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(Chest. 2004;125:482-488.)
© 2004 American College of Chest Physicians

Gender Differences in Health-Related Quality of Life in Patients Complaining of Chronic Cough*

Cynthia T. French, MS; Kenneth E. Fletcher, PhD and Richard S. Irwin, MD, FCCP

* From the Departments of Medicine (Ms. French and Dr. Irwin) and Psychiatry (Dr. Fletcher), University of Massachusetts Medical School, Worcester, MA.

Correspondence to: Richard S. Irwin, MD, FCCP, University of Massachusetts Medical School, Division of Pulmonary, Allergy, and Critical Care Medicine, 55 Lake Ave North, Worcester, MA 01655; e-mail: IrwinR{at}ummhc.org

Study objectives: 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.

Design: 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.

Setting: Cough clinic in an academic, tertiary care medical center.

Participants: Subjects seeking medical attention complaining of cough of at least 8 weeks duration and a control group of smokers not complaining of cough.

Measurements: Assessment of chronic cough on HRQOL utilizing a valid and reliable cough-specific HRQOL instrument, the cough-specific quality-of-life questionnaire (CQLQ).

Interventions: All subjects completed the CQLQ prior to any contact with the cough specialist and medical intervention.

Results: 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.

Conclusions: 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.

Key Words: chronic cough • gender differences in chronic cough • gender differences in cough and quality of life • health-related quality of life • quality of life







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