title: A secondary meta-synthesis of qualitative studies of gender and access to cardiac rehabilitation.
abstract: OBJECTIVE
  To discuss issues in the theorization and study of gender observed during a qualitative meta-synthesis of influences on uptake of secondary prevention and cardiac rehabilitation services.
  
  
  BACKGROUND
  Women and men can equally benefit from secondary prevention/cardiac rehabilitation and there is a need to understand gender barriers to uptake.
  
  
  METHODS
  Meta-method analysis secondary to meta-synthesis. For the meta-synthesis, a systematic search was performed to identify and retrieve studies published as full papers during or after 1995 and contained: a qualitative research component wholly or in a mixed method design, extractable population specific data or themes for referral to secondary prevention programmes and adults ≥18 years.
  
  
  METHODS
  Databases searched between January 1995-31 October 2011 included: CSA Sociological Abstracts, EBSCOhost CINAHL, EBSCOhost Gender Studies, EBSCOhost Health Source Nursing: Academic Edition, EBSCOhost SPORTDiscus, EBSCOhost SocINDEX.
  
  
  METHODS
  Studies were reviewed against inclusion/exclusion criteria. Included studies were subject to quality appraisal and standardized data extraction.
  
  
  RESULTS
  Of 2264 screened articles, 69 were included in the meta-method analysis. Only four studies defined gender or used gender theories. Findings were mostly presented as inherently the characteristic of gendered worldviews of participants. The major themes suggest a mismatch between secondary prevention/cardiac rehabilitation services and consumers' needs, which are usually portrayed as differing according to gender but may also be subject to intersecting influences such as age or socioeconomic status.
  
  
  CONCLUSIONS
  There is a persistent lack of theoretically informed gender analysis in qualitative literature in this field. Theory-driven gender analysis will improve the conceptual clarity of the evidence base for gender-sensitive cardiac rehabilitation programme development.
authors: Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada.
authors: Jan E
authors: JE
authors: Angus
authors: Faculty of Nursing and Department of Community Health Sciences, University of Calgary, Alberta, Canada.
authors: Kathryn M
authors: KM
authors: King-Shier
authors: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors: Melisa A
authors: MA
authors: Spaling
authors: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors: Amanda S
authors: AS
authors: Duncan
authors: Department of Physical Therapy, University of Toronto, Ontario, Canada.
authors: Susan B
authors: SB
authors: Jaglal
authors: Faculty of Medicine, University of Calgary Director of Research, Cardiac Wellness Institute of Calgary, Alberta, Canada.
authors: James A
authors: JA
authors: Stone
authors: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors: Alexander M
authors: AM
authors: Clark
mesh_terms: D005260:Female; D006297:Health Services Accessibility; D006331:Heart Diseases / Q000534:rehabilitation*; D006801:Humans; D008297:Male
keywords: access; cardiac rehabilitation; cardio thoracic nursing; gender; qualitative meta-synthesis; secondary prevention