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

Aim The aim of this study was to critically analyse and describe gender differences related to self-care among patients with chronic heart failure (HF). Methods and results A monocentric real-world cohort of 346 patients with chronic HF in follow-up was used for this cross-sectional study. We report data related to the cohort's demographic and clinical characteristics. Selfcare was assessed using the Self-Care of Heart Failure Index before patients' discharge. After bivariate analysis, logistical regression models were used to describe the relationship between gender, self-care behaviours and self-care confidence. While men were found to have more than quadruple the risk of poor self-care than women (OR 4.596; 95% CI 1.075 to 19.650), men were also found to be approximately 60% more likely to have adequate self-care confidence than women (OR 0.412; 95% CI 0.104 to 0.962). Considering that self-care confidence is described as a positive predictor of behaviours, our results suggest a paradox. It is possible that the patient- caregiver relationship mediates the effect of confidence on behaviours. Overall, adequate levels of self-care behaviours are a current issue, ranging 7.6%-18.0%. Conclusion This study sets the stage for future research where elements of the patient-caregiver relationship ought to be considered to inform the planning of appropriate educational interventions. We recommend routinely measuring patients' self-care behaviours to guide their follow-up and as a basis for any changes in their daily life behaviours.