Abstract 1590: Factors Influencing Heart Failure Self-Care Differ in Men and Women
Background: Self-care is integral to the management and outcomes of heart failure (HF). Although half of those with HF are women, little is known about gender differences in HF self-care.
Purpose: To compare self-care practices in men and women and identify gender-specific barriers and facilitators of HF self-care.
Methods: A cross-sectional, comparative mixed methods (QUAL+quan) study was done comparing 19 men (67.4±15.6 years) and 8 women (69.3±13.3 years) with chronic HF. Results from in-depth interviews were explored in the quantitative data. Qualitative and quantitative data were analyzed by blinded co-investigators until the stage of integration.
Results: No consistent gender-specific differences in specific self-care practices were found, although men were better at interpreting their symptoms as HF related and in initiating treatment. Differences were associated with self-care confidence, social support, and mood. Men reported higher self-care confidence on the Self-Care of HF Index (76.1±15.5 vs. 61.5±9.4, p=.02), which improved their ability to interpret symptoms, in spite of having more comorbid illnesses (79% concordance between qualitative and quantitative data). Men also reported more tangible support, while the women had insufficient tangible support and were socially isolated. When support was measured with the Multidimensional Scale of Perceived Social Support, men reported significantly higher support from a significant other (25.3±3.5 vs. 20.5±8.6, p=.04) and from family (23.8±6.7 vs. 17.7±6.5, p=.04) (93% concordance). In interviews, women described feeling sad while men were anxious, fearful, or angry. On the PHQ-9, men were more depressed (6.1±6.2 vs. 5.5±5.2, p=.08). On the Brief Symptom Inventory, men were more anxious (.55±.74 vs. .34±.40, p=NS) (concordance 52%).
Conclusion: Although gender-specific differences in specific self-care behaviors are minimal, men and women made decisions about the interpretation and response to symptoms differently. Self-care confidence, social support, and mood can help identify men and women who may have difficulties in performing self-care.