Date of Completion


Embargo Period



heart failure, self-care, women, gender differences

Major Advisor

Colleen Delaney

Associate Advisor

Cheryl Beck

Associate Advisor

Stephen Walsh

Field of Study



Doctor of Philosophy

Open Access

Open Access


Self-care is paramount to the successful management of heart failure. Although recent trends in heart failure have shown a decline in hospitalizations and emergency room visits, observational unit admissions related to heart failure exacerbations continue to rise (Albert, 2016). Although nearly half (47%) of the heart failure population is female women are historically under-represented in heart failure research that guide best practice recommendations (Pressler, 2016). Therefore, the primary aim of this mixed methods study was to identify differences in women who demonstrate an adequate heart failure self-care maintenance (score >70) behaviors as compared to women who score inadequately (score < 69) as measured by the Self-Care of Heart Failure Index (SCHFI) version 6.2. Quantitative data revealed a significant, parabolic relationship between heart failure self-care maintenance and self-care confidence scores. Qualitative analysis suggested that assuming an active or passive role in heart failure self-care plays an important role in women’s heart failure self-care maintenance. Mixed methods analysis revealed high heart failure self-care confidence levels may not reflect an adequate level of heart failure self-care maintenance behaviors. Further research is required to expand on the factors that were found to both facilitate and impede heart failure self-care and to continue to improve health outcomes for women with heart failure.