title: Gender differences in heart failure self-care: a multinational cross-sectional study.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104-6096, USA. csleern@gmail.com
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Lee
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.forename: Andrea
authors.initials: A
authors.lastname: Driscoll
authors.forename: Jom
authors.initials: J
authors.lastname: Suwanno
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Terry A
authors.initials: TA
authors.lastname: Lennie
authors.forename: Victoria V
authors.initials: VV
authors.lastname: Dickson
authors.forename: Jan
authors.initials: J
authors.lastname: Cameron
authors.forename: Linda
authors.initials: L
authors.lastname: Worrall-Carter
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care