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, Jan 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, Jan 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 Ltd
ISSN0020-7489
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ijnurstu.2009.04.004
PubMed ID19442974
Scopus EID2-s2.0-69949106748
PubMed Central IDPMC2743780
Open accessPublished as green open access
Page range1485-1495
FunderNational Institute of Nursing Research (NINR), National Institutes of Research
American Association of Critical Care Nurses
National Heart Foundation of Australia
National Health and Medical Research Council (NHMRC)
National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention
University of Pennsylvania
National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health
Research GroupSchool of Nursing, Midwifery and Paramedicine
Author's accepted manuscript
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Open
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All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online13 May 2009
Publication process dates
Accepted17 Apr 2009
Grant IDF31NR010299
R01 NR009280
R01 NR008567
1P20NR010679
R01 HL084394-01A1
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Triaging women with acute coronary syndrome :A review of the literature
Kuhn, Lisa, Page, Karen, Davidson, Patricia M. and Worrall-Carter, Linda. (2011). Triaging women with acute coronary syndrome :A review of the literature. Cardiovascular Nursing, The Journal of. 26(5), pp. 395 - 407. https://doi.org/10.1097/JCN.0b013e31820598f6
Systematic review of cardiovascular disease in women :Assessing the risk
Worrall-Carter, Linda, Ski, Chantal, Scruth, Elizabeth, Campbell, Michelle and Page, Karen Nicola. (2011). Systematic review of cardiovascular disease in women :Assessing the risk. Nursing and Health Sciences. 13(4), pp. 529 - 535. https://doi.org/10.1111/j.1442-2018.2011.00645.x
Readmission to intensive care: A qualitative analysis of nurses' perceptions and experiences
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]. Australian Catholic University. https://doi.org/10.26199/acu.89yv4
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.