Gender differences in heart failure self-care: A multinational cross-sectional study

Journal article


Lee, Christopher S., Reigel, Barbara, Driscoll, Andrea, Suwanno, Jom, Moser, Debra K., Lennie, Terry A., Dickson, Victoria V., Cameron, Janette and Worrall-Carter, Linda. (2009) Gender differences in heart failure self-care: A multinational cross-sectional study. International Journal of Nursing Studies. 46(11), pp. 1485 - 1495. https://doi.org/10.1016/j.ijnurstu.2009.04.004
AuthorsLee, Christopher S., Reigel, Barbara, Driscoll, Andrea, Suwanno, Jom, Moser, Debra K., Lennie, Terry A., Dickson, Victoria V., Cameron, Janette and Worrall-Carter, Linda
Abstract

Background: Despite a common view that women are better at self-care, there is very little evidence to support or challenge this perspective in the heart failure (HF) population. Objective: The purpose of this study was to determine if there are cross-cultural gender differences in self-reported HF self-care and to describe gender differences in the determinants of HF self-care. Design, setting, and participants: A secondary analysis was completed of cross-sectional study data collected on 2082 adults with chronic HF from the United States, Australia and Thailand. Methods: Comparisons were made between men and women regarding self-care maintenance, management and confidence as assessed by the Self-Care of Heart Failure Index, as well as the proportion of subjects engaged in adequate self-care. Multivariate comparisons were made to determine if gender explained sufficient variance in HF self-care and the likelihood of reporting adequate self-care, controlling for nine model covariates. Results: The sample was comprised of 1306 men and 776 women. Most (73.5%) had systolic or mixed systolic and diastolic HF and 45% had New York Heart Association class III or IV HF. Although small and clinically insignificant gender differences were found in self-care maintenance, gender was not a determinant of any aspect of HF self-care in multivariate models. Married women were 37% less likely to report adequate self-care maintenance than unmarried women. Comorbidities only influenced the HF self-care of men. Being newly diagnosed with HF also primarily affected men. Patients with diastolic HF (predominantly women) had poorer self-care maintenance and less confidence in self-care. Conclusion: Differences in HF self-care are attributable to factors other than gender; however, there are several gender-specific determinants of HF self-care that help identify patients at risk for practicing poor self-care.

Keywordsheart failure; gender; self-care; adherence
Year2009
JournalInternational Journal of Nursing Studies
Journal citation46 (11), pp. 1485 - 1495
PublisherElsevier
ISSN0020-7489
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ijnurstu.2009.04.004
Page range1485 - 1495
Research GroupSchool of Nursing, Midwifery and Paramedicine
Place of publicationOxford,United Kingdom
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Elliott, Malcolm, Crookes, Patrick, Worrall-Carter, Linda and Page, Karen. (2011) Readmission to intensive care: A qualitative analysis of nurses' perceptions and experiences. Heart & Lung: the journal of acute and critical care (print version). 40(4), pp. 299 - 309. https://doi.org/10.1016/j.hrtlng.2010.04.006
Symptom recognition in elders with heart failure
Riegel, Barbara, Dickson, Victoria, Cameron, Jan, Johnson, Jerry, Bunker, Stephen, Page, Karen and Worrall-Carter, Linda. (2010) Symptom recognition in elders with heart failure. Journal of Nursing Scholarship. 42(1), pp. 92 - 100. https://doi.org/10.1111/j.1547-5069.2010.01333.x
Self-Care Behaviours and Heart Failure: Does Experience with Symptoms Really Make a Difference?
Cameron, Janette, Worrall-Carter, Linda, Page, Karen and Stewart, Simon. (2010) Self-Care Behaviours and Heart Failure: Does Experience with Symptoms Really Make a Difference? European Journal of Cardiovascular Nursing. 9(2), pp. 92 - 100. https://doi.org/10.1016/j.ejcnurse.2009.10.004
The information and support needs of Faroese women hospitalised with an acute coronary syndrome
Askham, Jorun, Kuhn, Lisa, Frederiksen, Kirsten, Davidson, Patricia, Edward, Karen-Leigh and Worrall-Carter, Linda. (2010) The information and support needs of Faroese women hospitalised with an acute coronary syndrome. Journal of Clinical Nursing. 19(October), pp. 1352 - 1361. https://doi.org/10.1111/j.1365-2702.2009.03013.x
Does cognitive impairment predict poor self-care in patients with chronic heart failure?
