Multiple Gender Dimensions 59 3 Previous literature described the impact of chronic disease, and PD in particular, on identity, loss of valued social roles and the development of new ones.41,42 In living with PD, the activities that define one’s identity and social relations decline as the disease progresses, leading to a potential loss of the former gender role.41 These role changes can have an overwhelming negative impact on psychological well-being and quality of life.43 In line with this, the behaviours attributed to impulse control disorders related to dopamine replacement therapy in PD could be seen as an attempt to embolden one´s gender role. Previous studies have reported a higher prevalence of impulse control behaviours (ICB) such as hypersexuality and gambling behaviours in men, while compulsive buying appears more common among women with PD.44,45 It remains to be investigated whether these differences in behavioural expressions related to ICB are due to differences in pathophysiology or a result of socially acceptable genderrelated behaviours that reinforce gender roles. In our study population, more engagement in household tasks associated with slightly better overall health-related quality of life. More engagement might be explained by less PD-related disabilities and therefore higher HRQoL. However, unequal gender relations in household labour negatively affected the HRQoL of women more compared to men, potentially due to traditional gender relations that attribute the burden of household and informal care work mostly to women regardless of mounting PD-related disabilities.46 In line with earlier findings 47, our study suggests that relatively equal financial resources in the relationship of people with PD and their partner, slightly improved their health-related quality of life, possibly due to reduced financial stressors. Equal relative income distribution between partners/spouses could also potentially reduce financial stressors due to less dependency on a single income, which might be compromised if the person with PD is the primary provider. Study Limitations Gender assessments can contain sensitive questions and health researchers need to be mindful of the risk of social desirability bias. For this study, we strived to reduce socially desirable responses and non-responses by using a validated questionnaire when available21 and by systematically pre-testing survey items for which no validated or translated measure was available. Additionally, we studied the effect of private gender relations through involvement in household tasks and relative income using independent samples of men and women, without collecting data from participant spouses/partners. We analysed the perceptions of participants about their own involvement compared to their partner’s involvement. We also used the BSRI to operationalize gender roles. Although the BSRI has encountered criticism over the years 48, it is still the most widely used instrument to measure gender roles
RkJQdWJsaXNoZXIy MTk4NDMw