AN INVESTIGATION INTO GENDER DIFFERENCES IN SELF-CARE MAINTENANCE AND ITS IMPACT  AMONG PATIENTS WITH CHRONIC HEART FAILURE

CHAPTER ONE

INTRODUCTION

Background of the study

Chronic heart failure (CHF) is a multifaceted and progressive disorder marked by the heart's incapacity to pump enough blood to satisfy the body's requirements. It impacts over 64 million individuals globally and presents considerable problems to healthcare systems because to elevated morbidity and death rates (Yancy et al., 2013). The illness is linked to several symptoms, such as tiredness, dyspnoea, and oedema, which may significantly affect quality of life (Riegel et al., 2012). Effective treatment of CHF is essential, since it may alleviate symptoms, decrease hospitalisations, and enhance survival rates. Self-care is an essential component of controlling CHF, including tasks that patients do to preserve their health and regulate their condition. This include compliance with prescription medicines, dietary limitations, physical exercise, and symptom monitoring (Riegel et al., 2022). Studies have repeatedly shown that proficient self-care may result in enhanced clinical outcomes, including decreased hospital readmissions and increased health-related quality of life (Dunbar et al., 2013; Moser et al., 2012). Nonetheless, the practice of good self-care is often affected by several variables, such as socioeconomic position, health literacy, and social support (Hawkins et al., 2015).

Gender disparities in health behaviours have been extensively recorded in several chronic illnesses, including congestive heart failure (CHF). Research indicates that women often exhibit superior self-care behaviours compared to males, commonly ascribed to elevated levels of social support and enhanced contact with healthcare practitioners (Bennett et al., 2015; Moser et al., 2012). For example, female patients with CHF exhibit greater adherence to dietary guidelines and drug regimens than their male counterparts (Dunbar et al., 2013). Societal norms and expectations may impact these inequalities, typically prompting women to prioritise health and caring tasks (Bennett et al., 2015). Additionally, the psychological variables affecting self-care behaviours may differ by gender. Women may possess more resilient support networks, which may improve their capacity to manage their health (Moser et al., 2022). Conversely, males may display increased risk-taking behaviours and a propensity to downplay health concerns, which might result in suboptimal self-care practices and worse health outcomes (Dunbar et al., 2018). The difference in self-care routines across genders underscores the need for customised therapies that cater to the distinct requirements of male and female patients with CHF. Notwithstanding the acknowledgement of these gender variances, a considerable gap persists in comprehending how these discrepancies influence health outcomes in CHF patients. Most current research emphasises self-care behaviours while insufficiently examining the implications of gender-based disparities in self-care maintenance (Riegel et al., 2022). The complex interaction of gender, self-care, and health outcomes in chronic heart failure requires a detailed analysis to create effective treatments that enhance patient care. Therefore, the researcher sought to investigates gender differences in self-care maintenance and its impact  among patients with chronic heart failure.

1.2 Statement of the problem

Chronic heart failure (CHF) is a major public health concern impacting millions worldwide, resulting in elevated morbidity and death rates (Yancy et al., 2015). Self-care maintenance, including medication adherence, dietary adjustments, and symptom management, is essential for enhancing health outcomes in individuals with congestive heart failure (Riegel et al., 2012). Gender disparities in self-care behaviours have been noted, indicating that men and women may engage in self-care differently (Bennett et al., 2015). Studies demonstrate that female patients with congestive heart failure exhibit superior self-care maintenance compared to male patients (Dunbar et al., 2018). This gap may be ascribed to several reasons, such as social support, health literacy, and divergent views of sickness (Moser et al., 2022). Women often indicate elevated levels of social support, which may improve their self-care practices (Moser et al., 2022). In contrast, males may display increased risk-taking behaviours and less participation in self-care, thereby adversely affecting their health outcomes (Bennett et al., 2015). Although gender variations in self-care maintenance are known, there is little comprehension of how these disparities directly influence health outcomes in CHF patients. The absence of specific treatments addressing gender differences in self-care habits may result in inadequate management of CHF, especially among male patients (Riegel et al., 2022). Hence, the study investigates gender differences in self-care maintenance and its impact  among patients with chronic heart failure.

1.3 Objective of the study

The broad objective of the study is to investigate gender differences in self-care maintenance and its impact  among patients with chronic heart failure. The specific objectives is as follows

To assess the level of self-care maintenance among male and female patients with chronic heart failure.

To identify the self-care behaviors that differ between genders in patients with chronic heart failure.

To investigate the role of health literacy in influencing self-care practices among male and female patients with chronic heart failure.

To identify barriers to effective self-care faced by male and female patients with chronic heart failure.

1.4 Research questions

The following questions have been prepared to guide the study

What is the level of self-care maintenance among male and female patients with chronic heart failure?

What are the self-care behaviors that differ between genders in patients with chronic heart failure?

What is the role of health literacy in influencing self-care practices among male and female patients with chronic heart failure?

What are the barriers to effective self-care faced by male and female patients with chronic heart failure?

1.5 Significance of the study

Findings from this study can contribute to healthcare policies that promote gender equity in chronic disease management. Policymakers can leverage the findings to advocate for resources and programs that specifically address the self-care needs of diverse patient populations. Findings of the study will also be significant to the academic community as it will contribute to the existing literature, add to library resources and serve as a guide to future academic researchers

1.6 Scope of the study

The study focus on gender differences in self-care maintenance and its impact  among patients with chronic heart failure. Empirically, the study will assess the level of self-care maintenance among male and female patients with chronic heart failure, identify the self-care behaviors that differ between genders in patients with chronic heart failure, investigate the role of health literacy in influencing self-care practices among male and female patients with chronic heart failure and identify barriers to effective self-care faced by male and female patients with chronic heart failure.

Geographically, the study will be delimited to General hospital Asaba.

1.7 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint are: 

Time: The researcher encountered time constraint as the researcher had to carry out this research along side other academic activities such as attending lectures and other educational activities required of her.

Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process.

Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study.

1.8 Definition of terms

Chronic Heart Failure (CHF): A medical condition in which the heart is unable to pump sufficient blood to meet the body's needs, leading to symptoms such as fatigue, shortness of breath, and fluid retention. CHF is a progressive disease that can result from various underlying conditions, including coronary artery disease, hypertension, and diabetes.

Self-Care Maintenance: The activities and behaviors that patients engage in to manage their health and maintain their well-being. In the context of CHF, self-care maintenance includes adherence to prescribed medications, dietary modifications, regular physical activity, symptom monitoring, and lifestyle changes aimed at improving overall health.

Gender Differences: The distinct behaviors, attitudes, and practices associated with being male or female, often influenced by biological, psychological, social, and cultural factors. In this study, gender differences refer to variations in self-care maintenance practices between male and female patients with CHF.

Adherence: The extent to which a patient's behavior corresponds with agreed-upon recommendations from a healthcare provider regarding treatment regimens, including medication intake, lifestyle modifications, and self-monitoring practices.

Social Support: The emotional, informational, and practical assistance provided by family, friends, and community members. Social support can play a significant role in influencing self-care behaviors and health outcomes in patients with chronic illnesses like CHF.

Health Literacy: The ability of individuals to access, understand, and use health information to make informed decisions about their healthcare. Higher health literacy is associated with better self-care practices and health outcomes.

Psychosocial Factors: The interrelation of psychological and social aspects that can influence an individual's health behavior and outcomes. These factors may include mental health conditions (e.g., depression, anxiety), coping strategies, and social interactions.

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