By the end of this section, you will be able to:
decribe the challenges that HF patients live with every day
explain how factors affecting quality of life differ between genders
describe the emotional effect of HF, and how this is different between men and women
describe how the perception of health differs between genders, and how perceived health affects physical health
explain the impact of guilt and depression in HF
discuss the effect of ascribing feelings to an illness and the power of positive thinking
Heart failure is so damaging to quality of life (QoL) because of the pervasive way it damages the lungs, skeletal muscle and circulatory system. Patients are often left feeling fatigued, and unable to perform activities of daily living that they deem important . Both men and women complain about the physical and social restrictions that come hand in hand with a HF diagnosis .
Gender is important in determining which QoL factors are most important and how seriously affected a patient will be by certain symptoms. For example women reported that physical symptoms such as dyspnea had the greatest negative effect on their QoL 
Common factors that affect QoL
Activities of daily living
Social support is imperative for patients attempting to maintain or improve their QoL. One study found that the risk of fatal and non-fatal cardiovascular events in the year following hospital admissions was significantly decreased with the presence of emotional support. Interestingly, this relationship was only seen in women 
One study looked at a group of patients with a matched left ventricle ejection fraction and noticed that women experience significantly lower QoL levels, as well as low physical and social function 
The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is a tool commonly used to assess the perceived quality of life in heart failure patients.
2. Riedinger MS, Dracup KA, Brecht ML, Padilla G, Sarna L, for the SOLVD investigators, and Patricia A Ganz. Quality of life in patients with heart failure: Do gender differences exist? Heart Lung. 2001;30(2):105-16.
7. Krumholz HM, Butler J, Miller J, Vaccarino J, Williams C, Mendes de Leon C, Seeman T, Kasl S, Berkman L.Pr ognostic importance of emotional support for elderly patients hospitalized with heart failure.Cir culation 1998;97:958 –64.