Wimbush F B, Peters R M
Acute Care Nurse Practitioner Program, Wayne State University, College of Nursing, Detroit, Michigan 48202, USA.
Public Health Nurs. 2000 May-Jun;17(3):148-54. doi: 10.1046/j.1525-1446.2000.00148.x.
Cardiovascular disease (CVD) affects nearly 50 million Americans of all ages, races, and educational levels. Many of the risk factors for CVD are modifiable and public health nurses (PHNs) are in unique position to impact this major health problem because of their access to individuals, families, and groups. Addressing this major health problem requires early identification of those at risk for CVD. This article describes the implementation of a cardiovascular-specific genogram (CVSG) which can be used to identify persons at risk for CVD. Rationale for the development of this disease-specific tool and suggestions for its clinical application are discussed. The genogram was distributed to the parents of 100 6th grade students. All of the respondents reported cardiovascular risk factors present in at least one of three generations examined. The risk factors in the two younger generations were at the primary and secondary levels of prevention and were modifiable with intervention. Only the older generation in this sample had tertiary level risk factors. The CVSG can easily be incorporated into all aspects of public health nursing practice, from assessment for case finding to planning and implementing disease management strategies. The CVSG can identify individuals, families, and groups at risk for CVD allowing the nurse to focus attention on those most at risk, and to implement proactive assessment, screening, and educational programs.
心血管疾病（CVD）影响着近5000万各个年龄、种族和教育水平的美国人。心血管疾病的许多风险因素是可以改变的，而公共卫生护士（PHNs）由于能够接触到个人、家庭和群体，在影响这一重大健康问题方面处于独特地位。解决这一重大健康问题需要早期识别心血管疾病的高危人群。本文描述了一种心血管特异性系谱图（CVSG）的实施情况，该系谱图可用于识别心血管疾病的高危人群。讨论了开发这种疾病特异性工具的基本原理及其临床应用建议。该系谱图分发给了100名六年级学生的家长。所有受访者都报告在所检查的三代人中至少有一代存在心血管危险因素。较年轻两代人的危险因素处于一级和二级预防水平，可通过干预加以改变。在这个样本中，只有较年长的一代有三级危险因素。心血管特异性系谱图可以很容易地纳入公共卫生护理实践的各个方面，从病例发现评估到疾病管理策略的规划和实施。心血管特异性系谱图可以识别心血管疾病的高危个人、家庭和群体，使护士能够将注意力集中在那些风险最高的人身上，并实施积极主动的评估、筛查和教育计划。
