Davidson Patricia M, Daly John, Hancock Karen, Moser Debra, Chang Esther, Cockburn Jill
School of Nursing, Family & Community Health, College of Social & Health Sciences, University of Western Sydney, Locked Bag 1797, Penrith DC 1797, NSW, Australia.
Eur J Cardiovasc Nurs. 2003 Dec;2(4):255-64. doi: 10.1016/S1474-5151(03)00056-2.
Following diagnosis of heart disease women have poorer health related outcomes compared with men. Nursing science lacks well-evaluated interventions to address the specific rehabilitative needs of older women with heart disease. This paper seeks to inform the development of nursing intervention studies by a review of published studies on the experiences and rehabilitative needs of older women with heart disease.
The CINAHL, MEDLINE, FAMILY and PsychINFO databases were searched, identifying literature published from 1982 and written in English. Keywords used were women, old* (old, older) women, elderly women and: heart disease, heart failure, cardiac and rehabilitation. Hand searching of nursing and medical textbooks also occurred. These searches resulted in over 120 articles that met the criteria of describing experiences, perceptions, psychological responses and support rehabilitative needs of older women.
Older women present with symptoms that are different from those derived from a male-dominated research agenda and further there is a paucity of data related to evaluation of interventions tailored to the needs of women. Key themes emerging from the literature review include not only that older women compared with men have a poorer prognosis and experience greater disability moreover they: (1). are at a higher risk of psychosocial distress; (2). have a greater need for instrumental support and social support; (3). have an altered perception of risk; and (4). demonstrate the need for specific rehabilitation programs, tailored to their needs.
Future research should develop and evaluate intervention studies that better meet the unique needs of older women with heart disease. Particular emphasis needs to be on psychosocial aspects, given evidence that identify these are major concerns for women.
与男性相比，女性在被诊断出患有心脏病后，健康相关的预后较差。护理科学缺乏经过充分评估的干预措施来满足老年心脏病女性的特定康复需求。本文旨在通过回顾已发表的关于老年心脏病女性的经历和康复需求的研究，为护理干预研究的发展提供信息。
检索了CINAHL、MEDLINE、FAMILY和PsychINFO数据库，确定了1982年以来发表的英文文献。使用的关键词有女性、老年女性（old、older、elderly）以及：心脏病、心力衰竭、心脏和康复。还对手头的护理和医学教科书进行了检索。这些检索产生了120多篇符合描述老年女性经历、认知、心理反应和支持康复需求标准的文章。
老年女性出现的症状与以男性为主导的研究议程得出的症状不同，而且缺乏与针对女性需求的干预措施评估相关的数据。文献综述中出现的关键主题不仅包括与男性相比，老年女性的预后较差且残疾程度更高，此外还包括：（1）心理社会困扰的风险更高；（2）对工具性支持和社会支持的需求更大；（3）对风险的认知发生改变；（4）表明需要针对其需求制定特定的康复计划。
未来的研究应开展并评估能更好地满足老年心脏病女性独特需求的干预研究。鉴于有证据表明心理社会方面是女性的主要担忧，因此需要特别强调这些方面。
