期刊
INTERNATIONAL JOURNAL OF NURSING STUDIES
卷 46, 期 11, 页码 1485-1495出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.ijnurstu.2009.04.004
关键词
Heart failure; Gender; Self-care; Adherence
类别
资金
- U.S. National Institute of Nursing Research [F31NR010299, R01 NR009280, R01 NR008567]
- American Association of Critical Care Nurses-Philips Medical Award
- U.S. National Institutes of Health Center [1P20NR010679]
- National Heart Foundation of Australia (Australia)
- National Health and Medical Research Council (Australia)
- National Health and Medical Research Council & National Heart Foundation (Australia)
- U.S. National Institute for Occupational Safety and Health (Dickson)
- University of Pennsylvania School of Nursing Investing in the Future Initiative
- U.S. National Heart, Lung & Blood Institute [R01 HL084394-01A1]
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 HT 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. (C) 2009 Elsevier Ltd. All rights reserved.
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