Gender difference in the association of coping styles and social support with psychological distress among patients with end-stage renal disease.

Objectives: The study aimed to explore the association of coping styles and social support with psychological distress among patients with end-stage renal disease (ESRD) as well as gender differences in these associations.

Methods: A cross-sectional study of 769 ESRD patients was conducted at 25 hospitals in Qiqihar City, China. All information was collected using structured questionnaires that were self-administered by the patients. Patients' psychological health status, coping styles and perceived social support were measured using the 12-item General Health Questionnaire, the Medical Coping Modes Questionnaire and the Multidimensional Scale of Perceived Social Support. Student's test, analysis of variance (ANOVA) and binary logistic regression analysis were used for data analysis.

Results: A total of 72.3% of participants reported psychological distress, and the prevalence of distress was higher in females (77.0%) than in males (68.8%). The usage of the acceptance-resignation coping style was positively related to psychological distress (B = 0.459,  < 0.001). Social support level was negatively associated with psychological distress (B = -0.049,  < 0.001). The use of the confrontation style was negatively related to psychological distress in females (OR = 0.87, 95% CI [0.78-0.96]) but not in males (OR = 0.98, 95% CI [0.91-1.06]) ( for interaction term = 0.007).

Conclusions: Greater use of the acceptance-resignation style and lower social support are related to a higher risk of psychological distress. Greater use of the confrontation style is related to a lower risk of psychological distress in females but not in males.