Emilie Cewers, Adam Joensson, Jean Marc Weinstein, Tuvia Ben Gal, Tiny Jaarsma
Medical Faculty, Linkoping University, 58941 Linköping, Sweden.
DOI: 10.2340/16501977-2569

Objective: Physical activity is an essential part of managing heart failure. However, adherence to activity recommendations is low, especially in female patients. The aim of this study was to investigate the perceptions of healthcare providers regarding sex differences in physical activity, motivation, barriers, and whether adaptations in care based on sex might be meaningful.
Methods: This is a qualitative study; data were collected in semi-structured interviews with healthcare providers. The data were analysed using qualitative content analysis.
Results: The major overarching theme was that healthcare providers feel that “Men and women are equal, but different”. This theme was explained in terms of 7 sub-themes with associated categories, as follows: “Men and women prefer and perform different physical activity regardless of health status”, “Male and female heart failure patients have different motivations for, and barriers to, being active”, “Factors related to differences in physical activity and physical capacity between male and female heart failure patients”, “Heart failure has more impact on physical activity and physical capacity than patient’s sex”, and “Tailoring activity advice for heart failure patients based on sex. ”
Discussion: Healthcare providers had clear opinions regarding the existence of sex differences that might affect patients’ care. Several differences were identified in male and female heart failure patients in terms of physical activity. There seems to be a conflict between fear of discriminating and the value of personalizing care.

Physical activity is an essential part of managing heart failure. However, not all patients are active, especially women. This study investigated the perceptions of healthcare providers regarding sex differences in physical activity, motivations and barriers, and whether adaptations in care based on sex might be meaningful. This is a qualitative study and data were collected in interviews with healthcare providers. Data were analysed using qualitative content analysis. The major theme was that healthcare providers feel that “Men and women are equal, but they are different”. They described that men and women have different reasons and barriers to being active and that they perform different activities. They felt that different care might be needed for patients with heart failure, but that disease burden often has a greater impact on physical activity than patient’s sex.
Healthcare providers had clear opinions regarding the existence of sex differences that might affect patients’ care. Several differences were identified in male and female heart failure patients in terms of physical activity. There seems to be a conflict between fear of discriminating and the value of personalizing care.