Although health care providers need to interpret verbal and non-verbal cues of ill health to adapt their care, there is a lack of information regarding how people communicate their malaise and the factors predicting ill health communication. There is for instance no clear data on whether men and women communicate their sickness malaise differently. In addition, whether ill health communication accurately reflects the feeling of sickness remains unknown.
In this study, a state of sickness was experimentally induced in twenty-two men (n=13) and women (n=9) using an intravenous injection of a bacterial endotoxin (lipopolysaccharide, LPS) at a dose known to trigger intense flu-like symptoms in the majority of participants (2.0 ng/kg body weight). The participants were filmed under the experimental sickness condition and after a placebo injection, and two trained raters scored their communicated behaviors (i.e., verbal complaints, moaning and sighs/deep breaths). Sickness-related variables, i.e. body temperature, inflammatory cytokine plasma concentrations and subjective symptoms, were assessed.
The physiological (body temperature, cytokine concentrations) and the subjective sickness-related variables were increased during experimental sickness compared to the placebo condition, in a similar way in both sexes. Sick participants were more likely to moan and to complain but the frequency of these behaviors remained low and no significant difference between men and women was observed. The frequency of sighs and deep breaths was found to strongly increase during experimental sickness compared to the placebo condition, but only in men. More than 36 sighs/deep breaths was observed during experimental sickness in the majority (85%) of the men included in the study, but only in a minority (33%) of the women. No significant association was found between sickness-related variables and the frequency of sighs/deep breaths.
This study indicates that men strongly increase sighs and/or deep breaths during sickness, a cue that may signal their malaise to their caregivers. The difference between men and women in using sighs and deep breaths during sickness may explain why men are believed to exaggerate their symptoms when sick (i.e., are considered suffering of “man flu”). Importantly, our study suggests that ill-health communication does not necessarily reflect the intensity of the sickness feeling. Because of the relatively low sample size, results of this study should be considered of pilot character and further investigation is needed to confirm these findings.
Reference: Communication of health in experimentally sick men and women: A pilot study.; Psychoneuroendocrinology (2018), Lasselin J, Lekander M, Paues-Göranson S, Olsson MJ, Axelsson J..