Genom genuslinser Om patienters jämställdhet i tillgång till operation av gråstarr i Sverige

Sammanfattning: Aim: The aim was to examine waiting times for cataract extraction in Sweden from an intersectional gender perspective; quantitative with regard to waiting times for different patient groups, and qualitative in order to identify factors that might contribute to gender differences in waiting time. Furthermore, the aim was to examine implications of critical realism and situated knowledges for studies of gender differences among patients regarding access to cataract extraction and more generally as grounds for studies of (in)equity in care. Methods: Studies I and II were register studies, and linear regression was performed in Study I and logistic regression in Study II. Mean waiting times for female and male patients were calculated in both studies. In Study III, focus group interviews were conducted at two eye clinics with differences in gender-related waiting times. The analysis method used was constructivist grounded theory, and text analyses were performed in Study IV. Main findings: Longer waiting times were associated with patients who were female, retired, of higher age, born outside the Nordic countries, having lower income, lacking education at university level and not being categorized by means of NIKE. Female patients had longer waiting time in all categories.The following factors might contribute to why female patients have longer waiting times: Traditional male occupations were constructed as being more demanding for visual acuity, while the need for good visual acuity in women’s work life was questioned; Assertive behaviour among men was explained in legitimizing ways; Behaviour among men with poor vision was constructed as safety risks in relation to driving and hunting. Concerning meta-theoretical aspects, both critical realism and situated knowledges can be fruitful for studies of (in)equity in care but are to some degree incompatible with each other. Conclusions: Differences in waiting times at eye clinics can be related to gender constructions. The prevailing pattern of female cataract patients systematically having longer waiting time than male patients that emerges in this thesis is noteworthy in relation to the principle of equity in care. Furthermore, it is noteworthy that waiting times were related to age, retirement, and native country as well as income and education levels.