2003 Jun 1 Release.
For Immediate Release.
Contact: Rich Belanger 212-675-2658
Bonnie Arkus 609-771-9600
|CREATING WOMAN-FRIENDLY CARDIAC REHABILITATION
Heart-Health Tips From Two Successful Centers
Trenton, NJ, June 10, 2003 -When it comes to heart disease, many women feel they have been left out of the loop. A telephone survey of 204 women cardiac patients published in Women's Health Issues medical journal (Issue 13, 2003, 23-31) found that 52% are dissatisfied with their care; 58% attribute this to physician attitude. Most telling is the statistic that only 3% of women candidates attend cardiac rehabilitation (CR) and that, once attending, most drop out. Why are so few women benefiting from a program that offers support and improved quality of life?
"Heart disease survival has been tailored to men", says Bonnie Arkus, RN, president of the Women's Heart Foundation. "This situation is changing with the growing awareness that heart disease affects women differently and that there needs to be a different treatment approach for women".
Not all CR centers experience problems engaging the female population. Capital Health System (CHS) in Trenton, New Jersey reports 90% of women complete Phase II of the Cardiopulmonary Fitness and Rehabilitation Program at their facility. Nurse Manager Kathy Williamson explains why. "This is a very goal-driven outcome-based program. The few women that don't complete the program, it is usually because of family issues or because they have returned to work," says Kathy. "At CHS, we have a 40/ 60 ratio of females to males. We're seeing more younger women being referred and we're seeing increasing numbers of women overall". Kathy explains how her program is "Woman-Friendly". "We have a comprehensive approach to treating the whole person. We attend to many needs. For example, we know that women like to exercise and socialize with other women, so we look at our people that we put into classes and we keep women with women as much as possible. Women tend to talk with one another and offer each other support. While this doesn't happen during exercise, I have observed that they chat prior to and following their exercise programs. We also hold educational classes that are interactive and cover such skill-building topics as communication - because women don't ask questions - and time management. We show videos, complete quizzes and have guest lecturers. Our dietitian conducts a cooking class every 3 months. This is a lot of work, very labor-intensive, but most enjoyed. Our dietitian also features a "recipe of the month" that gets posted onto our bulletin board. Our hospital takes care of transportation for only those that are involved in the comprehensive rehab program, and there is no fee.
CHS recently added support groups as another component of care for our cardiac patients. These have been very successful. The groups are open to both men and women but it is predominantly the women who attend" says Kathy. "These are large groups of 14 people. It is facilitated by two social workers. It runs for four weeks. They meet weekly from 1-2 pm so women can come on an extended lunch hour. Upon completion of the program, we offer one-on-one counseling with the social worker for those who need it - again at no cost. Many women are dealing with troubling home situations so this continuation of support is vital."
Nieca Goldberg, MD, Chief of the Women's Heart Program at Lenox Hill Hospital in New York presented on her successful model at a recent Women and Heart Disease conference held by Pascack Valley Hospital. Dr. Goldberg believes that too many women have ignored their own health problems because they were so busy taking care of others. She wanted her program to help women recognize their own needs. "Women have to go home and take care of the family. We help women give themselves permission to take care of (their own needs) and we provide them with a structure and daily plan for doing so…We treat women as unique individuals…the whole person with brains, and a life as well as a heart. " Dr. Goldberg quoted findings from the WISH study (Women's Initiative to Save Heart):
"At Lenox Hill, we know how important it is to greet the woman when she arrives - acknowledge her - make the social connection", Dr. Goldberg said. "Education -- giving women the most up-to-date research information -- is a priority", she said. "Diet information is tailored to the individual because one size does not fit all. Women with metabolic syndrome must be especially careful to watch their carbohydrate intake". Other suggestions for a successful program include inquiring about special concerns a woman may have when entering the program, then following up; and, upon discharge, providing informational brochures on community programs like YMCA/YWCA where she may continue her level of activity. Include scholarship information since cost may be a factor.
The cardiac patients who participated in the telephone survey offered this advice to other women: "Educate yourself and ask questions".
The benefits of cardiac rehabilitation include increased endurance, reduced anxiety, improved awareness of heart disease risk factors and how to change them, increased social support and improved self-esteem. "We need to do a better job as doctors. More women need to be referred. Success (at getting women into cardiac rehabilitation) depends upon the strength of the physician referral".
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