Sex and Gender in Multidisciplinary PD Care 31 2 Gender aspects in coping and informal care Several differences in care management between men and women with PD have been reported. In this section, we discuss two examples that highlight the potential impact of such differences on multidisciplinary care for people with PD: coping strategies and informal care. Gender can influence individual coping strategies and should be taken into account in systematically measuring differences in distress and coping.(43) General studies on gender differences coping strategies are conflicting. Some authors report that women use more emotion-focused coping strategies while men prefer focusing on avoidant coping.(60,61) However, a study targeting coping strategies among people with PD reported the opposite, with women reporting more problem-focused coping strategies compared to males.(10) Interestingly, less polarized gender roles might associate with better quality of life in women. Specifically, androgynous women with PD, expressing masculine and feminine personality traits equally, scored significantly better on quality of life than androgynous men with PD.(62) Similar to the impact of gender roles on the response to negative life events in the context of depression, clinicians should be aware of the potential impact of gender roles on (in)effective coping strategies. Additionally, researchers should continue to explore the impact of different gender dimensions on coping strategies and health-related quality of life in people with PD. In the context of informal care, women with PD report less social support and less informal caregiving resources compared to men.(8) Women worldwide are still more frequently active caregivers than men, although this is changing in younger generations.(63) Previous studies describe fewer negative outcomes and less impaired quality of life in male caregivers.(64,65) Women caregivers reported exhaustion, social constraints and time limitations more frequently than men and women report more adverse consequences from the progression of the disease of their partners, such as feelings of manipulation, excessive demands and lack of freedom.(38) One study noted that women caregivers appeared to experience a higher incidence of depression and dysfunctional fear of progression compared to men caregivers(66), but another failed to find any gender differences in psychological, social and health outcomes.(67) Progression of disease and the potentially associated cognitive decline, which is higher in men with PD compared to women, also places a higher burden on caregivers with potential impact on their health.(14,68–71)
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