Apr. 8, 1998 ATHENS, Ohio -- A new study by researchers at Ohio University suggests women are more likely than men to use coping strategies such as relaxation to deal with arthritic pain and also are better at decreasing the emotional impact of severe pain on their lives.
For the study, 48 men and 99 women diagnosed with either osteoarthritis or rheumatoid arthritis were asked to keep a daily log of their activities. For 30 consecutive days, participants recorded the amount of pain they experienced and their response to the pain. During their project, the researchers found that women employed a variety of coping mechanisms, including relaxation, distraction and seeking emotional support from others when they had pain, says Francis Keefe, professor of health psychology at Ohio University and principal investigator on the project.
"The study suggests women may be better at regulating the emotional aspect of pain and therefore able to limit its emotional consequences," Keefe says.
The study, supported by the National Institutes of Health, will be presented April 8 at a conference entitled "Gender and Pain: A focus on how pain impacts women differently than men." Keefe is one of 30 presenters at the meeting in Bethesda, Md., April 7-8, which is sponsored by the NIH Pain Research Consortium, a group representing 22 NIH institutes and centers.
None of the female study participants had taken part in formal coping skills training prior to the study's onset, Keefe says. The techniques the women used -- relaxation, distraction techniques, looking at the pain in a different light, seeking emotional support -- were developed on their own.
"On days when women experienced high pain, they were much more likely to use emotion-focused coping," Keefe says. "And, on the days after these high-pain days, men were much more likely to report that their mood was poor. However, women did not show this pattern."
The research also found that female patients reported more joint pain than men.
"Certainly, in our society, we're taught to act in certain ways," Keefe says. "Men don't show their feelings and don't seek out assistance as readily as women. That may very well be what's going on in this case."
His findings are important for clinicians who treat arthritis patients, Keefe says, because it suggests male patients may need more coping skills training.
In addition to these study findings, Keefe will present research results from two studies of spousal response to patients suffering from osteoarthritis.
In a study of 48 osteoarthritis patients and their spouses, the researchers videotaped the couples as they performed regular household tasks, such as sweeping the floor.
"In the patients, we were looking for signs that the patient was hurting," Keefe says. "In spouses, we wanted to see how they responded to the pain their husbands or wives were experiencing."
Researchers found that husbands and wives tended to do these tasks together. Women who had arthritis, however, reported more pain during the tasks. The husbands of these women were more likely to encourage and support their partner and less likely to take over the tasks themselves.
"Taken together, these findings suggest that both husbands and wive may benefit from spouse-assisted training in pain control skills," Keefe says. "The fact that husbands are supportive is positive, but they also may need to learn specific techniques to help their partners deal with higher levels of pain during daily tasks."
A final study was designed to measure a spouse's ability to detect his or her partner's pain. Researchers videotaped 19 osteoarthritis patients doing daily activities, such as sitting, standing and walking. Each patient then watched the videotape and graded the pain he or she felt during each act ranging from "no pain" to "pain as bad as it can be."
In the next phase, each spouse reviewed the videotape of her or his partner, and graded their husband's or wife's pain following the same scale.
"If the spouse was a woman, she was much better at tracking her partner's pain than male spouses were at tracking their wives' pain," Keefe says. "It could be that women can pick up on their partners' pain more accurately than men. However our other study suggests that even though women may be more perceptive in detecting their partners' pain, they may need special training to help their spouses deal more effectively with that pain.
"Clinicians should be aware that there are often differences in the pain reporting of men and women, and sometimes pain therapy will need to be tailored differently according to the patient's gender," Keefe says.
The studies, funded by a $530,000 NIH grant, also suggest that involving a patient's partner in her or his therapy could improve pain management and overall quality of life for the patient. "Spousal training could be a very important key to the success of a treatment program designed to help arthritis patients deal with their pain," Keefe says.
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