Journal of Cardiovascular Nursing: The Beat

The Journal of Cardiovascular Nursing: 9/10 2019 - Volume 34 - Issue 5 - p 380-389

doi: 10.1097/JCN.0000000000000588

Abstract

Adverse life experiences (ALE; eg, discrimination and sexual abuse) may contribute to cardiovascular disease (CVD) risk in sexual minority women (SMW), but few studies have tested whether ALE explain the association of sexual identity with cardiovascular health (CVH) markers in women.

The aim of this study was to examine sexual identity differences in CVH among women and the role of ALE.

In the Epidemiologic Study of Risk in Women, we used multinomial logistic regression to assess sexual identity differences (SMW vs heterosexual women [reference group]) in CVH markers (ideal vs poor, intermediate vs poor) using the American Heart Association's Life's Simple 7 metric and the total score. Next, we tested whether the association of sexual identity with the total CVH score was attenuated by traditional CVD risk factors or ALE.

The sample consisted of 867 women (395 heterosexual, 472 SMW). Sexual minority women were more likely to have experienced discrimination (P < .001) and lifetime sexual abuse (P < .001) than heterosexual women. Sexual minority women were also less likely to meet ideal CVH criteria for current tobacco use (adjusted odds ratio, 0.43; 95% confidence interval, 0.24–0.73) or intermediate CVH criteria for body mass index (adjusted odds ratio, 0.60; 95% confidence interval, 0.40–0.92). Sexual minority women had a lower cumulative CVH score (B [SE] = −0.35 [0.14], P < .01) than heterosexual women. This difference was not explained by traditional CVD risk factors or ALE.

Smoking, body mass index, and fasting glucose accounted for much of the CVH disparity due to sexual identity, but those differences were not explained by ALE. Health behavior interventions tailored to SMW should be considered.

The Journal of Cardiovascular Nursing: 9/10 2020 - Volume 35 - Issue 5 - p 416-422

doi: 10.1097/JCN.0000000000000695

https://journals.lww.com/jcnjournal/Fulltext/2020/09000/Patterns_of_Heart_Failure_Dyadic_Illness.2.aspx?context=FeaturedArticles&collectionId=2

The ways in which patients with heart failure (HF) and their care partners work together to manage HF are often overlooked.

The aim of this study was to identify and compare different patterns of HF dyadic illness management.

This was a secondary analysis of data on HF dyads. Heart failure management was measured using patient and care partner versions of the Self-Care of HF Index and European HF Self-care Behavior Scale. Latent class modeling was used to identify patterns of HF dyadic management.

The mean age of the 62 patients and their care partners was 59.7 ± 11.8 and 58.1 ± 11.9 years, respectively. A majority of patients (71.0%) had class III/IV HF, and a majority of the couples (95.2%) were married. Two distinct dyadic patterns were observed, 1 collaborative management type (n = 42, 67.7%) and 1 autonomous management type (n = 20, 32.3%). Dyads in the autonomous pattern were mostly female patients with male care partners; patients in this pattern also were more anxious and depressed, and reported worse relationship quality compared with collaborative dyads.

There is an engendered spectrum of collaboration in how HF patient–care partner dyads work together to manage HF that needs to be considered in clinical care and research.

The Journal of Cardiovascular Nursing: 7/8 2020 - Volume 35 - Issue 4 - p 400-414

doi: 10.1097/JCN.0000000000000654

Abstract

Cardiovascular disease (CVD) and intimate partner violence (IPV) are 2 major chronic problems that prevalently affect women's health and quality of life in the United States. However, whether female IPV survivors are at risk for developing adverse cardiovascular outcomes has not been clearly understood.

This integrative review was conducted to bridge the literature gap by examining cardiovascular health in female adults with a history of IPV experience.

Three electronic databases including PubMed, CINAHL, and Web of Science were used to search for studies published between 1998 and 2019. The search process followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines.

Of the 229 records retrieved from the literature, 19 met the criteria for review. All included studies were quantitative research. Although the overall findings showed a mixed relationship between IPV and CVD, women who experienced abuse were more likely to engage in unhealthy behaviors, have higher levels of CVD biomarkers, experience cardiovascular symptoms, and exhibit long-term cardiovascular complications when compared with non-abused women.

Intimate partner violence is a stressor that directly and indirectly influences women's cardiovascular health. Therefore, it is essential for healthcare providers to routinely screen IPV status in clinical practice. Targeted interventions, such as assessing women's coping strategies and evaluating their cardiovascular health using a total risk factor approach, are recommended to prevent or reduce the deleterious effects of violence on this large, vulnerable group of women.