Gender Differences in Health-Related Quality of Life in Adults with Cystic Fibrosis: An Integrative Literature Review

Written by Leigh Ann Bray, Sigrid Ladores, Aimee Holland, Nataliya Ivankova, Patricia Patrician, & Sylvie Mrug

doi: https://doi.org/10.13178/jnparr.2019.0901.0906

Abstract

Background: Life expectancy for individuals with cystic fibrosis (CF) has doubled in the last 20 years. There is currently no cure for the disease, thus, it is imperative that quality of life is optimized. Females with CF consistently report a poorer health-related quality of life than males, however, the causes of this disparity remain unknown.

Objective: The purpose of this integrative literature review was to examine the state of the science related to factors that influenced gender differences in health-related quality of life (HRQoL) in those with CF.

Methods: Databases used in the literature review included Scopus, PubMed, PsycINFO, and Google Scholar. Sources were included if they: 1) were available in the English language; 2) included adolescents and/or adults (> 12 years) with CF; 3) included gender differences in HRQoL in CF; and 4) were published between the years 2003 and 2018.

Results: A total of 29 articles were included in the review. The following gender differences in CF-specific HRQoL emerged from the literature review: 1) females were more likely to challenge their prescribed treatment regimen, needed more support to complete treatments, and were also less compliant with their prescribed treatment regimen when compared to males; 2) females reported more CF-related strain compared to males; 3)
in those diagnosed during childhood, (birth to 10 years) lung function declined faster in females over age 40 when compared to males; 4) females were more susceptible to poorer HRQoL despite a similar lung function to males 5) females noted a better HRQoL in the area of body image despite a lower BMI; 6) activity level declined with puberty in females with CF, which was not present in males; 7) in a social setting, females were more embar-
rassed of treatment regimen and found it harder to maintain a job or college course compared to males; and 8) females reported higher levels of anxiety, depression, and emotional strains related to CF and lower self-esteem when compared to males.

Conclusion: This literature review showed several gender differences in the HRQoL between males and females with CF, including physical and psychosocial aspects. While the physical aspects of HRQoL in CF may be stable over time, the psychosocial aspects varied over time, thus indicating a need to understand the determinants or factors for the differences in the trajectory of physical versus psychosocial quality of life in order to design theory-driven interventions that can improve patient outcomes.

Keywords: cystic fibrosis, health-related quality of life, gender, adults