Chest
Volume 125, Issue 2, February 2004, Pages 482-488
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Clinical Investigations
COUGH
Gender Differences in Health-Related Quality of Life in Patients Complaining of Chronic Cough

https://doi.org/10.1378/chest.125.2.482Get rights and content

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.

Section snippets

Materials and Methods

We performed a post hoc analysis of data collected prospectively2 during psychometric testing of the cough quality-of-life questionnaire (CQLQ) in a control group of 31 smokers who were observed to be coughing but were not complaining of cough, and in 154 consecutive and unselected patients complaining of chronic cough (ie, the original cohort) who were seeking medical attention in the cough clinic of our academic, tertiary care, medical center. Chronic cough was defined as a cough of at least

Characteristics of Control Smoker Group

This group was composed of 31 smokers who were not seeking medical attention. They were observed to be coughing in an employee smoking area and were not complaining of cough. There were 22 women and 9 men in the group with a mean (± SD) age of 41.4 ± 11.3 years.

CQLQ Scores for Women and Men in the Control Smoker Group

Men's total CQLQ scores were higher than those for women (32.86 ± 7.85 vs 40.44 ± 7.53, respectively; t29 = 2.47; p < 0.02). Men also scored higher than women on the following two subscales: physical complaints (10.18 ± 2.12 vs 14.33 ±

Discussion

Cough can mean different things to different people. It depends on their perspective. To the patient, coughing is an indicator that something is wrong with their body, and it can be the cause of a variety of complications6 that can significantly decrease their HRQOL.2 Because the term HRQOL defines a patient's perception of the impact of health and disease on multiple domains of his/her life (eg, physical function and psychosocial state), it is of the highest importance to patients. With

Conclusion

We conclude that women with chronic cough in our study were probably more inclined to seek medical attention than men with chronic cough because the HRQOL of the women was more adversely affected than men, and because women were more apt to experience physical complaints such as stress urinary incontinence that provoked psychosocial issues such as becoming embarrassed. Because we did not measure cough reflex sensitivity in our study, it is not possible to know whether or not a higher cough

References (16)

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Presented in part and published in abstract form at the annual meeting of the American Thoracic Society, May 20, 2001, in San Francisco, CA.

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