Davidson Patricia M, Daly John, Hancock Karen, Jackson Debra
School of Nursing, Family and Community Health, College of Social & Health Sciences, University of Western Sydney and Western Sydney Area Health Service, New South Wales.
Contemp Nurse. 2003;16(1-2):62-73. doi: 10.5172/conu.16.1-2.62.
Heart disease commonly manifests as acute coronary syndromes (unstable angina pectoris, or myocardial infarction) and heart failure (HF). These conditions are major causes of morbidity and mortality in Australia and internationally. Australian faces particular challenges in health care delivery given the cultural and ethnic diversity of society and unique issues related to rurality. These factors have significant implications for health care delivery. Following an acute cardiac event women have poorer outcomes: higher mortality rates, higher incidence of complications and greater psychological morbidity compared with men. Language barriers, socioeconomic factors, psychological trauma related to migration and alternate health seeking behaviors and varying perceptions of risk are likely to impact adversely on health outcomes. Self-management in chronic cardiovascular disease underscores the importance of models of care that incorporate aspects related to self-care and promotion of adherence to primary and secondary prevention initiatives. Implicit in this statement is the inclusion of the individual in negotiating and developing their care plan. Therefore health professionals need to be aware of the patient's needs, values, beliefs and health seeking behaviours. These factors are strongly influenced by culture and ethnicity. The cultural diversity of Australian society mandates cultural competence in health care. This paper presents an overview of nursing science related to women and heart disease in Australia and suggests directions for culturally-competent research and development and evaluation of models of care to improve health outcomes for all Australians.
心脏病通常表现为急性冠状动脉综合征（不稳定型心绞痛或心肌梗死）和心力衰竭（HF）。这些病症是澳大利亚乃至全球发病和死亡的主要原因。鉴于澳大利亚社会的文化和种族多样性以及与农村地区相关的独特问题，澳大利亚在医疗服务提供方面面临着特殊挑战。这些因素对医疗服务的提供有着重大影响。与男性相比，女性在发生急性心脏事件后预后较差：死亡率更高、并发症发生率更高且心理发病率更高。语言障碍、社会经济因素、与移民相关的心理创伤以及不同的就医行为和对风险的不同认知，可能会对健康结果产生不利影响。慢性心血管疾病的自我管理凸显了护理模式的重要性，这些模式应包含与自我护理相关的方面，并促进对一级和二级预防措施的依从性。这一表述中隐含着让个体参与协商和制定其护理计划。因此，卫生专业人员需要了解患者的需求、价值观、信念和就医行为。这些因素受到文化和种族的强烈影响。澳大利亚社会的文化多样性要求医疗服务具备文化能力。本文概述了澳大利亚与女性和心脏病相关的护理科学，并提出了开展具有文化能力的研究以及开发和评估护理模式的方向，以改善所有澳大利亚人的健康结果。
