Relationship of Depressive Symptoms to the Impact of Physical Symptoms on Functional Status in Women With Heart Failure

Abstract

Background Among patients with heart failure, women have worse functional status than do men, but little research has focused on determining factors that influence functional status in either sex. Objectives To compare factors that influence functional status in men and women with heart failure and to test whether depressive symptoms mediate the relationship between physical symptoms and functional status. Methods A cross-sectional, descriptive study design was used. A total of 231 patients, 133 men and 98 women, were recruited from an inpatient heart failure clinic in South Korea. Functional status (the Korean Activity Scale/Index), physical symptoms (the Symptom Status Questionnaire), depressive symptoms (the Beck Depression Inventory), and situational factors (living status, socioeconomic status) were measured. Hierarchical multiple regression and mediation analysis were used for data analysis. Results Women (mean score, 24.5; SD, 17.3) had worse functional status than did men (mean score, 31.9; SD, 20.1; P = .004). Dyspnea on exertion (β = -0.16), ankle swelling (β = -0.19), fatigue (β = -0.20), and depressive symptoms (β = -0.19) were independently associated with functional status in women, whereas only dyspnea on exertion (β = -0.30) influenced functional status of men in hierarchical multiple regression analysis. Mediation analysis indicated that depressive symptoms mediated the relationship between physical symptoms and functional status in women with heart failure, but not in men. Conclusions Distinct physical and psychological symptoms influence functional status in women with heart failure. A systematic multidimensional intervention may be required to target depressive symptoms to improve functional status in women with heart failure.

Family Support, Social and Demographic Correlations of Non-Adherence among Haemodialysis Patients

“…Theofilou explains that the number of pills in elderly is greater than in young patients leading in NA. Similar results are mentioned in other studies [29][30][31]. Searcher argues that women are more vulnerable to mental disorders.…”

“…However, marital status was not found to be related to patient adherence in three recent studies [54][55][56].Lack of social/family support is sometimes a bar to adherence in HD according to the reviewed literature [29,32,34,[37][38][39][40][41][42].Friends and family offers an incentive for learning and complying with the life changes. However, social support affects positively outcomes and is a link between HD patient and adherence to treatment regimen.…”

Life satisfaction, depressive symptoms and perceived social support in heart failure patients [Satisfacción vital, síntomas depresivos y apoyo social percibido en pacientes con insuficiencia cardiaca]

“…Gender was also a signifi cant predictor; life satisfaction was more associated with male than with female patients. Women with HF have been found to experience worse functional status (Song, Moser, & Lennie, 2009) and less quality of life (Bennett et al, 2001;Chin & Goldman, 1998) than male patients. Our results point out that gender is an important factor to be considered in the development of interventions to help women with HF to live a satisfying and productive life (Plach, 2008).…”

Knowledge of Women With Heart Failure

“…6 Isso está relacionado à perda da proteção estrogênica ocasionada pela menopausa. Assim, as mulheres vivenciam significativo aumento da morbimortalidade por doenças cardiovasculares conforme o envelhecimento, especialmente após os 50 anos.…”

“…3,5 Mulheres com IC demonstram menos qualidade de vida, mais comprometimento da capacidade funcional e mais sintomas de depressão do que homens, além de apresentarem sinais clínicos mais graves e sinais e sintomas mais frequentes. 6 Outro aspecto que não pode ser ignorado é o reduzido envolvimento das mulheres nos ensaios clínicos em insuficiência clínica, que corresponde a 17-23%, sendo significantemente menor que homens. 7 Segundo a American Heart Association 8 , o autocuidado no caso dos pacientes portadores de IC exige diversas ações, como o seguimento correto das medicações, dieta com baixo teor de sódio, comportamentos preventivos e atenção aos sinais e sintomas apresentados.…”