Cardiology Research and Practice Table 4: Baseline and 12-month functional scores and functional outcomes by gender. SF-12-PCS KCCQ-PL Baseline 12 months Baseline 12 months Functional outcomes SF-12-PCS change KCQ-PL change Maintained/improved Declined Died Too ill to participate LTFU/Missing Maintained/improved Declined Died Too ill to participate LTFU/Missing LTFU: loss to followup. Women n 160 81 149 80 n 164 164 Mean (SD) 28.7 (7.6) 30.3 (7.5) 45.4 (24.2) 51.0 (24.4) n (%) 54 (32.9) 13 (7.9) 12 (7.3) 12 (7.3) 73 (44.5) 46 (28.0) 26 (15.9) 12 (7.3) 12 (7.3) 68 (41.5) Men n 263 143 254 137 n 271 271 Mean (SD) 30.8 (8.6) 34.2 (10.4) 52.1 (26.8) 61.5 (27.9) n (%) 99 (36.5) 20 (7.4) 42 (15.5) 18 (6.6) 92 (33.9) 72 (26.6) 47 (17.3) 42 (15.5) 16 (5.9) 94 (34.7) 7 P .012 .003 .012 .006 .078 .121 physical function, to drop out of the study due to increased illness, or to die within one year of an acute HF exacerbation when they perceived high levels of emotional/informational, aﬀectionate, and positive social interactional support. No signiﬁcant moderating eﬀect of gender on social support and adverse outcomes were seen in women in this cohort. This is somewhat contradictory to ﬁndings reported in the liter- ature. Similar to our study, previous literature supports the ﬁnding that increased social support has positive associations with health outcomes, however, the speciﬁcs of who beneﬁts, and how they beneﬁt diﬀers between studies. Bennett et al. [2] found that the likelihood of a HF-related admission decreased by 10% for each unit increase in tangible support (P = .05) for both male and female participants of all ages [2]. In another study of older persons (≥65 years) with HF, absence of emotional support signiﬁcantly increased the odds of cardiovascular events, deﬁned as death or hospitalization due to cardiovascular disease, within one year of HF-related admission (OR 3.2; 95% CI: 1.4, 7.8) [5]. These associations were only found in women. Social support seems to exert an inﬂuence on selected functional outcomes and/or cardiovascular events, but the direction and strength of this inﬂuence is not clear, nor is it consistent between genders. Our study contributes novel ﬁndings about the inﬂuence of support on functionally related outcomes and the nature of the interactions between gender and support on these outcomes. Further investigation is needed to be able to identify the type and amount of support needed to assist both men and women in managing their HF. 7. Strengths and Limitations A particular strength of this study is the detailed data captured at baseline and followup on patients with HF, a population that is usually diﬃcult to recruit and engage in study participation. As well, we employed standardized questionnaires, allowing for comparisons across reported studies. Self-report measures are valid measures of person’s perception of their illness and are related to clinical outcomes [1]. Furthermore, where possible, we ensured that partici- pants were able to complete the self-report questionnaires. However, we do acknowledge that questionnaire completion may have been compromised by the eﬀect of age and/or heart failure on cognitive and other abilities. Another strength of our study is that our outcome of interest was based on clinically important functional changes. Results are therefore more clinically meaningful and relevant to practice. A 52% completion rate limits the result validity; 20% of the baseline participants did not complete one-year followup due to death, or illness which emphasizes the fragility of this population. We addressed patient attrition to some extent in the sensitivity analysis. Patient attrition likely diluted relationships found between outcomes and support; however, trends found for both PL and PCS-based outcomes