.2 Report on gender and age-related issues associated with the acquisition of informed consent. Nature:a R Dissemination level :b PU Due date of delivery : OCT-2017 Actual date of delivery : Document version : v 0.1 Responsible partner & Jaime Fons-Martínez (FISABIO) authors: Cooperating partner & Javier Diez-Domingo (FISABIO) authors: Fernando Calvo Rigual (FISABIO) Cristina Ferrer Albero (UCV) María Cubillo Diaz-Valdes (GSK) Revision: UNESCOBIOCHAIR, SPARKS&CO a R = Report, DEM = Demonstrator, prototype, DEC = Websites, press & media actions, videos, OTHER = Software, technical diagram, etc b PU = Public, CO = Confidential, restricted under conditions set out in Model Grant Agreement This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 741856. Document Information Contract Number 741856 Acronym I-Consent Full title Improving the guidelines of Informed Consent, including vulnerable populations, under a gender perspective Deliverable Number D1.2 Name Report on gender and age- related issues associated with the acquisition of informed consent. Task Number 1.2 Name Gender and age-related issues associated with the acquisition of informed consent. Work package Number WP1 Name Review and analysis Date of delivery Contractual 31/10/2017 Actual 30/10/2017 Nature R (Report) DEM (Demonstrator/Prototype) DEC (Websites, press & media actions, videos) OTHER (software, technical diagram) Dissemination Level PU CO Project Coordinator FISABIO (contact person) Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana Avenida de Cataluña, 21. 46020 Valencia, Spain. Javier Diez-Domingo [email protected] Project Officer Zakaria BENAMEUR 2 I-Consent Project Consortium P1 Fundacion Para el Spain Fomento de la Investigacion Sanitaria y Biomedica Dela Comunitat Valenciana FISABIO P2 Ateneo Pontificio Italy Regina Apostolorum UNESCOBIOCHAIR P3 Libera Universita Italy Maria ss. Assunta di Roma LUMSA P4 Glaxosmithkline SA Spain GSK P5 Synectika Research United and Consulting LTD Kingdom SYNECTIKA P6 Sparks & Co France SPARKS&CO P7 Meningitis Research United Foundation Kingdom MRF P8 Ospedale Pediatrico Italy Bambino Gesu OPBG 3 Revision History Revision Action Date List of changes Author Responsible V0.0 16/10/2017 None: first draft 4 Table of contents Document Information ................................................................................................................... 2 I-Consent Project Consortium .......................................................................................................... 3 Revision History ........................................................................................................................... 4 EXECUTIVE SUMMARY .................................................................................................................... 9 TABLE OF MAIN RESULTS .............................................................................................................. 12 Task description ............................................................................................................................. 13 A. GENDER ISSUES ASSOCIATED WITH THE ACQUISITION OF INFORMED CONSENT: GENDER DIFERENCES IN COMMUNICATION. ............................................................................................. 14 A.1. Introduction ........................................................................................................................ 14 A.2. Sex vs gender ...................................................................................................................... 17 A.3. Theoretical bases to the differences in the pattern of communication by gender: ...... 19 A.3.1 Introduction ................................................................................................................ 19 A.3.2 Main paradigms .......................................................................................................... 21 A.3.2.1 The deficit model ................................................................................................ 21 A.3.2.2 Dominance approach ......................................................................................... 22 A.3.2.3 Difference theory ................................................................................................ 23 A.3.2.4 Diversity, constructivist and performative approaches .................................... 24 A.3.3 Linguistic style accommodation ................................................................................. 26 A.4. Differences in the patters of communication by gender ................................................. 29 A.4.1 Motivation to communicate ...................................................................................... 29 A.4.2 Main characteristics of the different styles of communication ............................... 30 A.4.2.1 The gendered styles: the reflection of differences of role. The “report talk” and the “rapport talk”. .......................................................................................................... 33 A.4.2.2 Constructing the discourse ................................................................................ 34 A.4.2.3 Telling a story ...................................................................................................... 34 A.4.2.4 Telling jokes ......................................................................................................... 35 A.4.2.5 Gossip and “sport-talk” ....................................................................................... 35 A.4.2.6 Choosing a topic .................................................................................................. 36 A.4.2.7 Talking about troubles: “trouble talk” ............................................................... 36 A.4.2.8 Minimal responses .............................................................................................. 37 5 A.4.2.9 Hedges ................................................................................................................. 37 A.4.2.10 Silent, interruption and overlapping .................................................................. 37 A.4.2.11 Asking questions ................................................................................................. 38 A.4.2.12 Paralanguage: prosody ....................................................................................... 39 A.4.2.13 Vocabulary ........................................................................................................... 39 A.4.2.14 Politeness ............................................................................................................ 40 A.4.2.15 Compliments ....................................................................................................... 40 A.4.2.16 Non-verbal communication ................................................................................ 41 A.4.2.17 Written................................................................................................................. 43 A.5. Gender differences in skills................................................................................................ 47 A.5.1 Gender differences in scholars: the PISA survey ...................................................... 47 A.5.1.1 Other contributions to this topic ....................................................................... 48 A.5.2 Gender differences in adults: the survey of adults skills (PIAAC)............................. 49 A.5.3 Differences in gender comprehension of IC by gender ............................................ 50 A.6. Online gender differences ................................................................................................. 53 A.6.1 Gender differences in online communication .......................................................... 53 A.6.2 Gender differences in online shopping ..................................................................... 54 A.6.3 Gender differences in social networking sites .......................................................... 55 A.6.4 Gender differences in smartphone and texting ........................................................ 57 A.6.5 Gender differences in eye tracking ........................................................................... 58 A.7. The patient - physician communication............................................................................ 61 A.7.1 Why is important? ...................................................................................................... 61 A.7.2 Gender differences in the relationship physician-patient ........................................ 62 A.7.2.1 Physicians communication ................................................................................. 63 A.7.2.2 Patient communication ...................................................................................... 64 A.7.2.3 Gender concordance and communication ........................................................ 66 A.7.2.4 Accommodation in physician-patient communication ....................................