title: Coping strategies, satisfaction with life, and quality of life in Crohn's disease: A gender perspective using structural equation modeling analysis.
abstract: OBJECTIVE
  To identify coping strategies and socio-demographics impacting satisfaction with life and quality of life in Crohn's disease (CD).
  
  
  METHODS
  402 patients completed the Patient Harvey-Bradshaw Index, Brief COPE Inventory, Satisfaction with Life Scale (SWLS), Short Inflammatory Bowel Disease Questionnaire (SIBDQ). We performed structural equation modeling (SEM) of mediators of quality of life and satisfaction with life.
  
  
  RESULTS
  The cohort comprised: men 39.3%, women 60.1%; P-HBI 4.75 and 5.74 (p = 0.01). In inactive CD (P-HBI≤4), both genders had SWLS score 23.8; men had SIBDQ score 57.4, women 52.6 (p = 0.001); women reported more use of emotion-focused, problem-focused and dysfunctional coping than men. In active CD, SWLS and SIBDQ scores were reduced, without gender differences; men and women used coping strategies equally. A SEM model (all patients) had a very good fit (X2(6) = 6.68, p = 0.351, X2/df = 1.114, SRMR = 0.045, RMSEA = 0.023, CFI = 0.965). In direct paths, economic status impacted SWLS (β = 0.39) and SIBDQ (β = 0.12), number of children impacted SWLS (β = 0.10), emotion-focused coping impacted SWLS (β = 0.11), dysfunctional coping impacted SWLS (β = -0.25). In an indirect path, economic status impacted dysfunctional coping (β = -0.26), dysfunctional coping impacted SIBDQ (β = -0.36). A model split by gender and disease activity showed that in active CD economic status impacted SIBDQ in men (β = 0.43) more than women (β = 0.26); emotional coping impacted SWLS in women (β = 0.36) more than men (β = 0.14).
  
  
  CONCLUSIONS
  Gender differences in coping and the impacts of economic status and emotion-focused coping vary with activity of CD. Psychological treatment in the clinic setting might improve satisfaction with life and quality of life in CD patients.
authors.affiliation: Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Sarid
authors.affiliation: Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: V
authors.initials: V
authors.lastname: Slonim-Nevo
authors.affiliation: Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Pereg
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Friger
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Schwartz
authors.affiliation: Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Greenberg
authors.affiliation: Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Shahar
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Chernin
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: H
authors.initials: H
authors.lastname: Vardi
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Eidelman
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Segal
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Ben-Yakov
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Gaspar
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Munteanu
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Rozental
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Mushkalo
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: V
authors.initials: V
authors.lastname: Dizengof
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Abu-Freha
authors.affiliation: Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Fich
authors.affiliation: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Odes
mesh_terms: D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010549:Personal Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult