Perceptions of health‐related quality of life of men and women living with coeliac disease

Abstract

Women with long-standing coeliac disease express poorer health-related quality of life (HRQoL) than men do for unclear reasons. This led us to explore differences in their understanding of HRQoL using a phenomenographic approach. We interviewed 10 coeliac subjects (mean age 57 years, range 35-73) who had been on a gluten-free diet for 10 years and had scored either high or low in the Short Form 36 Health Survey (SF-36) General Health and Vitality scales. Three dimensions were revealed that pertained to their perception of HRQoL: bodily sensations, social consequences and coping strategies. Within these, the women experienced more bowel symptoms than men did, despite keeping to a strict diet. This item was the only one predicting the SF-36 scores. The women also described more distress caused by the restrictions in daily life, closely related to their controlling of food contents. The coeliac men took advantage of using a problem-oriented coping approach while the women seeking an emotionally oriented strategy showed less satisfaction with the outcome. We conclude that the intriguing difference in HRQoL between coeliac men and women may have some of its origin in the way living with the disorder is conceptualized and coped with. The results imply that in the management of coeliac patients, gender-related aspects need to be taken into account to improve treatment outcome.

Reduced quality of life in coeliac disease is more strongly associated with depression than gastrointestinal symptoms

“…; medical (e.g., gastrointestinal symptoms, whereby more severe symptoms are associated with poorer QOL) (22)(23)(24)(25)(26)(27); and dietary (e.g., GFD adherence, whereby poorer adherence is associated with poorer QOL; and perceived difficulty of adherence, which was also associated with poorer QOL) (23,(28)(29)(30) aspects of the disease. While these factors are important for QOL, one area that has received less attention is psychological symptoms and coping, despite higher rates of psychological symptoms within CD patients compared to the general population (16,(31)(32)(33)(34)(35)(36).…”

Comparações de medidas de qualidade de vida entre mulheres e homens em hemodiálise

“…Além de informar sobre o impacto do tratamento no bem-estar dos pacientes, a avaliação da QVRS ajuda a identificar aqueles com risco maior de eventos adversos [2][3][4][5] . Os resultados de diversos estudos sugerem que, no curso de determinadas doenças, as mulheres são mais afetadas do que os homens na QVRS [6][7][8][9][10] . Os dados do DOPPS, um estudo em pacientes tratados cronicamente por hemodiálise em diversos países, também indicam que as mulheres apresentam menores níveis no aspecto físico de QVRS e maior incômodo devido a sintomas de insuficiência renal do que os homens, independente do efeito de um grande número de co-variáveis 5 .…”

Coeliac Disease in Later Life: An Interpretive Phenomenological Analysis

“…These themes, and associated subthemes, are presented in order to provide insights into psychosocial issues considered to be specific to older people. Themes like those reported by younger individuals also arose [33][34][35][36][37][38], but are not reported.…”

“…Using IPA, participants were invited to describe their lived experiences and an analysis of the data enabled us to draw themes specific to a diagnosis later in life and to issues experienced by older people specifically. Three superordinate themes emerged, each with associated subthemes and although the reported extracts only denote themes deemed relevant to a later life diagnosis, common themes to a CD diagnosis for adults in general were also identified [33][34][35][36][37][38]. Our interaction with the data suggests that the diagnosis and management of CD later in life is complicated, at least in part, by older adult specific considerations, including fears about being diagnosed with a "more serious or life threatening illness" more commonly seen in later life (e.g., cancer), delayed help seeking, poorer engagement with available support systems, and reduced confidence in maintaining adequate self-care if appropriate support were unavailable.…”

“…An appropriate starting point, therefore, would be to employ qualitative methods. Until now, qualitative research in individuals with CD has focused on understanding the experiences of younger people [33][34][35][36][37][38]. Indeed, a broad literature search indicated that there are, to our knowledge, no published studies applying a qualitative method to better understand CD in older adults.…”