Background There is an increasing focus on how patients with inflammatory arthritis (IA) manage living with arthritis. There are a preponderance of women with RA (70%), thus previous research has overall focused on female patients and their management. Research in other long term conditions suggests men need their own health strategy1, thus it is important to investigate whether there are gender differences in coping strategies and illness acceptance within chronic IA.
Objectives To explore gender differences in IA as reflected by coping strategies and illness acceptance. Furthermore, to identify factors associated with high degree of illness acceptance.
Methods The study was conducted as a nationwide cross-sectional study using online survey during 2016. Patients >18 with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) were invited to contribute through: The Danish Rheumatism Organization, local arthritis networks, diagnosis networks, and rheumatology departments across the country. The self-report online questionnaire comprised Socio-demographics, Diagnosis, Symptoms (pain, fatigue, global), Medications, Disease Activity, Functional Status, Coping (i.e. confrontation, avoidance and acceptance-resignation) and Illness Acceptance. As recommended by EULAR 2 patients with RA (KVJ & LA; male and female, respectively), were included as equal research partners in all phases of the study. Descriptive statistics were applied to explore gender differences, and logistic regression analyses were performed to test for factors associated with illness acceptance.
Results In total, 664 (85% women) were included in the study; RA 53%, PsA 27% and axSpA 20%. More men (40%) than women (30%) were treated with biological DMARDS (p=0.048). No significant gender differences were found in disease activity, symptoms and functional status. Overall, the total sample had high degree of illness acceptance and no significant difference was found between males and females. Regarding illness coping, women with IA tend to use avoidance as a coping strategy significantly more than men (p=0.015). In the final multivariable regression model, higher education (OR=1.46; 1.02–2.11), longer time diagnosed (OR=1.21 per 1-yr. increase; 1.01.-1.05), lower physical disability (OR=0.76; 0.69–0.85), better coping with fatigue (OR=1.13; 1.05–1.22), less avoidance (OR=0.93; 0.87–0.99) and acceptance-resignation (OR=0.62; 0.62–0.75) as coping strategies were significantly associated with high degree of illness acceptance.
Conclusions No significant differences were found in illness acceptance among women and men with IA. However, women tended to use avoidance as a coping strategy more than men. High levels of illness acceptance may be explained by high education, longer disease duration, and better physical function, better coping of fatigue and less use of passive coping strategies.
White A, McKee M, Richardson N, et al. Europe's men need their own health strategy. BMJ 2011;343:d7397.
Disclosure of Interest None declared