Influence of the environment on activity performance in older women with heart failure

Purpose. To examine the influence of the environment on activity performance in older women with heart failure living in the community. Method. The cross-sectional study included 55 older women with heart failure. Differences in activity performance collected through performance observation in the clinic and home were analysed with repeated measures ANOVAs and paired samples t-tests. Results. Overall, the influence of the environment in the clinic was neutral for activity independence, and disabling for activity safety and activity adequacy at the global level. At the domain level, functional mobility and personal care were more independent but equally safe and adequate in the clinic compared to the home, cognitively-oriented instrumental activities were less independent, safe and adequate in the clinic compared to the home, and physically-oriented instrumental activities were equally independent, but less safe and adequate in the clinic compared to the home. At the activity level, 6 activities were positively influenced by the environment in the clinic and 13 activities were negatively influenced. Conclusions. Findings suggest that the influence of the environment can be neutral, enabling, or disabling depending on the global scores or level of analysis being considered.