Cameron, Janette, Worrall-Carter, Linda, Page, Karen, Riegel, Barbara, Lo, Sing Kai and Stewart, Simon. (2010) Does cognitive impairment predict poor self-care in patients with chronic heart failure? European Journal of Heart Failure. 12(5), pp. 508 - 515. https://doi.org/10.1093/eurjhf/hfq042
Theoretical considerations in reducing risk for cardiovascular diseases: Implications for nursing practice
Gholizadeh, Leila, Davidson, Patricia, Salamonson, Yenna and Worrall-Carter, Linda. (2010) Theoretical considerations in reducing risk for cardiovascular diseases: Implications for nursing practice. Journal of Clinical Nursing. 19(15-16), pp. 2137 - 2145. https://doi.org/10.1111/j.1365-2702.2009.03189.x
Gender-specific barriers and facilitators to heart failure self-care: A mixed methods study
Riegel, Barbara, Dickson, Victoria, Lisa, Kuhn,, Page, Karen and Worrall-Carter, Linda. (2010) Gender-specific barriers and facilitators to heart failure self-care: A mixed methods study. International Journal of Nursing Studies. 47(7), pp. 888 - 895. https://doi.org/10.1016/j.ijnurstu.2009.12.011
Recovering from an acute cardiac event- the relationship between the depression and life satisfaction.
Page, Karen, Davidson, Patricia, Edward, Karen-Leigh, Allen, Josh, Cummins, Robert, Thompson, David and Worrall-Carter, Linda. (2010) Recovering from an acute cardiac event- the relationship between the depression and life satisfaction. Journal of Clinical Nursing. 19(June), pp. 736 - 743. https://doi.org/10.1111/j.1365-2702.2009.03106.x
Awareness and causal attributions of risk factors for heart disease among immigrant women living in Australia
Gholizadeh, Leila, Salamonson, Yenna, Worrall-Carter, Linda, DiGiacomo, Michelle and Davidson, Patricia M.. (2009) Awareness and causal attributions of risk factors for heart disease among immigrant women living in Australia. Journal of Women's Health. 18(9), pp. 1385 - 1393. https://doi.org/10.1089/jwh.2008.0956
The nexus between cognitive function and self-care ablility in patients with chronic heart failure
Cameron, Janette. (2009) The nexus between cognitive function and self-care ablility in patients with chronic heart failure [Thesis]. https://doi.org/10.4226/66/5a95f334c681d
Testing a model of patient characteristics, psychologic status, and cognitive function as predictors of self-care in persons with chronic heart failure
Cameron, Janette, Worrall-Carter, Linda, Riegel, Barbara, Lo, Sing Kai and Stewart, Simon. (2009) Testing a model of patient characteristics, psychologic status, and cognitive function as predictors of self-care in persons with chronic heart failure. Heart & Lung: the journal of acute and critical care. 38(5), pp. 410 - 418. https://doi.org/10.1016/j.hrtlng.2008.11.004
Evidence-based chronic heart failure management programs: Reality or myth?
Driscoll, Andrea, Worrall-Carter, Linda, Hare, David, Davidson, Patricia, Riegel, Barbara, Tonkin, Andrew and Stewart, Simon. (2009) Evidence-based chronic heart failure management programs: Reality or myth? BMJ Quality and Safety. 18(6), pp. 450 - 455. https://doi.org/10.1136/qshc.2008.028035
Measuring self-care in chronic heart failure: A review of the psychometric properties of clinical instruments
Cameron, Janette, Worrall-Carter, Linda, Driscoll, Andrea and Stewart, Simon. (2009) Measuring self-care in chronic heart failure: A review of the psychometric properties of clinical instruments. The Journal of Cardiovascular Nursing. 24(6), pp. E10 - E22. https://doi.org/10.1097/JCN.0b013e3181b5660f
Opting in and opting out: A grounded theory of nursing's contribution to inpatient rehabilitation
Pryor, Julie, Walker, Annette, O'Connell, Beverley and Worrall-Carter, Linda. (2009) Opting in and opting out: A grounded theory of nursing's contribution to inpatient rehabilitation. Clinical Rehabilitation. 23(12), pp. 1124 - 1135. https://doi.org/10.1177/0269215509343233
Heart failure self-care in developed and developing countries
Riegel, Barbara, Driscoll, Andrea, Suwanno, Jom, Moser, Debra K., Lennie, Terry A., Chung, Misook L., Wu, Jia-Rong, Dickson, Victoria Vaughan, Carlson, Beverley and Cameron, Janette. (2009) Heart failure self-care in developed and developing countries. Journal of Cardiac Failure. 15(6), pp. 508 - 516. https://doi.org/10.1016/j.cardfail.2009.01.009
Relationship of heart failure patients' knowledge, perceived barriers, and attitudes regarding low-sodium diet recommendations to adherence
Lennie, Terry, Worrall-Carter, Linda, Hammash, M., Odom-Forren, J., Roser, L. P., Smith, C. S., Trupp, T., Chung, Misook and Moser, Debra. (2008) Relationship of heart failure patients' knowledge, perceived barriers, and attitudes regarding low-sodium diet recommendations to adherence. Progress in Cardiovascular Nursing. 23(1), pp. 6 - 11. https://doi.org/10.1111/j.1751-7117.2008.tb00525.x
Improving depression and anxiety screening of patients with heart disease: implementing a multidisciplinary Clinical Pathway
Rahman, Aziz and Worrall-Carter, Linda. (2008) Improving depression and anxiety screening of patients with heart disease: implementing a multidisciplinary Clinical Pathway [Dataset].
