French Cynthia T, Fletcher Kenneth E, Irwin Richard S
Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Chest. 2004 Feb;125(2):482-8. doi: 10.1378/chest.125.2.482.
To confirm that more women than men who complain of chronic cough seek medical attention, to determine whether the health-related quality of life (HRQOL) of these women is more adversely affected than men, and to determine whether there are gender differences in the ways that chronic cough adversely affects HRQOL.
Analysis of previously, prospectively collected data, but not previously analyzed or reported data, plus additional prospectively collected data to enrich the database to make meaningful gender comparisons.
Cough clinic in an academic, tertiary care medical center.
Subjects seeking medical attention complaining of cough of at least 8 weeks duration and a control group of smokers not complaining of cough.
Assessment of chronic cough on HRQOL utilizing a valid and reliable cough-specific HRQOL instrument, the cough-specific quality-of-life questionnaire (CQLQ).
All subjects completed the CQLQ prior to any contact with the cough specialist and medical intervention.
In the original cohort of subjects, women (116 subjects) outnumbered the men (38 subject) by 3:1 (p < 0.0001). In the current study, total CQLQ scores for women were higher than for men (67.1 vs 59.7, respectively; p = 0.002). Women had higher scores than men in three of six subscales, as follows: physical complaints (21.6 vs 19.0, respectively; p = 0.004); psychosocial issues (14.7 vs 12.9, respectively; p = 0.002); and extreme physical complaints (8.9 vs 6.6, respectively; p < 0.001). Men and women had similar scores on the remaining subscales. Women scored significantly higher on 10 of the 28 items that make up the six subscales. The item that showed the greatest disparity and the most significant difference between women and men was wetting the pants (p < 0.001) as a result of chronic coughing.
Women with chronic cough were probably more inclined to seek medical attention than men because their HRQOL was more adversely affected and because they were more apt to suffer from physical complaints such as stress incontinence, which provoked psychosocial issues such as becoming embarrassed.
确认因慢性咳嗽而寻求医疗帮助的女性多于男性,确定这些女性的健康相关生活质量(HRQOL)是否比男性受到更严重的负面影响,并确定慢性咳嗽对HRQOL产生不利影响的方式是否存在性别差异。
分析之前前瞻性收集的数据,但此前未进行分析或报告的数据,再加上额外前瞻性收集的数据以丰富数据库,从而进行有意义的性别比较。
一所学术性三级医疗中心的咳嗽诊所。
因咳嗽至少持续8周而寻求医疗帮助的受试者,以及一组不抱怨咳嗽的吸烟对照组。
使用有效且可靠的咳嗽特异性HRQOL工具——咳嗽特异性生活质量问卷(CQLQ),评估慢性咳嗽对HRQOL的影响。
所有受试者在与咳嗽专科医生接触和进行医疗干预之前完成CQLQ。
在最初的受试者队列中,女性(116名受试者)与男性(38名受试者)的人数比为3:1(p<0.0001)。在当前研究中,女性的CQLQ总得分高于男性(分别为67.1和59.7;p = 0.002)。在六个子量表中的三个方面,女性得分高于男性,具体如下:身体不适(分别为21.6和19.0;p = 0.004);心理社会问题(分别为14.7和12.9;p = 0.002);以及严重身体不适(分别为8.9和6.6;p<0.001)。在其余子量表上,男性和女性得分相似。在构成六个子量表的28个项目中,女性在10个项目上得分显著更高。在女性和男性之间差异最大且最显著的项目是因慢性咳嗽导致的尿湿裤子(p<0.001)。
患有慢性咳嗽的女性可能比男性更倾向于寻求医疗帮助,因为她们的HRQOL受到更严重的负面影响,并且她们更容易出现如压力性尿失禁等身体不适,这引发了如尴尬等心理社会问题。