Paradox of self-care gender differences among Italian patients with chronic heart failure: findings from a real-world cross-sectional study

Dellafiore, Federica; Arrigoni, Cristina; Pittella, Francesco; Conte, Gianluca; Magon, Arianna; Caruso, Rosario

doi:10.1136/bmjopen-2018-021966

Cited by 45 publications

(40 citation statements)

References 34 publications

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“…Finally, future studies should also consider the experience of healthcare providers when dealing with this patient population or the lived experiences of patients with CHD during the paternal experience. Because sex-related differences among various populations are a field of research that has recently grown,39–41 we imagine substantial differences in the parenting experience between mothers and fathers with CHD. Thus, another interesting study would describe the impact of a mother’s CHD diagnosis on married couples42 and on the experiences of their child.…”

Section: Discussionmentioning

confidence: 99%

Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

et al. 2020

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ObjectiveThis study explored the lived experiences of women with congenital heart disease (CHD) during pregnancy and early motherhood.DesignQualitative study using semistructured interviews. Data were analysed according to interpretative phenomenological analysis.SettingSan Donato Milanese, Italy.Participants12 adult women during pregnancy or early motherhood.ResultsThree main themes emerged from the analysis that were labelled as follows: ‘Being a woman with CHD’; ‘Being a mother with CHD’; and ‘Don’t be alone’. Mothers described both positive and negative feelings about their pregnancies and transitions from childless women to mothers with CHD. They needed supportive care to improve the management of their health during pregnancy and early motherhood.ConclusionThis study explored the lived experiences of women with CHD during pregnancy and early motherhood. The emerged themes represent an initial framework for implementing theory-grounded educational and supportive strategies that improve self-care, engagement and quality of life for women with CHD. Furthermore, the study’s results provide guidance for operationalising the described experiences into items and domains for future cross-national surveys.

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Section: Discussionmentioning

confidence: 99%

Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

et al. 2020

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“…3 Despite the evidence supporting the benefits of HF selfcare, 4 patients find it difficult to perform self-care, and self-care is often insufficient. [5][6][7] Investigators are struggling to find interventions that can effectively improve self-care. Recent trials of various interventions have had inconsistent results.…”

Section: Introductionmentioning

confidence: 99%

Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial

et al. 2020

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Aims Self-care, an essential component of heart failure (HF) treatment, is inadequate in most patients. We evaluated if motivational interviewing (MI) (i) improves patient self-care maintenance (primary endpoint; e.g. taking medications), self-care management (e.g. responding to symptoms) and self-care confidence (or self-efficacy) 3 months after enrolment; (ii) changes self-care over 1 year, and (iii) augments patient self-care if informal caregivers are involved. Methods and results Parallel randomized controlled trial (1:1:1). A sample of 510 patients (median 74 years, 58% male) and caregivers (median 55 years, 75% female) was randomized to Arm 1 (MI only for patients), Arm 2 (MI for patients and caregivers), or Arm 3 (usual care). The intervention in Arms 1 and 2 consisted of one face-to-face MI session with three telephone contacts. Self-care was evaluated with the Self-Care of HF Index measuring self-care maintenance, management, and confidence. Scores on each scale range from 0 to 100 with higher scores indicating better self-care; ≥70 is considered adequate. At 3 months, self-care maintenance improved 6.99, 7.42 and 2.58 points in Arms 1, 2, and 3, respectively (P = 0.028). Self-care maintenance was adequate in 18.4%, 19.4%, and 9.2% of patients in Arms 1, 2 and 3, respectively (P = 0.016). Over 1 year, self-care maintenance, management, and confidence scores in Arms 1 and 2 were significantly higher than in Arm 3 in several follow-ups. Over 1 year, Arm 2 had the best scores in self-care management.Conclusions MI significantly improved self-care in HF patients. Including caregivers may potentiate the effect, especially in self-care management. ClinicalTrial.gov, identifier: NCT02894502.

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“…According to several studies, women with cardiac conditions are more likely to experience psychological distress, have poor functional status, and need more social support than men [18,24]. However, Dellafiore et al [25] reported that men with chronic heart failure had more than quadruple the risk of poor self-care than women, while about 60 percent of men were more likely to have adequate self-care confidence than women, paradoxically. Therefore, in this study we assessed the effect of gender on associations between frailty, cognitive impairment, and self-care behaviors among older adults with AF.…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in the Association between Frailty, Cognitive Impairment, and Self-Care Behaviors Among Older Adults with Atrial Fibrillation

Son

Lee

Kim

2019

IJERPH

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Atrial fibrillation (AF), common in older adults, increases the risk of heart failure, stroke, and all-cause mortality. Self-care behaviors help avoid adverse events in older patients with AF. However, while frailty and cognitive impairment can contribute to poor self-care behaviors, few studies have explored these relationships in older adults with AF. This cross-sectional study aims to determine associations between frailty, cognitive impairment, and self-care behaviors among older adults with AF by gender. A total of 298 patients with AF aged 60 and over were assessed with a self-reported questionnaire consisting of the Korean version of the FRAIL scale, modified mini-mental state examination, and self-care scale for AF. Prevalence of frailty and prefrailty in men and women was around 11% and 48.4% and 28% and 47.4%, respectively. According to the hierarchical linear regression analysis, in men, prefrailty (β = −2.874, p = 0.013) and frailty (β = −7.698, p < 0.001) were associated with self-care behaviors; in women, frailty (β = −5.476, p = 0.003), and cognitive impairment (β = −3.350, p = 0.044) were associated with self-care behaviors. Developing individualized care plans will require periodic screening of older patients with AF to determine their frailty status and cognitive function.

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Paradox of self-care gender differences among Italian patients with chronic heart failure: findings from a real-world cross-sectional study

Cited by 45 publications

References 34 publications

Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial

Gender Differences in the Association between Frailty, Cognitive Impairment, and Self-Care Behaviors Among Older Adults with Atrial Fibrillation

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