The impact of an ICU liaison nurse service on patient outcomes
Elliott, Suzanne, Ernest, David, Doric, Andrea, Page, Karen, Worrall-Carter, Linda, Thalib, Lukman and Chaboyer, Wendy. (2008) The impact of an ICU liaison nurse service on patient outcomes. Critical Care and Resuscitation. 10(4), pp. 296 - 300.
Ethical dilemmas of a large national multi-centre study in Australia: Time for some consistency
Driscoll, Andrea, Currey, Judy, Worrall-Carter, Linda and Stewart, Simon. (2008) Ethical dilemmas of a large national multi-centre study in Australia: Time for some consistency. Journal of Clinical Nursing. 17(16), pp. 2212 - 2220. https://doi.org/10.1111/j.1365-2702.2007.02219.x
Returning to work: Exploring the experiences of women with acute coronary syndromes
Parry, A., Worrall-Carter, Linda, Page, Karen, Kuhn, Lisa, DiGiacomo, Michelle and Davidson, Patricia. (2007) Returning to work: Exploring the experiences of women with acute coronary syndromes. British Journal of Cardiac Nursing. 2(6), pp. 292 - 301.
Depression, anxiety and stress in women following acute coronary syndrome: Implications for secondary prevention
DiGiacomo, Michelle, Davidson, Patricia, Vanderpluym, A., Snell, R. and Worrall-Carter, Linda. (2007) Depression, anxiety and stress in women following acute coronary syndrome: Implications for secondary prevention. Australian Critical Care. 20(2), pp. 69 - 76. https://doi.org/10.1016/j.aucc.2007.03.002
Extent of heart failure self-care as an endpoint to patient education: A review of the literature
Cameron, Jan, Worrall-Carter, Linda, Driscoll, Andrea, New, G. and Stewart, Simon. (2007) Extent of heart failure self-care as an endpoint to patient education: A review of the literature. British Journal of Cardiac Nursing. 2(4), pp. 188 - 197.
Gender differences in adherence to the sodium-restricted diet in patients with heart failure
Chung, Misook, Moser, Debra, Lennie, Terry, Worrall-Carter, Linda, Bentley, B., Trupp, T. and Armentano, D.. (2006) Gender differences in adherence to the sodium-restricted diet in patients with heart failure. Journal of Cardiac Failure. 12(8), pp. 628 - 634. https://doi.org/10.1016/j.cardfail.2006.07.007
Assessment of cognitive function in heart failure patients
Wolfe, R, Worrall-Carter, Linda, Foister, K., Keks, N. and Howe, V.. (2006) Assessment of cognitive function in heart failure patients. European Journal of Cardiovascular Nursing. 5(2), pp. 158 - 164. https://doi.org/10.1016/j.ejcnurse.2005.10.005
Heterogeneity of heart failure management programs in Australia
Driscoll, Andrea, Worrall-Carter, Linda, McLennan, Skye, Dawson, Anna, O'Reilly, J. and Stewart, Simon. (2006) Heterogeneity of heart failure management programs in Australia. European Journal of Cardiovascular Nursing. 5(1), pp. 75 - 82. https://doi.org/10.1016/j.ejcnurse.2005.08.001
Prognostic importance of cognitive impairment in chronic heart failure patients : Does specialist disease management make a difference?
McLennan, Skye, Pearson, Sue, Cameron, Janette and Stewart, Simon. (2006) Prognostic importance of cognitive impairment in chronic heart failure patients : Does specialist disease management make a difference? European Journal of Heart Failure. 8(5), pp. 494 - 501. https://doi.org/10.1016/j.ejheart.2005.11.013
Rationale and design of the national benchmarking and evidence-based national clinical guidelines for chronic heart failure management programs study
Driscoll, Andrea, Worrall-Carter, Linda and Stewart, Simon. (2006) Rationale and design of the national benchmarking and evidence-based national clinical guidelines for chronic heart failure management programs study. Journal of Cardiovascular Nursing. 21(4), pp. 276 - 282. https://doi.org/10.1097/00005082-200607000-00007
The experiences and adjustments of women following their first acute myocardial infarction
Worrall-Carter, Linda, Jones, T. and Driscoll, Andrea. (2005) The experiences and adjustments of women following their first acute myocardial infarction. Contemporary Nurse. 19(February), pp. 211 - 221.
Psychosocial issues facilitating recovery post-CABG surgery
Theobald, K, Worrall-Carter, Linda and McMurray, Anne. (2005) Psychosocial issues facilitating recovery post-CABG surgery. Australian Critical Care. 18(2), pp. 76 - 85. https://doi.org/10.1016/S1036-7314(05)80006-2
A historical review of the nurse practitioner role in Australia
Driscoll, Andrea, Worrall-Carter, Linda, O'Reilly, J. and Stewart, Simon. (2005) A historical review of the nurse practitioner role in Australia. Clinical Excellence for Nurse Practitioners. 9(3), pp. 141 - 152.
Nurse academics meeting the challenges of scholarship and research
Worrall-Carter, Linda and Snell, R.. (2003) Nurse academics meeting the challenges of scholarship and research. Contemporary Nurse. 16(February), pp. 40 - 50.