Abstract
Gender-sensitive care (GSC+) is a key component of personalized medicine and essential for ensuring quality and equity in cardiovascular care. By integrating biological, social, and cultural dimensions of gender as well as diversity-related factors, GSC + can enhance diagnostic accuracy and therapeutic effectiveness. Although cardiovascular guidelines increasingly incorporate sex- and gender-specific recommendations, little is known about physicians' awareness, knowledge, and the extent to which GSC + is implemented in practice. This study aimed to assess physicians' gender sensitivity, knowledge of sex- and gender-specific guideline content, and the perceived implementation of GSC+ in inpatient cardiology settings. A cross-sectional online survey was conducted among physicians working in German inpatient cardiology wards (n = 155). The questionnaire assessed gender sensitivity (N-GAMS), knowledge of sex- and gender-specific cardiovascular guideline content, and perceived implementation of in clinical practice. Descriptive, correlational, and regression analyses were performed. Physicians demonstrated high gender sensitivity (M = 3.95, SD = 0.73) and moderate-to-high knowledge of guideline content (M = 0.63, SD = 0.08). Specific knowledge gaps were identified. The perceived implementation of GSC+ in clinical practice was rated as moderate to low (M = 2.45, SD = 0.59). Higher knowledge levels were observed among physicians working in university hospitals, while differences in gender sensitivity were observed with respect to country of birth. Importantly, no significant relationships were found between gender sensitivity, knowledge, and perceived implementation, indicating a disconnect between awareness, knowledge, and clinical application. The findings indicate a gap between existing scientific evidence and its translation into practice. While physicians exhibit high awareness and adequate knowledge, this does not consistently translate into implementation. This discrepancy underscores structural and systemic barriers to integrating GSC+ into care. Strengthening the systematic incorporation into clinical guidelines, medical education, and institutional quality frameworks may enhance implementation, reduce diagnostic and therapeutic disparities, and promote more equitable, evidence-based cardiovascular care.