Gender differences and quality of life in atrial fibrillation: The mediating role of depression

Abstract

Objective: This study investigated gender differences, depression, and health-related quality of life (QoL) in a crosssectional sample of patients with atrial fibrillation (AF). Methods: This cross-sectional study involved a convenience sample of AF patients from two tertiary-care clinics in Toronto, Canada. Ninety-three AF patients completed psychometrically validated measures of generic QoL and depression. Mediation analyses evaluated the relationship between gender and QoL using depression as mediating variable. Results: Relative to male patients, female patients reported lower physical, but not mental, QoL. Gender was associated with both depression and physical QoL, while depression was correlated with poorer physical QoL. Path analyses demonstrated that depression significantly mediated the relationship between gender and physical QoL. Conclusion: Among AF patients, female patients report lower physical QoL relative to male patients, and this relationship may be mediated by self-reported symptoms of depression. Albeit correlational, the findings underscore the need to develop a better understanding of the role of depression in physical QoL, especially when considering the burden of AF in women. D

Depression as a Potential Explanation for Gender Differences in Health-Related Quality of Life among Patients on Maintenance Hemodialysis

“…There are data to suggest that in the general population and among non-dialysis patients with chronic conditions and after major trauma, women also face higher prevalence of depression and poorer HRQOL [14,15,16,17]. There is also evidence that, among non-dialysis patients, depression plays a role in explaining the poorer HRQOL in women than in men [18,19]. Frustrations with unattended expectations and lack of social support are some of suggested potential explanations for a higher likelihood of depression and poorer HRQOL among women than among men [20,21,22].…”

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

“…806,1046,1047,1048,1049 However, the rate of referral of women for catheter ablation of AF is significantly lower than men, and women are referred much later after failing more AADs. 920 There has not been consistent evidence to support female sex as a predictor of recurrence after AF ablation, based on multiple univariate and multivariate analyses.…”

Gendered Communicative Construction of Patients in Consultation Settings

“…Previous studies on heart diseases have shown that assumptions that male and female patients can be diagnosed and treated similarly -often based on research on men -has had negative consequences for women (Low, Thurston, and Matthews 2010). Regarding AF, research has demonstrated more severe clinical effects for women, including a higher mortality rate, bleeding complications (Michelena et al 2010), risk of stroke (Sullivan et al 2012;Michelena et al 2010), recurrences and higher heart rates (Volgman et al 2009) and depression-like conditions (Ong et al 2006). Consequently, attention has increased for biological sex differences and thus might be reason to suspect gender differences in communication regarding AF on the part of physicians and nurses.…”

“…Although the effects of AF tend to be worse for women (Michelena et al 2010;Sullivan et al 2012;Volgman et al 2009;Ong et al 2006), downplaying the symptoms or the health conditions for male patients may increase the risks for negligence and substandard care for these patients. Furthermore, overstating and, in some cases, almost forcing troublesome symptoms and effects onto female patients, may result in both unwarranted and inaccurate treatments, which may lead to necessary treatments being ignored (Michelena et al 2010).…”