Gender-specific barriers and facilitators to heart failure self-care: A mixed methods study

Background: Although approximately half of adults with heart failure (HF) are women, relatively little is known about gender differences and similarities in HF self-care. Aims: The aim of this study was to describe HF self-care in men and women and to identify gender-specific barriers and facilitators influencing HF self-care. Methods: A total of 27 adults (8 women) with chronic HF participated in a cross-sectional, comparative mixed methods study. An analysis of in-depth interviews was used to describe gender-specific barriers and facilitators of self-care. After the interview data were analyzed, the results were confirmed in quantitative data obtained from the same sample and at the same time. Concordance between qualitative and quantitative data was assessed. Results: There were no consistent gender-specific differences in self-care practices but there were distinct gender differences in the decisions made in interpreting and responding to symptoms. The men were better than the women at interpreting their symptoms as being related to HF and in initiating treatment. These differences were associated with differences in self-care confidence, social support, and mood. Conclusion: Gender-specific differences in self-care behaviors are minimal. However, gender-specific barriers and facilitators greatly influence the choice of self-care behaviors.