Whose job is it? Gender differences in perceived role in heart failure self-care

Abstract

dickson vv, worrall‐carter l, kuhn l & riegel b (2011) Journal of Nursing and Healthcare of Chronic Illness3, 99–108 Whose job is it? Gender differences in perceived role in heart failure self‐care Aim. To describe gender differences in perceived role in heart failure (HF) self‐care and to explore how an individual’s perception of their role influences self‐care behaviours. Specifically, two hypotheses were tested: (1) there are gender‐specific differences in perceived self‐care roles in HF and (2) there are differences in self‐care secondary to a patient’s perceived role. Background. Gender differences in roles are ubiquitous in all societies. Rarely have these roles been examined as they contribute to performance of self‐care in adults with chronic illnesses. Methods. Secondary analysis of three mixed methods studies (n = 99) of adults with chronic heart failure. Data were collected between 2006–2008. Conclusions. Two dominant perceived roles in self‐care were identified: (1) active and (2) passive. These were further categorised according to the degree of independence described by participants in self‐care decision making: (1) primary responsibility (27%), (2) collaboration (22%) and (3) reliant upon direction from others (51%). Relevance to clinical practice. Clinicians are encouraged to assess the individual’s perceived role in HF self‐care as part of the self‐care education process. Understanding patient perceptions of their role may help guide education, which may be particularly useful for those patients most likely to defer to others for HF management advice.

Qualitative Analysis of Naturalistic Decision Making in Adults With Chronic Heart Failure

“…We found that when faced with competing personal goals, for example childcare versus managing symptoms, participants chose the action most compatible with their personal goals. This finding is consistent with our prior work in which we found that when other roles and responsibilities compete with self-care, decisions are affected (Dickson, Kuhn, , Worrall-Carter, & Riegel, 2011;Dickson, McCauley, & Riegel, 2008).…”

Predictors of Heart Failure Self-care in Patients Who Screened Positive for Mild Cognitive Impairment

“…Previous studies have found that male gender is a significant predictor for self-care maintenance 31 and management. 43 Some factors may impact men and women differently. 43 Some factors may impact men and women differently.…”

“…50 In this study, higher perceived social support was a significant predictor of better self-care maintenance and higher confidence in self-care abilities. Dickson and colleagues 43 found that regardless of the support, patients who took a passive role and relied on others for direction and help in managing symptoms had poorer self-care. 15,31,32 It may be that social support is more critical to success with self-care maintenance and improving confidence in patients with MCI.…”

The Situation-Specific Theory of Heart Failure Self-Care

“…21 Similarly, even among those who weigh themselves daily, lack of skill in evaluating the data obtained 32 and using it to manage symptoms (eg, diuretic titration) results in poor self-care. 33 Finally, the action or behavior chosen must be compatible with one's values. Values can be defined broadly as preferences concerning appropriate courses of action or outcomes and reflect one's sense of right and wrong.…”