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. 2025 Feb 15;45(3):52.
doi: 10.1007/s00296-025-05805-7.

Gender differences in illness acceptance and coping strategies among patients with rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis: a cross-sectional survey study

Luise Holberg Lindgren  1 , Nanna Maria Hammer  2   3 , Caroline A Flurey  4 , Kim Vilbæk Jensen  2   5 , Lena Andersen  2   5 , Bente Appel Esbensen  2   6
Affiliations

Gender differences in illness acceptance and coping strategies among patients with rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis: a cross-sectional survey study

Luise Holberg Lindgren et al. Rheumatol Int. .

Abstract

This study aimed to investigate potential gender differences in illness acceptance and coping strategies in patients with inflammatory arthritis (IA). Furthermore, the study aimed to identify factors associated with illness acceptance and coping strategies specific to men and women. A cross-sectional nationwide survey design was applied. Illness acceptance was measured by using the Acceptance of Illness Scale and coping was measured by using the Medical Coping Modes Questionnaire. Descriptive statistics were used to explore gender differences in illness acceptance and coping strategies in patients with IA, while logistic regression analyses investigated associated factors. The study included 664 participants (85.1% women) with a mean age of 50 and median disease duration of 10 years. Diagnoses included 53.3% rheumatoid arthritis, 27.1% psoriatic arthritis, and 19.6% axial spondyloarthritis. A statistically significant difference was found between men and women in use of avoidance (P = 0.015). Higher illness acceptance was associated with tertiary education in men (OR: 3.90) and older age in women (OR: 1.35 per 10 years). Women with higher disease activity used confrontation more (OR: 1.64) than women with less activity. Men relied more on avoidance when facing psychological distress (OR: 1.29) or severe fatigue (OR: 1.31), as did women with high disease activity (OR: 2.09). Acceptance-resignation was linked to higher disability and psychological distress in men (OR: 1.32 and 1.52) and higher disease activity in women (OR: 2.09). We identified factors associated with illness acceptance and coping strategies among IA patients. Gender-sensitive approaches are needed to address specific factors influencing illness acceptance and coping in men and women.

Keywords: Arthritis; Coping; Cross-sectional studies; Female; Illness acceptance; Male; Patient-reported outcome measures; Surveys and questionnaires.

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Conflict of interest statement

Declarations. Ethical approval: This study was approved by the Danish Ethics Committee of the Capital Region (reference number 16016528) on the 3 of February 2016. The questionnaire was completed fully anonymously without collecting any personally identifiable information. The principles of the Declaration of Helsinki were followed. Consent for publication: Not applicable. Patient consent: Consent to participate was given by completing the questionnaire. No part of this manuscript has been previously posted online or published in any form. However, an abstract based on this study was presented as a poster at the EULAR Conference in 2017 (SAT0723-HPR).Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third-party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ . Competing interests: The study was supported by grants from the Danish Rheumatism Association (R141-A4016). The funder had no role in the design of the study or the collection, analysis, and interpretation of data in writing the manuscript.

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