Self-Management of Cardiac Pain in Women: A Meta-Summary of the Qualitative Literature

Abstract

Symptom recognition and self-management is instrumental in reducing the number of deaths related to coronary artery disease (CAD) in women. The purpose of this study was to synthesize qualitative research evidence on the self-management of cardiac pain and associated symptoms in women. Seven databases were systematically searched, and the concepts of the Individual and Family Self-Management Theory were used as the framework for data extraction and analysis. Search strategies yielded 22,402 citations, from which 35 qualitative studies were included in a final meta-summary, comprising data from 769 participants, including 437 (57%) women. The available literature focused cardiac pain self-management from a binary sex and gender perspective. Ethnicity was indicated in 19 (54%) studies. Results support individualized intervention strategies that promote goal setting and action planning, management of physical and emotional responses, and social facilitation provided through social support.

Síndrome coronario agudo en mujeres desde la teoría del manejo del síntoma

“…(16) Sobre el tema, Bjørnnes et al concluyeron que las mujeres tienden a negar o racionalizar sus síntomas, recurrir a la automedicación, consultar a otros y retrasar la búsqueda de atención médica; mientras tanto los síntomas se agravan. (28) El 83% de las mujeres presentaron la sintomatología del SCA en el hogar, condición que puede estar asociada con la respuesta ante los síntomas y el retraso en buscar ayuda profesional. (16,29) El inicio tardío del tratamiento frente al SCA está directamente relacionado con la carga de morbimortalidad de las enfermedades cardiovasculares; debido a que un número importante de mujeres que buscan atención de forma tardía, presentan complicaciones potencialmente fatales que se convierten en factores determinantes del tamaño del infarto y de la función cardiaca, los cuales reducen la posibilidad a ser beneficiarias de tratamiento definitivo como angioplastia o terapia trombolítica.…”

Experiences of informal caregivers after cardiac surgery: a systematic integrated review of qualitative and quantitative studies

“…Ryan and Sawin’s76 individual and family self-management theory, proposes that self-management is a dynamic interaction between factors related to the context (ie, risk and protective factors), the process (ie, knowledge and beliefs, self-regulation skills and abilities, and social facilitation), and outcomes. Despite the focus on self-management for CVD (cardiovascular disease) patients, according to a systematic review77 and a meta-summary78 reviewing 92 studies including approximately 14 000 participants, the physiological and social environment context was only briefly mentioned in three out of 57 RCTs, and in seven out of 35 qualitative studies, focusing on self-management of cardiac pain in women. The importance of including resources related to the care recipients context to support caregivers are also supported in a recent systematic review of 44 studies representing 17 different countries,79 suggesting the need for developing easy and comprehensive access to information, support services, and adequate financial compensations for caregivers in outpatient care.…”

Nurses’ Perception of a Tailored Web-Based Intervention for the Self-Management of Pain After Cardiac Surgery

“…For instance, the acceptability study with patients underlined that women felt that the most important aspect of the intervention was the awareness-raising content, while men focused on the convenience of the support provided (Martorella et al., 2014). It was also found that promoting hope, particularly for women living alone, could improve outcomes after cardiac surgery (Bjornnes, Parry, Lie, et al., 2018). Another study with patients suffering from chronic musculoskeletal pain illustrated the importance of sociodemographic factors in showing that women had better levels of pain acceptance while men experienced more fear of movement (Rovner et al., 2017).…”

“…Sex and gender differences are individual risk factors that have gained great interest in pain-related research in general. These differences are currently an important concern in the context of postoperative pain after cardiac surgery where women have been underrepresented (Bjornnes, Parry, et al., 2016; Bjornnes, Parry, Leegaard, et al., 2018; Bjornnes, Parry, Lie, et al., 2018; Parry et al., 2018). Previous studies on pain after cardiac surgery indicate that sex is an independent predictor of CPSP with more women experiencing relatively high levels of pain up to 2 years postoperatively (Choiniere et al., 2014; Van Gulik et al., 2011).…”