The symptom experience of women with chronic illness.
OBJECTIVE
This integrative review examined how women interpret, cope with, and manage chronic illness symptoms.


BACKGROUND
Women with chronic illness report more symptoms and poorer physical health than men. They also enter the health care system later and sicker than their male counterparts. One possible reason for their increased morbidity and mortality is gender differences in interpreting and managing symptoms.


METHODS
The inclusion criteria that guided this review were that: (a) the study was published between January 1, 1990 and December 31, 1999; (b) participants were women with at least one chronic health problem; and (c) the study addressed symptom perception, symptom evaluation, and/or symptom management. Databases were searched using women, symptoms, chronic illness, coping, and research as key words.


RESULTS
One hundred and ten published studies were reviewed, yielding 35 journal articles reporting on 32 separate studies that met the inclusion criteria. The analysis identified important gender differences in symptom experience. While studies of coping with symptoms are well represented in the literature, symptom strategies and the cultural meaning of symptoms are understudied.


CONCLUSIONS
Five categories of practice implications emerged from the data. These included physical functioning, coping, self-care, roles and relationships, and socio-cultural issues. Within each category specific directions for nursing practice were developed.
O'Neill
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College of Nursing, University of Massachusetts, Dartmouth, Massachusetts, USA. eoneill@jauanet.com
Morrow
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D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D005783:Gender Identity; D006801:Humans; D008875:Middle Aged; D015404:Nursing Methodology Research; D012648:Self Care / Q000379:methods / Q000523:psychology*; D012959:Socioeconomic Factors; D014930:Women / Q000523:psychology*; D016387:Women's Health