Elsevier

Heart & Lung

Volume 35, Issue 2, March–April 2006, Pages 130-136
Heart & Lung

Issues in pulmonary nursing
Gender difference in coping strategies among patients enrolled in an inpatient rehabilitation program

https://doi.org/10.1016/j.hrtlng.2005.09.004Get rights and content

Background

Previous research has not addressed gender differences in coping strategies among patients with mild to moderate chronic obstructive pulmonary disease (COPD) who are enrolled in inpatient and multidisciplinary rehabilitation programs.

Methods

The coping strategies of 182 consecutive patients (61 women aged 61.1 years; 121 men aged 62.7 years) with mild to moderate COPD were assessed on admission and then at discharge after 29 days of pulmonary rehabilitation, using the Coping Inventory for Stressful Situations. A one-way analysis of variance for repeated measures was used to test the differences in coping scores.

Results

During the rehabilitation program, problem-focused strategies increased (+2.54 [95% confidence interval: 1.41–3.67] with F = 23.77, P < .0001), emotion-focused strategies decreased (−2.75 [95% confidence interval: −4.06, −1.45], F = 15.37, P < .001), and avoidance strategies were differently (t = 2.97, P < .05) influenced in women (+2.43 [95% confidence interval: .66–4.19]) compared with men (−1.30 [95% confidence interval: −2.82–.22]). The prevalence of COPD in women is increasing, and rehabilitation professionals need a greater awareness of how women cope differently than men with this disease.

Section snippets

Participants

Patients with COPD entered the study on admission to the inpatient pulmonary rehabilitation center. Criteria for inclusion were diagnosis of COPD according to American Thoracic Society guidelines,2 age between 40 and 80 years, and ability to read in French. A patient was defined as having stable disease if he or she had had no change in symptoms or medication for 2 months before entry.2 A total of 182 patients with mild to moderate COPD, 61 women and 121 men, took part in this study. Nineteen

Results

Overall scale scores returned internal consistency reliabilities using Cronbach’s alpha. The alpha coefficients for the present study were .90, .83, and .85, respectively. The principal components factor analysis with varimax rotation showed excellent coefficients for each dimension (problem-focused: .46–.74; emotion-focused: .42–.75; avoidance strategies: .41–.74), which explained 39.9% of the variance. The questionnaire measures independent and consistent dimensions.

For the problem-focused

Discussion

The aim of the study was to explore coping strategies among males and females with mild to moderate COPD in an inpatient rehabilitation program. The results showed a difference between men and women with mild to moderate COPD regarding coping strategies. Compared with the men, the women used fewer problem-focused strategies and more emotion-focused strategies.

This gender difference regarding coping strategies could be explained by findings that women generally show higher anxiety than men,26, 27

Conclusion

Our study described relationships between a program of intensive inpatient rehabilitation session and coping styles in patients with mild to moderate COPD. The results suggest that a program improves the use of problem-focused strategies, decreases reliance on emotion-focused strategies, and influences the use of avoidance strategies differently in men and women. Randomized controlled trials are needed to confirm these changes, which were probably the result of rehabilitation programs. The

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