Abstract 1546: Whose Job is It? Examining Gender Differences in Perceptions About the Heart Failure Self-Care Role
Heart failure (HF) self-care requires individuals to become actively involved in maintaining physiologic stability (maintenance) and responding to symptoms when they occur (management). Despite extensive educational efforts, many struggle with self-care. Gender differences in self-care have been particularly difficult to explain. The purpose of this mixed methods study was to define perceived role in HF self-care, explore how perceived role influences self-care behaviors, and examine differences in perceived role by gender.
Methods: Using qualitative descriptive meta-analysis techniques, transcripts from three mixed methods studies (n=90) were re-examined to yield themes about role perception in HF self-care. Role was then coded into a quantitative variable and analyzed descriptively using the Self-Care of Heart Failure Index (SCHFI) scales of management and maintenance.
Results: The sample was 73.7% Caucasian, 65.7% male, mean age of 59.61 years (± 15). Most (52.9%) were NYHA class III. Three major themes emerged from the qualitative data regarding self-care role:
a primary responsibility (“It’s my job”) (27%),
collaboration (22%), and
follow the direction of others (“I just do what I’m told”) (51%).
Men were most likely to see self-care as a primary responsibility and women were most likely to collaborate with others in making decisions. Although, men were more likely to make independent decisions related to self-care management (p=0.01), the women had higher self-care management scores (p=.04). When adequacy of self-care (defined as ≥70 on the each standardized SCHFI scale) was compared across the role groups, significant differences found (p=.03). Those who described their role as only to do what they were told (i.e., followed the direction of others) had poorer self-care (management, p=.03; maintenance, p=.06).
Conclusion: Perceived role in HF self-care varies by gender and is linked to quantitative evidence of self-care. Assessment of perceived role by clinicians can guide patient education, especially for those who are likely to defer to others. Tailored instructions may be needed to help women assume independent responsibility for self-care and to improve the decisions made by men.