N 163 265 162 266 161 265 154 264 158 263 163 269 Baseline Mean (SD) 69.5 (27.4) 73.9 (27.0) 71.3 (31.0) 80.3 (27.7) 80.9 (27.0) 80.4 (30.4) 67.3 (31.7) 73.4 (32.0) 67.6 (31.5) 72.3 (32.9) 71.0 (24.6) 75.7 (26.6) P .108 .002 .844 .057 .144 .068 study of 1382 age and LVEF-matched HF patients [28]. When controlling for NYHA class, age, and LVEF, women had lower mean scores (SD) than men in measures of functional status including basic activities of daily living (ADLs) (P < .01), intermediate ADLs (P < .01), and perceived general health (P < .01). Qualitative research in the ﬁeld has given valuable insight into patients’ experiences with HF and its subsequent eﬀects on their functional well-being [29, 30]. Bosworth et al. [29] identiﬁed 5 themes from a cross-sectional qualitative study of focus groups of male patients with HF. Symptoms, role loss, aﬀective responses, coping, and social support were all areas patients identiﬁed as being negatively aﬀected by their HF and consequently decreased their QOL. Similar themes were identiﬁed by Heo and colleagues [27] in 6 LV ejection fraction ≤40% >40% Missing Comorbid conditionsb 0–2 comorbidities >2 comorbidities Missing Emotional/information Women Men Tangible Women Men Aﬀectionate support Women Men Positive social interaction Women Men Additional Women Men Overall Women Men aDiagnosis of CHF requires the simultaneous presence of at least 2 major criteria or 1 major in conjunction with 2 minor criteria which is outlined by the Framingham Criteria for congestive heart failure. bThe functional comorbidity index is an 18-item list of diagnoses associated with functional impairment. Median number of comorbidities for both females and males was 2.0. Table 3: Gender diﬀerences in baseline social support scores. Cardiology Research and Practice (b) Continued. Women n = 164 54 (32.9) 81 (49.4) 29 (17.7) 72 (43.9) 78 (47.6) 14 (8.5) Men n = 271 126 (46.5) 103 (38.0) 42 (15.5) 139 (51.3) 103 (38.0) 29 (10.7) P .006 .068 an interview-based qualitative study of men and women living with HF. Participants identiﬁed personal and material supports from their signiﬁcant others as having an important impact on their quality of life. Findings from our study suggest that both men and women experience considerable physical burden living with HF and that women report more limitations than men. 6.2. Gender and Maintenance of Functional Well-Being. Despite the gender diﬀerences in functional levels, no diﬀerences existed in functional maintenance or decline over one year. These results are consistent with other studies. After adjusting for disease severity, although women rated QOL worse than men in a number of domains, Riedinger et al. [28] found no signiﬁcant diﬀerences between genders with respect to QOL changes. Possible explanations for our ﬁndings include (1) women started with a lower functional score, perhaps less severe disease (i.e., higher LV function) with greater opportunity for improvement and less capacity for decline, whereas men started with higher scores, more severe disease and less capacity for improvement and more capacity for decline; (2) individuals who completed the 12-month data collection period were more likely to be functioning at a higher level to begin with and, as reﬂected in the reported 12-month scores, were more likely to maintain or improve functioning regardless of gender; (3) the disease progression of HF is diﬃcult to inﬂuence, and so functional decline inevitably occurs. As reﬂected in the physical limitation scores of the KCCQ, more participants experienced disease-related functional decline versus overall functional decline in the physical component score of the SF- 12. Unfortunately, the long-term prognosis for HF is poor, with 5-year survival rates for men and women being <40%; thus, functional decline, especially which relates directly to the disease and disease impact, is expected. 6.3. Social Support and Functional Outcomes. Levels of social support at baseline had little impact on 12-month disease- speciﬁc functional outcomes; however, social support inﬂu- enced 12-month generic functional outcomes. Men were signiﬁcantly less likely to report a decline in general health or