title: Gender and Racial Differences in Stress, Coping, and Health-Related Quality of Life in Chronic Kidney Disease.
abstract: Living with chronic kidney disease can be stressful and influence an individual's health-related quality of life. Effective coping strategies may reduce stress and improve quality of life in individuals with chronic medical conditions.
  
  
  
  Health-related quality of life (HRQOL) is an important outcome for patients living with chronic kidney disease (CKD), and it is necessary to better understand potential gender and racial differences and predictors associated with reduced HRQOL, so that effective interventions can be developed.
  
  
  
  Participants included 182 patients with CKD who were administered a battery of questions that included the Medical Outcomes Study Short-Form 36, Perceived Stress Scale, and the Brief COPE. Demographic and disease-specific information was abstracted from the patients' medical record.
  
  
  
  No differences by race were observed with regard to stress, quality of life, or coping with the exception that minority patients reported use of religious coping more often (P = 0.001) and had higher levels of energy compared with nonminority patients with CKD (P = 0.27). Women with CKD tended to use self-distraction (P = 0.002), positive reframing (P = 0.035), venting (P = 0.024), and religious coping (P = 0 < 0.001) more often than men. No significant differences in perceived stress or domains of quality of life were observed between men and women with CKD. A link between coping strategies and HRQOL was observed in women (P = 0.001-0.02) but not men. Perceived stress was associated with poorer quality of life for men (P = 0.017 to <0.001) and women (P = 0.001 to <0.001), but more domains of men's quality of life were affected by perceived stress compared with women.
  
  
  
  The findings of the study suggest that the wider range of coping strategies used by women may be associated with buffering the link between perceived stress and quality of life. Men with CKD may benefit from interventions that not only reduce stress but also facilitate the use of a broader range of coping strategies to reduce stress and improve quality of life.
authors.affiliation: Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Leigh A
authors.initials: LA
authors.lastname: Gemmell
authors.affiliation: Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, Pennsylvania, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Terhorst
authors.affiliation: Department of Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Manisha
authors.initials: M
authors.lastname: Jhamb
authors.affiliation: Department of Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Unruh
authors.affiliation: Department of Medicine and Psychiatry, University of Pittsburgh, School of Medicine, and Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Myaskovsky
authors.affiliation: Department of Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Kester
authors.affiliation: Department of Surgery, Psychiatry, and Psychology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. Electronic address: steeljl@upmc.edu.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Steel
mesh_terms: D000223:Adaptation, Psychological; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000523:psychology*; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology*
keywords: Health-related quality of life; chronic kidney disease; coping; gender; stress