ISSUES IN CARDIOVASCULAR NURSING Gender and racial differences in psychosocial factors of low-income patients with heart failure Aurelia Macabasco-O’Connell, PhD, RN, ACNP-BC, FAHA, a Michael H. Crawford, MD, b Nancy Stotts, EdD, RN, b Anita Stewart, PhD, b and Erika S. Froelicher, PhD, RN b BACKGROUND: Heart failure (HF) is a debilitating chronic disease with incidence and prevalence continuing to increase, particularly in low-income, minority groups. Psychosocial variables have recently emerged as important predictors of cardiovascular risk and health outcomes in HF. However few data exist in this group. Thus, the purpose of this study is to examine the sociodemographic and psychosocial variables in low-income patients with HF. METHODS: This is a descriptive, cross-sectional study using 1-time interviews. Subjects with HF were recruited from 3 cardiology clinics and 1 community hospital. RESULTS: Fifty-five percent of the sample (n = 65) were women with a mean (standard deviation) age of 59 years (14); 35% were non-white, 86% were unemployed, 56% had an annual income < $10,000, and 52% were uninsured. Most reported having high social support (83%), poor health perception (82%), and severe depressive symptoms (70%). Non-white men seemed to have worse health perceptions and more depressive symptoms. CONCLUSION: Low-income patients with HF, particularly non-white men, have poor health perception and more depressive symptoms. This is important because HF has been associated with increased morbid- ity and mortality in patients. Future research is necessary to explore ways in designing effective interven- tions to improve health outcomes. (Heart LungÒ 2010;39:2–11.) H eart failure (HF) is a debilitating chronic dis- ease with incidence and prevalence continu- ing to increase, particularly in low-income, minority groups. 1 It is well known that in developed countries, lower socioeconomic status (SES) groups have a greater prevalence of cardiovascular (CV) risk factors that can lead to HF, a higher incidence of CV disease, and a higher mortality. 2 In addition, survival remains poor and HF is one of the leading causes of hospitalizations and costs. 1 Given the high morbid- ity and mortality associated with HF, these patients often report psychologic distress and diminished quality of life (QOL). 3-7 As the demographic characteristics of the popu- lation changes, we are likely to see greater variations in ethnicities and SES within the population of adults with HF. Persons from lower SES groups experience more stressful life events and subjective distress than their higher SES counterparts, as well as a higher prevalence of psychosocial factors and poorer availability of psychosocial resources. 8,9 Psy- chosocial variables such as health perception, social support, and depression have recently emerged as important predictors of risk for CV events among patients with cardiac disease, as well as predictors of health outcomes in patients with HF. 10 Thus, given the increasing costs associated with HF, as- sessing psychosocial factors in low SES, uninsured, minority patients is imperative to assist clinicians in identifying those at increased risk. Few data exist on this increasing population of patients with HF. Therefore, the purpose of this descriptive study was to examine the sociodemographic and psycho- social variables in low SES, uninsured patients with HF. From the a University of California Los Angeles, Los Angeles, California; and b University of California San Francisco, San Fran- cisco, California. Corresponding author: Aurelia Macabasco-O’Connell, PhD, RN, ACNP-BC, FAHA, 700 Tiverton Ave, 4-242 Factor Bldg, Los Angeles, CA 90095-6918. 0147-9563/$ – see front matter Ó 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.hrtlng.2009.05.001 2 www.heartandlung.org JANUARY/FEBRUARY 2010 HEART & LUNG