Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA.
Department of Obstetrics and Gynecology and Cedars-Sinai Medical Center, Los Angeles, California, USA.
J Womens Health (Larchmt). 2021 Sep;30(9):1288-1302. doi: 10.1089/jwh.2020.8506. Epub 2021 Jan 11.
Younger women with chronic disease (<60 years of age), especially women with stereotypically "men's" heart disease (HD), are understudied. Unique difficulties may occur with HD, which is less commonly associated with women, compared with breast cancer (BC). Similarities may also exist across younger women, as chronic disease is less normative in younger people. Intersections of gender, age, and the specific disease experience require greater attention for improving women's health. This exploratory qualitative study compared younger women's experiences of HD or BC. Semistructured interviews with 20 women ( = 10 per disease) were analyzed using applied thematic analysis. Amidst building careers, intimate relationships, and families, women felt thwarted by disease-related functional problems. Cognitive-behavioral coping strategies spurred resilience, including integrating the illness experience with self-identity. Barriers arose when medical professionals used representativeness heuristics (., chronic disease occurs in older age). Important experiences in HD included worsened self-image from disability, negative impact of illness invisibility, and persisting isolation from lacking peer availability. Initial medical care reported by women with HD may reflect gender biases (., HD missed in emergency settings and initial diagnostics). New information provided by the younger women includes limited illness-related optimism in women with HD facing age and gender stereotypes, as well as the advantages and disadvantages of peer availability in BC. Greater public awareness of younger women with chronic disease, alongside structural support and connection with similarly challenged peers, is suggested. As advocacy for BC awareness and action has strengthened over past decades, similar efforts are needed for younger women with HD.
患有慢性疾病的年轻女性（<60 岁），尤其是患有典型“男性”心脏病（HD）的女性，研究较少。与乳腺癌（BC）相比，HD 不太常见于女性，因此可能会出现独特的困难。对于患有慢性疾病的年轻人来说，这种疾病不太常见，因此年轻女性之间也可能存在相似之处。性别、年龄和特定疾病经历的交叉点需要更多关注，以改善女性的健康状况。本探索性定性研究比较了年轻女性患 HD 或 BC 的经历。对 20 名女性（每病 10 名）进行了半结构式访谈，并使用应用主题分析进行了分析。在建立职业、亲密关系和家庭的过程中，女性因与疾病相关的功能问题而感到挫败。认知行为应对策略激发了韧性，包括将疾病体验与自我认同相结合。当医疗专业人员使用代表性启发式（例如，慢性疾病发生在老年）时，就会出现障碍。HD 中的重要经历包括残疾导致自我形象恶化、疾病不可见性的负面影响以及由于缺乏同龄人的可用性而持续孤立。HD 女性报告的初始医疗护理可能反映了性别偏见（例如，HD 在紧急情况下和初始诊断中被忽视）。年轻 HD 女性提供的新信息包括，面对年龄和性别刻板印象的 HD 患者的疾病相关乐观情绪有限，以及 BC 中同龄人的可用性的优缺点。建议提高公众对患有慢性疾病的年轻女性的认识，同时提供结构性支持，并与同样面临挑战的同龄人建立联系。在过去几十年中，BC 意识和行动的倡导得到了加强，因此需要为 HD 年轻女性做出类似的努力。
