Home and Community Care Digest
Methods: In a literature review, qualitative studies from 1995 to 2007 that explored cardiac pain for acute myocardial infarction, angina, congestive heart failure and pain post-treatment were reviewed. Of 221 studies, 6 studies met the inclusion criteria of being qualitative and focused on women's experience of cardiac pain. Main concepts, participants and themes were included in a summary table of the studies.
Findings: The six studies reviewed by the author used qualitative methods to examine the pain experience of women from Australia, the United States and England. Two focused on interpretation of pain, two on symptoms of AMI, one on illness perception following AMI and one on the lived experiences of women with angina. Five themes were identified. (1) Prodromal and acute pain symptoms can vary widely (from general chest discomfort and include left breast pain, fatigue, shoulder blade discomfort, arm heaviness or ache, chest sensations, sudden shortness of breath, hot or flushed, and sweating). (2) Most women did experience prodromal (warning) signs, but failed to seek medical treatment because of the lack of recognition of cardiac pain and risk factors. (3) Living with CHD is a process involving continual reorganizing of the cardiac pain experience. (4) There is a disconnect between the approach of women and practitioners to CHD and (5) Gender differences in cardiac pain experience were key factors influencing access to appropriate treatment. Cardiac disease is prevalent in women of all ages and in all cultures ranging from 27 to 82, with mean age 66.
Conclusions: The author concluded that misconceptions of "typical heart pain" have caused lack of recognition, diagnosis and treatment of CHD in women. Research and education need to increase awareness that cardiac pain differs in women. Healthcare practitioners and leaders need to be cognizant of women's experience of chest pain to dispel assumptions that CHD is benign in women. Moreover, health promotion strategies need to target: (1) women's recognition of cardiac pain and risk factors, (2) barriers to treatment seeking behavior, and (3) impact of CHD on women's quality of life. Nurses also need to promote an interdisciplinary approach to caring for women with CHD.
O'Keefe-McCarthy, S. Women's Experience of Cardiac Pain: A Review of the Literature. Canadian Journal of Cardiovascular Nursing, 2009; 18(3): 18-25.
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