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Below are the responses I received to the following abstract:

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Scand J Caring Sci. 2003 Sep;17(3):301-7

Perceptions of health-related quality of life of men and women living with
coeliac disease.

Hallert C, Sandlund O, Broqvist M.

Coeliac Centre, Faculty of Health Sciences, Linkoping University,
Linkoping, Sweden.

Women with long-standing coeliac disease express poorer health-related
quality of life (HRQoL) than men do for unclear reasons. This led us to
explore differences in their understanding of HRQoL using a
phenomenographic approach. We interviewed 10 coeliac subjects (mean age 57
years, range 35-73) who had been on a gluten-free diet for 10 years and had
scored either high or low in the Short Form 36 Health Survey (SF-36)
General Health and Vitality scales. Three dimensions were revealed that
pertained to their perception of HRQoL: bodily sensations, social
consequences and coping strategies. Within these, the women experienced
more bowel symptoms than men did, despite keeping to a strict diet. This
item was the only one predicting the SF-36 scores. The women also described
more distress caused by the restrictions in daily life, closely related to
their controlling of food contents. The coeliac men took advantage of using
a problem-oriented coping approach while the women seeking an emotionally
oriented strategy showed less satisfaction with the outcome. We conclude
that the intriguing difference in HRQoL between coeliac men and women may
have some of its origin in the way living with the disorder is
conceptualized and coped with. The results imply that in the management of
coeliac patients, gender-related aspects need to be taken into account to
improve treatment outcome.

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Interesting, Roy.  Thanks.

I wonder, however, (at the risk of sounding sexist) if the male perception
of 'not being such a bad thing to live with' doesn't have more to do with
the fact that women tend to be the shoppers and preparers and, therefore,
have more direct and critical involvement with dietary compliance.

Joanne

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It's simple.  Women are usually responsible for the purchase, preparation
and serving of food.  Men are mostly simply the consumers of it.

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Thank you for addressing this particular problem.  Assumptions regarding
gender bias can be greatly overdone, but I think there are relevant factors
in coping with a GF diet.  As a woman who has been living CD life for 47
years, I would like to share some of my observations from personal
experience.  The first addresses gender differences, but there are also
societal issues which may bring about more problems with a GF diet for
women than for men.

In situations where one is not in control of food preparation, say
restaurants or other people's homes, men (in general!!!!) are less apt to
feel guilty for inconveniencing others in food preparation.  They need what
they need, and if it's a problem for others to understand or comply, well
then, that's their problem.  Whereas, women (again in general) are more apt
to stress over troubling others, and also over the risks of depending on
other people in food prep.

As an illustration, my husband takes good care of me - I tend to be more
resigned, and just do without when food is not prepared as I need.  He
steps in & has it made right.  Because, as above, what I need is what I
need, and he sees no reason to accept less.  I do love having him to play
the white knight, after hassling with such situations since childhood.
Speaking for myself, it's difficult to enjoy a meal you've had an argument
over.

With regard to societal issues, (& again, a generalized opinion) applying
to people in relationships, rather than singles; more women than men do the
actual shopping and food preparation.  Therefore, they are more directly
dealing with the work & hassle involved in screening their diets.

Another unfortunate social factor which I have experienced too often to
disregard - the public at large is more apt to pay attention to a man than
a woman.  They tend to downplay importance and accuracy when information
comes from a woman.  I have had so many 'accidents' because someone just
didn't take what I said seriously.  Of course, they were apologetic when I
was puking my guts out, but, too little, too late.  & it is not that I
equivocate or don't state my needs clearly (in 47 years I have learned a
courteous, but clear and concise approach).  They just didn't listen, or
thought I was exagerating.  Or more recently, just on a fad diet, and it
really wasn't that critical.

I would like to state that eating GF today is, for me, simpler than it was
years ago.  Albeit, more foods now contain hidden gluten, but awareness of
special needs is much greater now than before.  There is still room for
improvement, but hey, it is what it is, and I am ever grateful to all the
people who have helped me through the years.  Thanks for an opportunity to
contribute my 2 cents' worth.

Kyra

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Fascinating!  I've had a moderate eating disorder most
of my life, and am dealing with that through therapy
now.  CD has made things more intense and complicated,
but it's also forced me to really take charge of
things and get better about how I take care of myself.
Many women have unhealthy approaches to body image
and food, and I wonder how many of us find that the
strict limitations of CD aggravate our emotional
attachments to food.  This is probably also made worse
because so many women are responsible for food
preparation and nurturing for their families, and
aren't conditioned to give priority to their own
needs.

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