AN INVESTIGATION ON GENDER-BASED VARIATIONS IN SELF-CARE MAINTENANCE AND THEIR EFFECTS AMONG INDIVIDUALS LIVING WITH CHRONIC HEART FAILURE

CHAPTER ONE INTRODUCTION 1.1 Background of the Study Chronic Heart Failure (CHF) is a complex and long-term health condition characterized by the heart’s inability to pump enough blood to meet the body’s needs. Affecting more than 64 million people worldwide, CHF presents significant challenges for healthcare systems due to its high rates of illness and mortality (Yancy et al., 2013). It is commonly associated with symptoms like fatigue, shortness of breath (dyspnoea), and fluid retention (oedema), all of which severely impact patients’ quality of life (Riegel et al., 2012). Effective management of CHF is crucial, as it helps in alleviating these symptoms, reducing the number of hospital admissions, and improving patient survival rates. A key part of managing CHF lies in self-care—daily tasks that individuals undertake to maintain their health and control their condition. These include taking prescribed medications, following dietary restrictions, engaging in regular physical activity, and consistently monitoring symptoms (Riegel et al., 2022). Research consistently shows that effective self-care leads to improved health outcomes, such as lower hospital readmission rates and better quality of life (Dunbar et al., 2013; Moser et al., 2012). However, numerous factors can influence a person’s ability to maintain proper self-care, including their socioeconomic status, level of health literacy, and the extent of social support they receive (Hawkins et al., 2015). There is substantial evidence pointing to gender-based differences in health-related behaviors, especially in chronic conditions like CHF. Studies suggest that women often practice better self-care behaviors than men, a trend often linked to stronger social support networks and more frequent interactions with healthcare providers (Bennett et al., 2015; Moser et al., 2012). For example, women with CHF are more likely to adhere to medication routines and dietary recommendations compared to men (Dunbar et al., 2013). Social and cultural norms may also contribute to this trend, as women are generally expected to prioritize health and caregiving responsibilities (Bennett et al., 2015). Psychological factors also differ between genders and can influence self-care practices. Women often have more robust support systems, which can enhance their ability to manage their health effectively (Moser et al., 2022). On the other hand, men are more likely to engage in risk-taking behaviors and may underreport or ignore health issues, leading to poorer self-care and worse health outcomes (Dunbar et al., 2018). These gender-based differences in self-care behaviors highlight the need for tailored interventions that address the unique needs of male and female CHF patients. Despite growing recognition of these gender differences, there remains a significant gap in understanding how these disparities affect health outcomes in CHF patients. While existing research often focuses on self-care behaviors, it falls short of fully exploring the implications of gender-specific variations in self-care maintenance (Riegel et al., 2022). Therefore, this study aims to examine gender differences in self-care maintenance and assess how these differences impact the health outcomes of individuals living with chronic heart failure. 1.2 Statement of the Problem Chronic heart failure is a widespread public health issue that affects millions across the globe, contributing significantly to increased rates of illness and death (Yancy et al., 2015). Effective self-care—encompassing adherence to medications, dietary changes, and symptom monitoring—is essential for improving outcomes in CHF patients (Riegel et al., 2012). Evidence shows that men and women approach self-care differently, with women generally demonstrating better self-care maintenance (Bennett et al., 2015). This trend has been attributed to various factors such as social support systems, health literacy, and differing perceptions of illness (Moser et al., 2022). Female CHF patients often report higher levels of social support, which positively influences their self-care practices (Moser et al., 2022). Conversely, male patients are more likely to engage in risky behavior and participate less in self-care, which may lead to poorer health outcomes (Bennett et al., 2015). Although these gender-related differences in self-care are well-documented, there is limited understanding of how they directly affect the health outcomes of CHF patients. The lack of targeted interventions that consider these gender variations may result in ineffective disease management, especially for male patients (Riegel et al., 2022). This study therefore seeks to explore how gender differences in self-care maintenance influence patient outcomes in chronic heart failure cases. 1.3 Objective of the Study The general aim of this study is to investigate gender differences in self-care maintenance and their impact on patients living with chronic heart failure. The specific objectives are: i. To evaluate the level of self-care maintenance among male and female CHF patients. ii. To identify gender-specific self-care behaviors among CHF patients. iii. To assess how health literacy influences self-care practices in male and female CHF patients. iv. To examine the barriers to effective self-care experienced by male and female CHF patients. 1.4 Research Questions To guide the study, the following research questions have been formulated: i. What is the level of self-care maintenance among male and female CHF patients? ii. Which self-care behaviors differ between male and female CHF patients? iii. How does health literacy affect self-care practices in male and female CHF patients? iv. What barriers to effective self-care are encountered by male and female CHF patients? 1.5 Significance of the Study The outcomes of this research may play a crucial role in shaping healthcare policies that support gender-sensitive approaches to managing chronic illnesses. Policymakers can use the findings to develop programs and allocate resources more equitably, ensuring that the unique self-care needs of different genders are addressed. Furthermore, the study will add valuable insights to the academic field, contribute to existing scholarly literature, and serve as a useful reference for future researchers and students. 1.6 Scope of the Study This study focuses specifically on the differences in self-care maintenance between male and female patients with chronic heart failure and the resulting effects on their health. Empirically, it will examine the levels of self-care among genders, identify behavioral differences, explore the role of health literacy, and uncover barriers to effective self-care. Geographically, the study is limited to patients receiving treatment at the General Hospital in Asaba. 1.7 Limitation of the Study As with many academic endeavors, this research faced some challenges. Time Constraints: The researcher had to juggle this project with other academic responsibilities, including attending lectures and fulfilling coursework. Financial Limitations: Significant personal expenses were incurred during the study, including costs related to typesetting, printing, data collection, and sourcing relevant materials. Availability of Materials: A major hurdle was the limited availability of literature related to this specific research topic, which made the process of literature review more difficult. 1.8 Definition of Terms Chronic Heart Failure (CHF): A persistent condition where the heart fails to pump adequate blood to meet the body’s demands, often resulting in symptoms like fatigue, breathlessness, and fluid buildup. It usually stems from underlying health issues such as coronary artery disease, hypertension, or diabetes. Self-Care Maintenance: Activities and behaviors undertaken by individuals to manage their health and well-being. In CHF, this includes sticking to medication, adjusting diet, exercising regularly, monitoring symptoms, and making lifestyle changes. Gender Differences: Variations in behavior, attitudes, or practices between males and females, shaped by biological, psychological, social, and cultural influences. In this study, it refers to differences in how men and women with CHF manage their self-care.