Gender differences in coping strategies and mental health outcomes among people living with chronic medical conditions

Abstract

Mental health challenges are common among individuals with chronic medical conditions, and coping strategies may vary by gender. However, evidence from resource-constrained settings such as Ghana remains limited. This study examined gender differences in mental health outcomes and coping strategies among people with hypertension and diabetes. A cross-sectional study was conducted among 457 patients receiving care at two public hospitals in the Central Region of Ghana. Participants completed self-report measures including the Depression, Anxiety, and Stress Scale (DASS-21) and the Africultural Coping Systems Inventory (ACSI). Data were analysed using descriptive statistics and independent t-tests to assess gender differences. Statistical analysis was done using Jamovi statistical software version 2.5.3. Results showed a high burden of psychological distress among participants. Stress was most common at the severe level, reported by 187 participants (40.9%), while anxiety was most frequently reported at the extremely severe level, affecting 307 participants (67.2%). Depression was most frequently classified as extremely severe, affecting 202 participants (44.2%), followed by moderate depression among 132 participants (28.9%). Female participants reported significantly higher depression, anxiety, and stress scores than male participants, with moderate-to-large effect sizes. Male participants reported significantly greater use of collective coping and cognitive-emotional debriefing, although the effect sizes were small. The findings highlight a high burden of psychological distress among persons living with hypertension or diabetes, with women reporting higher psychological distress and men reporting greater use of selected coping strategies. Routine mental health screening should be considered within chronic disease clinics, alongside gender-sensitive and culturally relevant psychosocial support that reflects patients’ coping needs and lived experiences.