Women’s Lived Experiences with Heart Disease in NW Ontario Paulette Lacroix, RN, MPH Diverse Symptoms
Introduction Cardiovascular Disease (ischemic heart disease, coronary artery disease and stroke) is the number one iller of men and women in Canada and the leading cause of hospital admissions. Residents in NW Ontario have higher rates of risk for CVD than the provincial average, and individuals present at younger ages with multiple risk factors. The NWO District Health Council predicted a 28% increase in cardiovascularrelated deaths for women between 1995 and 2016.
Women who DID NOT experience crushing chest pain expressed surprise they had suffered a heart attack. They expected a heart attack “…like
you see on TV. I didn’t think I had a heart attack, that’s what it boils down to, so I waited. I didn’t even go to the doctor”.
Method Purposive sampling of 30 participants (15 urban,15 rural) aged 45 to 80 years with diagnosed cardiovascular disease in the past 6 months to 3 years. Taped interviews and survey questionnaires were transcribed for analysis.
Demographics Median Age/Dx 66.0 (SD 11.2, 46-81) Median Age/Interview 56.8 (SD 11.6, 31-78) Note: 8< 40 years Marital Status 70.0% married Father CVD <55 30.0% Mother CVD <65 16.7% Sibling CVD any age 44.4% (1st degree) Spouse CVD any age 46.7% (lifestyle)
Diagnosis AMI Arrhythmias IHD Angina CHF
46.7% 13.3% 16.7% 13.3% 3.6%
Treatment CABG Medication
60.8% 39.2%
Lack of Information and Misinterpretation of Results Led to Avoidance of Subsequent Testing A younger woman with school-aged children asked about having an angioplasty for CVD blockages of 40 and 70% and was told that she
“didn’t need it until (she) had chest pain”. The message she
Information and Community Care 43% first received information about heart disease in hospital. 40% received NO information at all. Lack of Community services on discharge meant women relied on family and friends. Two women talked of washing floors, doing laundry and shopping within 2 days post-op
Self-Reported Confidence with Health How do you feel about your health Uncertain Somewhat certain Confident Total Scores Pearson chi-square value Degrees of Freedom Significance Level
“I am stubborn and I figure there is no reason why I can’t do all of this”.
At Dx 10 8 12 30 0.800 df = 2 p = .670
At Interview 4 7 19 30 12.600 df = 2 p. = .002
CABG.
83.3% of women reported having a lot/fair bit of control over their health. Older women reported having control more often (60%) than the younger women who remained uncertain.
⌘ A young woman post-AMI with no community follow-up was readmitted in heart failure. Her husband as caregiver regulated her medications and made meals, not aware this almost caused her death.
“The Doctor never said that she couldn’t have salt, or this or that – and that’s what happened”.
Conclusion 1.Increase
awareness
of
gender-based
symptom diversity of CVD.
internalized was that she was a
2.Women’s perceived role may influence type
“train wreck waiting to happen”
and amount of information/services provided
and was afraid to leave her home.
“It was easier to change doctors than go back for a stress test”. Another woman stated,
75% of women (aged 46-59) rated themselves as having worse health than other women of the same age. Older women rated their health as better or same as their contemporaries.
post-discharge. 3.CVD
in
Women
sense of control.
Selected References 1. Clark, A. et al (2006). Health Promotion in heart failure: A paradigm shift. Holistic Nursing Practice, 20(2), 73-79. Retrieved March 12 2006 http://gateway.ut.ovid.com.ezproxy.lakeheadu.ca/gw1/ovidweb.cgi 2. Fridlund, B. (2000). Self-rated health in women after their first myocardial infarction: A 12-month comparison between participation and non-participation in a cardiac rehabilitation programme. Health Care For Women International, 21, 727-738.
4. Rosenfeld, J. (2000). Gender-specific statistics and prevention strategies for a population at risk. Postgraduate Medicine, Heart Disease in Women, 107(6), 111-116.
years
were
more
adversely affected in self-rated health and
(r = -.523, p = .01).
3. Johansen H. (1999). Living with heart disease: The working-age population. Health Reports, 10(4), 33-45.
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