Chapter 3 50 from ‘this situation did not occur’ to ‘very troublesome’. A social stressors score was calculated, summarizing statements about loss of social contacts, cancellation of social events and tension or conflict at home, and a care stressors score, summarizing statements about problems with access to care, medication and nursing. Two additional COVID-19 stressors, regarding COVID-19 symptoms and physical activity and relaxation, were not included in the sub scores, but were summed up in the stressors sum score including all eight items. A detailed description of the questionnaire can be found in Supplement A. Statistical analysis We performed descriptive statistics on the participants demographic and gender dimension variables. Differences between demographic, gender related data with sex assigned at birth and gender identity were compared using Kruskal-Wallis rank sum test or the Fisher exact test. For univariate and multivariate regression analyses of gender dimensions and HRQoL, self-reported gender identity was included as a proxy for the dimension of gender identity, gender role orientation (BSRI) for the dimension of gender roles and household task division and relative income for the dimension of gender relations. Living situation included a dichotomous measure of being married/living with a partner or not and was used as a determinant for private gender relations. Therefore, only participants that indicated that they were married/living together with a partner were included in the analyses related to gender relations. The association between 1) gender identity (self-reported gender identity) and HRQoL (PDQ-SI scores), 2) gender role orientation (BSRI score) and HRQoL and 3) gender relations (household task division and relative income) and HRQoL was determined using multiple linear regression, which were adjusted for age, clinical disease duration and COVID-19 stressors. A multiplicity adjusted P-value < 0.0127 indicated statistical significance for the PDQ-SI scores. Statistical analyses were performed using R Studio Version 1.1.463. The data that support the findings of this study are available from the corresponding author upon reasonable request.
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