Women's Cardiovascular Health Initiative, Women's College Hospital, Toronto, Canada.
J Cardiovasc Nurs. 2010 Jul-Aug;25(4):332-41. doi: 10.1097/JCN.0b013e3181c83f6b.
The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI.
Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility.
Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation.
While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address persistent barriers for women related to physician referral and transportation to programs.
有充分的文献证明,心脏康复(CR)对患有心脏病的女性的健康有益,但在传统结构的 CR 项目中,女性的参与度仍然较低。造成这种医疗服务提供差距的原因有很多,与女性有关,包括医生推荐率较低、旅行相关障碍、工作和照顾责任冲突、更严重的心血管疾病以及更多的合并健康状况。专门为女性设计的项目是否能够解决这些障碍并促进女性的参与,这是 CR 文献中很少探讨的问题。作为一项探索女性健康的 6 个既定原则(增强妇女权能、提供便捷的项目、广泛定义医疗保健、提供高质量的护理、协作规划和创新方法)是否反映在妇女心血管健康倡议(WCHI)(为女性设计的综合 CR 和初级预防计划)实践中的更大研究的一部分,本分析的目的是探讨参与 WCHI 的女性是如何体验“便捷项目”原则的。
14 名之前参加过 WCHI 项目的女性参加了一次单独的面对面定性访谈。使用恒定比较方法分析转录本,以确定与项目可及性相关的主题。
确定的主要主题包括参与者获得医生推荐、协商交通问题和安排项目时间表的经验。女性讨论了同伴支持和工作人员愿意解决她们的健康相关问题如何促进了她们的参与。
虽然以女性为中心的 CR/初级预防计划通过提供灵活的项目时间表以及同伴和专业支持,可能会促进和鼓励女性的参与,但仍需要努力解决与医生推荐和前往项目的交通相关的持续存在的女性障碍。