Gender Differences in Symptoms, Functional Status and Quality of Life in Frail Elderly Heart Failure Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/151831
Type:
Presentation
Title:
Gender Differences in Symptoms, Functional Status and Quality of Life in Frail Elderly Heart Failure Patients
Abstract:
Gender Differences in Symptoms, Functional Status and Quality of Life in Frail Elderly Heart Failure Patients
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Todero, Catherine
P.I. Institution Name:University of Nebraska Medical Center
Objective. The primary purpose of this study was to examine gender differences in symptom status, functional status and quality of life in heart failure (HF) patients recently dismissed from the hospital following a heart failure exacerbation. A secondary purpose was to examine the impact of selected patient characteristics (i.e. severity of HF, and presence of comorbidities) on functional status and quality of life following acute exacerbation of failure. Design. This study used a descriptive, comparative design. Population, Sample, Setting: The sample included 92 subjects, 46 males and 46 females, with a diagnosis of heart failure who were recently dismissed from the hospital to their own home or apartment in a Midwestern, metropolitan area in the USA. Data collection occurred in the subjects' homes. Concepts/Variables. Selected demographic and patient clinical characteristics were examined for influence on symptom status, functional status and quality of life measures. Methods. Patient characteristics measured included severity of HF, presence of comorbidities and self-efficacy for heart failure management behaviors. The NYHA classification was used to estimate HF severity. Comorbidities were assessed through patient history and physician report. The Barnason Efficacy Expectation Scale-Heart Failure (BEES-HF) measured self-efficacy for heart failure management behaviors. The Cardiac Symptom Survey (CSS) measured patients’ symptom status on four dimensions: frequency, severity, and interference with physical activity and interference with enjoyment of life. Two measures determined functional status: the Heart Failure Functional Status Inventory (HFFSI), which estimates MET levels expended, and the 6-minute walk test. The Medical Outcomes Study Short Form-36 (SF-36) was used to measure health-related quality of life. Findings. There were significant gender differences in socioeconomic factors, HF severity, symptom status, MET level scores and some quality of life constructs. Females reported living alone more, less income, and classified heart failure more severely. Females reported greater numbers of symptoms, more severity in angina and fatigue, more interference with physical activity due to fatigue, shortness of breath and anxiety, and more interference with enjoyment of life due to fatigue and shortness of breath. Functional status measures varied significantly by heart failure severity. Males reported higher MET levels, but were not different from females in the objectively measured 6-minute walk distances. Self-efficacy scores were positively correlated with MET level in both men and women, and with 6-minute walk distances only for women. Males scored higher on the SF36 subscale constructs of physical functioning and mental health. Conclusions. Despite an objective functional status score similar to men, women perceived functional status as lower and reported greater numbers of symptoms and greater distress related to these symptoms. They perceived their heart failure as more severe and had lower quality of life scores for physical functioning and mental health. Implications. Managing heart failure and improving functional status and quality of life may require gender specific interventions. Efforts to improve physical functioning and quality of life may need to consider psychosocial factors that impact symptoms experienced, particularly by elderly women.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleGender Differences in Symptoms, Functional Status and Quality of Life in Frail Elderly Heart Failure Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151831-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Gender Differences in Symptoms, Functional Status and Quality of Life in Frail Elderly Heart Failure Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Todero, Catherine</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Nebraska Medical Center</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ctodero@unmc.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective. The primary purpose of this study was to examine gender differences in symptom status, functional status and quality of life in heart failure (HF) patients recently dismissed from the hospital following a heart failure exacerbation. A secondary purpose was to examine the impact of selected patient characteristics (i.e. severity of HF, and presence of comorbidities) on functional status and quality of life following acute exacerbation of failure. Design. This study used a descriptive, comparative design. Population, Sample, Setting: The sample included 92 subjects, 46 males and 46 females, with a diagnosis of heart failure who were recently dismissed from the hospital to their own home or apartment in a Midwestern, metropolitan area in the USA. Data collection occurred in the subjects' homes. Concepts/Variables. Selected demographic and patient clinical characteristics were examined for influence on symptom status, functional status and quality of life measures. Methods. Patient characteristics measured included severity of HF, presence of comorbidities and self-efficacy for heart failure management behaviors. The NYHA classification was used to estimate HF severity. Comorbidities were assessed through patient history and physician report. The Barnason Efficacy Expectation Scale-Heart Failure (BEES-HF) measured self-efficacy for heart failure management behaviors. The Cardiac Symptom Survey (CSS) measured patients&rsquo; symptom status on four dimensions: frequency, severity, and interference with physical activity and interference with enjoyment of life. Two measures determined functional status: the Heart Failure Functional Status Inventory (HFFSI), which estimates MET levels expended, and the 6-minute walk test. The Medical Outcomes Study Short Form-36 (SF-36) was used to measure health-related quality of life. Findings. There were significant gender differences in socioeconomic factors, HF severity, symptom status, MET level scores and some quality of life constructs. Females reported living alone more, less income, and classified heart failure more severely. Females reported greater numbers of symptoms, more severity in angina and fatigue, more interference with physical activity due to fatigue, shortness of breath and anxiety, and more interference with enjoyment of life due to fatigue and shortness of breath. Functional status measures varied significantly by heart failure severity. Males reported higher MET levels, but were not different from females in the objectively measured 6-minute walk distances. Self-efficacy scores were positively correlated with MET level in both men and women, and with 6-minute walk distances only for women. Males scored higher on the SF36 subscale constructs of physical functioning and mental health. Conclusions. Despite an objective functional status score similar to men, women perceived functional status as lower and reported greater numbers of symptoms and greater distress related to these symptoms. They perceived their heart failure as more severe and had lower quality of life scores for physical functioning and mental health. Implications. Managing heart failure and improving functional status and quality of life may require gender specific interventions. Efforts to improve physical functioning and quality of life may need to consider psychosocial factors that impact symptoms experienced, particularly by elderly women.</td></tr></table>en_GB
dc.date.available2011-10-26T11:15:08Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T11:15:08Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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