New help for female heart patients

By Dr. Susy Santos

Cardiac rehabilitation is a medically-supervised exercise and education program designed to help patients regain strength, reduce the risk of a subsequent event and prevent their condition from worsening.

A person experiencing a heart attack or upon being diagnosed with certain heart conditions may be referred to cardiac rehabilitation. A recently completed study of the Winnipeg Regional Health Authority’s cardiac rehabilitation program measured the program’s efficacy and benefits to participants. It measured indicators such as quality of life, social health, mental health and physical health.

The study found that for patients who completed the cardiac rehabilitation program, the average mental health score increased as did the average physical health score, which indicated positive outcomes for participants. On average, waist circumference and blood cholesterol levels, as well as depression decreased.

The Role of Depression
Recent studies suggest, moreover, there is a connection between women and depression following a cardiac event. Typically, depression is more common in women than in men and current research supports the fact that depression is associated with an increased risk of mortality after recovery from cardiac events. It can interfere with a woman’s ability to make lifestyle changes that can improve health and reduce cardiac risk factors.

Research supports the notion that women face barriers in attending cardiac rehabilitation programs, such as a lack of emotional support and a lack of support to make them feel that they belonged to the program. It has been shown that women tend to prefer a group setting where they can share their thoughts and ideas with other women. According to a 2003 study by Dr. Elisa Maruccio, women may also feel uncomfortable participating in exercise sessions that include male participants.

Women have missed out
The study found that women make up only approximately 30 per cent of the cardiac rehabilitation referrals. These findings are consistent with those of a 2004 national study by Sandy Keefe of American women with coronary artery disease which found the majority of the women studied did not receive cardiac rehabilitation services.

The Keefe study found that women with a higher family income and higher self-efficacy (basically one’s belief in one’s own ability to complete tasks and reach goals) were much more likely to participate in the cardiac rehabilitation program. Lack of time, transportation, family support, and the pressure to return to work could all be potential barriers to women completing suggested sessions in the program.

In response, the Victoria General Hospital’s Research & Evaluation team, in collaboration key partners from The University of Manitoba and the Winnipeg Regional Health Authority cardiac rehabilitation program: including The Wellness Institute as well as The Reh Fit Centre have designed a cardiac rehabilitation ‘step’ program specifically for women, who have declined cardiac rehabilitation.

For Her Heart’s Sake
The innovative For Her Heart’s Sake program was created to treat, heal and prevent further damage for women living with chronic heart disease and to produce more long-term survivors.

The program – labeled For Her Heart’s Sake: Strategies To Enhance Participation (FHHS: STEP) – was launched last month and continues over a three-year period. The FHHS: STEP program is an evidence-based program aimed to assist cardiac rehabilitation female non-attenders by offering an individualized program suited to each individual patient’s needs. The program seeks to provide a collaborative team environment that will engage, educate and empower women and ultimately to take steps toward cardiac rehabilitation and a lifelong commitment to heart health. The For Her Heart’s Sake STEP program will assist “her” to help combat the growing threat of heart disease, which is now the leading killer of women.

Modeled after the highly successful inter-professional team approach of the hospital’s Mature Women’s Centre, For Her Heart’s Sake provides each woman with specialized treatment and care as well as peer support to help her to make the lifestyle changes necessary for long-term survival. For Her Heart’s Sake allows women to customize the level of care they receive so they are able to easily incorporate cardiac rehabilitation into their lives, a situation which will in turn maximize success and self-directed participation, so that more lives can be saved.

To donate to this valuable cause and initiative and/or patient care at Victoria General Hospital, please contact Victoria General Hospital Foundation at 204-477-3513 or online at http://www.thevicfoundation.ca.

Dr. Susy Santos is the director of the Victoria General Hospital’s Research and Evaluation.

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