Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Do Men and Women Cope Differently with Disease Impact of Rheumatoid Arthritis, and If So, Why?

Englbrecht2,  Matthias, Gossec1,  Laure, DeLongis3,  Anita, Kvien4,  Tore K., Scholte-Voshaar6,  Marieke, Sokka5,  Tuulikki, Georg2,  Schett

APHP, Rheumatology B Department, Paris Descartes University, Medicine Faculty, Paris, France
Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
Department of Psychology, University of British Columbia, Vancouver, Canada
Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
Jyvaskyla Central Hospital, Jyvaskyla, Finland
Rheumatology, VU University Medical Center and Jan van Breemen Institute, Amsterdam, Netherlands.

Background:

Coping with impact of disease is recognized as essential by RA patients(1). However, the knowledge of promising strategies to handle RA is still very limited and gender differences in coping have only been scarcely investigated. We therefore checked the use of a previously introduced 18-item questionnaire(2) during the validation process of the RAID-questionnaire(1).

Objectives:

First, to investigate the usage of coping strategies among men and women. Secondly, to find reasons for eventually occurring differences.

Methods:

We analyzed the data of 433 RA patients from 12 countries stemming from the RAID study database(1) and providing complete information on all coping items. Before the start of the validation process, two numeric rating scales asking for the extent of coping effectiveness and helplessness were added to the original coping questionnaire(2). First, we evaluated to which extent men and women are using cognitive reframing, pushing through the pain, emotional expression and active problem solving – the coping scales previously derived(2) from the questionnaire. We then addressed the question whether there are gender differences with respect to coping effectiveness and perceived helplessness. Finally, we set these results into relation to other common outcome variables measuring disease activity and health status.

Results & Conclusion:

Men (N=99) and women (N=334) had long-standing (mean disease duration, men: 10.27±9.77yrs; women:13.47±10.24yrs) and active (mean DAS28, men: 3.45±1.72; women 4.3±1.54) RA. Women made significantly more use of coping strategies when compared to men and showed a strong trend towards higher levels of perceived helplessness whereas coping effectiveness was not different.

Table 1. Descriptive data of coping scales and comparison of gender differences

 Mean ± SD (sample)Mean ± SD (stratified for gender)p ValueSignificance test
Pushing Through The Pain*1.90 ± 0.78Male1.79 ± 0.800.11t-test
  Female1.93 ± 0.77  
Active Problem Solving*1.66 ± 0.87Male1.51 ± 0.860.04t-test
  Female1.72 ± 0.87  
Cognitive Reframing*1.73 ± 0.79Male1.57 ± 0.790.03t-test
  Female1.78 ± 0.78  
Emotional Expression†1.43 ± 0.74Male1.30 ± 0.740.04t-test
  Female1.47 ± 0.73  
Helplessness†4.00 ± 2.75Male3.54 ± 2.600.06t-test
  Female4.13 ± 2.78  
Coping Effectiveness†5.65 ± 2.22Male5.64 ± 2.190.94t-test
  Female5.66 ± 2.23  
*Scale ranging from 0–3†Scale ranging from 0–10

We set these results into relation to measures of disease activity and found significantly elevated levels of the patient's and physicians evaluation of general health (VAS), the tender joint count 28, the HAQ-DI and accordingly the DAS28 in female patients (all p < 0.01). Hence, female RA patients seem to have both, a higher disease activity and worse physical functioning. Therefore, they might be urged to cope more frequently with impact of disease, while tending to feel more helpless at the same time.

References:

1Gossec, L et al, Ann Rheum Dis 2009;68(11):1680–5.

2NewthDelongis, SA. Psychology and Health. June 2004;19(3):283–305.

To cite this abstract, please use the following information:
Englbrecht, Matthias, Gossec, Laure, DeLongis, Anita, Kvien, Tore K., Scholte-Voshaar, Marieke, Sokka, Tuulikki, et al; Do Men and Women Cope Differently with Disease Impact of Rheumatoid Arthritis, and If So, Why? [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1027
DOI: 10.1002/art.28794

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