A cardiac rehabilitation program to improve psychosocial outcomes of women with heart disease.
OBJECTIVE
Heart disease in women is characterised by greater disability and a higher rate of morbidity and early death after an acute coronary event compared with men. Women also have lower participation rates than men in cardiac rehabilitation. This study sought to describe development of a nurse-directed cardiac rehabilitation program tailored to the needs of women following an acute cardiac event to address their psychological and social needs.


METHODS
The Heart Awareness for Women program (HAFW) commenced in 2003 with phase I involving development of program elements and seeking validation through consumers and clinical experts. The program was then trialed in an 8-week program in a convenience sample of 6 women. Phase II applied the revised program using action research principles focusing on enabling clinical staff to implement the ongoing program. A total of 54 women participated in this phase, 48 of whom completed baseline questionnaires. A mixed-method evaluation, using questionnaires, interviews, and observation, assessed the impact of the intervention on psychological and social aspects of women's recovery following an acute coronary event.


RESULTS
Women welcomed the opportunity to discuss their individual stories, fears, and challenges and to derive support from contact with other women. Via health professional facilitation, women were able to develop strategies collectively to address risk factor modification and achieve optimal cardiovascular health. No statistically significant changes in depression, anxiety, stress, cardiac control, role integration, or perceived social support were found; however, descriptive and qualitative findings revealed decreases in anxiety and an increased sense of social support.


CONCLUSIONS
On the basis of this study, a cardiac rehabilitation program tailored to the needs of women appears to be feasible and acceptable. The efficacy of this intervention to improve health-related outcomes needs to be tested in a randomized, controlled trial.
Davidson
Patricia
P
School of Nursing and Midwifery, Centre for Cardiovascular and Chronic Care, Curtin University of Technology, Australia. p.davidson@curtin.edu.au
Digiacomo
Michelle
M
Zecchin
Robert
R
Clarke
Mary
M
Paul
Glenn
G
Lamb
Kate
K
Hancock
Karen
K
Chang
Esther
E
Daly
John
J
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003327:Coronary Disease / Q000451:nursing / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000451:nursing / Q000523:psychology* / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D010353:Patient Education as Topic; D011322:Primary Prevention / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D011788:Quality of Life; D012017:Referral and Consultation; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States; D016387:Women's Health