Australian women and heart disease: Trends, epidemiological perspectives and the need for a culturally competent research agenda
Patricia M Davidson
Centre of Cardiovascular and Chronic Care, School of Nursing and Midwifery, University of Technology Sydney, Sydney NSW; Curtin University, Perth WA
John Daly
Faculty of Nursing, Midwifery and Health; WHO Collaborating Centre for Nursing, Midwifery and Health Development, University of Technology Sydney, Sydney NSW
Karen Hancock
Research Fellow, University of Western Sydney, NSW
Debra Jackson
Professor, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney (UTS), Broadway NSW
PP: 062 - 073
Abstract
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.
Keywords
Australia; cultural diversity; women; cultural competence
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