SHAWN KISE, BSN, RN

May 14th 2012

Wright State University

CVD IN MIDDLE AGE MEN

BACKGROUND

In 2008, an estimated 17.3 million deaths around the world were due to CVD (World Health Organization (WHO), 2012).

150,000 deaths in the US occurred in men that were under the age of 65 from CVD in 2008 (American Heart Association (AHA, 2012).

CVD is the leading cause of death in men for most ethnicities in the United States (Centers for Disease Control and Prevention (CDC), 2012)

HEALTH AND WELLNESS

There is a wide range of perspectives on health and well being and with no set definition of health in the medical field.

Definitions of health

The state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity (WHO,2012).

Health is a dynamic state of well-being characterized by a physical, mental and social potential, which satisfies the demands of a life commensurate with age, culture, and personal responsibility (Bircher, 2005).

A state of balance, an equilibrium that an individual has established within himself and between himself and his social and physical environment (Sartorius, 2006).

MIDDLE AGE MEN

Lack of knowledge, lifestyle, and low screenings and prevention of risk factors for CVD make this group vulnerable.

Heart disease is the leading cause of death for men of most racial/ethnic groups in the United States, including African Americans, American Indians or Alaska Natives, Hispanics, and whites. For Asian American men, heart disease is second only to cancer (CDC, 2012).

Half of the men that experience sudden cardiac death had no prior symptoms (CDC, 2012).

HEALTHY PEOPLE 2020

Goal - to improve cardiovascular health through prevention, detection, and treatment of risk factors for heart attack and stroke (Healthy People 2020, 2012).

Lower rates of hypertension.

Increase knowledge of early warning signs of heart attacks and strokes.

Increase the use of aspirin in patients free of CVD.

Increase medication compliance for HTN and lipid lowering medications.

Decrease hospitalizations with heart failure as the principle diagnosis.

DETERMINANTS OF HEALTH

There are controllable and non-controllable determinants of health.

Non-controllable

Sex, race, and family history.

Controllable

Smoking, diet, exercise, weight, and medication compliance.

REVIEW OF LITERATURE

There is a vast amount of research in CVD in this vulnerable population.

BMI and metabolic syndrome linked to risk for CVD.

Lowering of normal high blood pressure decreases risk for CVD.

Use of screening for carotid and femoral plague to predict risk for CVD.

Lowing risk factors for CVD leads to lower risk for CVD.

Parental CVD predictive of offspring risk for CVD.

Genomics of CVD to create a genetic risk score for CVD.

OVERVIEW OF THEORIES

Nola Pender’s Health Promotion Model

Health Belief Model

James Prochaska and Carlo Di Clemente’s Transtheoretical Model

FRAMEWORK FOR CVD IN MIDDLE AGE MEN

Health Belief Model

This a psychological theory that attempts to explain and predict a person’s health behavior based on their attitudes and beliefs. (Family Health International, 2002)

This model takes into account a person’s perception of a health problem’s seriousness and their susceptibility to the health problem.

CULTURAL COMPETENCE/DIVERSITY

Cultural competency is being used as a framework to increase the knowledge of cultural diversity issues, and to improve the quality of care for all (Seeleman, Suurmond, & Stronks, 2009).

Heart disease is the leading cause of death for men of most racial/ethnic groups in the United States, including African Americans, American Indians or Alaska Natives, Hispanics, and whites. For Asian American men, heart disease is second only to cancer (CDC, 2012).

TEACHING/LEARNING STRATEGIES AND PRINCIPLES

Knowing Your Population

Assess Cultural/Religious Beliefs and Practices

Provide an Environment Suitable for Learning

Knowing the Different Types of Learners

Use Your Resources

(Alspaugh, 2012)

BARRIERS TO TEACHING/LEARNING STRATEGIES

Culture

Language

Beliefs and attitudes

Location

Health literacy

COLLABORATION OF HEALTH PROFESSIONALS

CVD has multiple risk factors and requires a team of health professionals to address these risk factors.

Family physician

Cardiologist

Nutritionist

Diabetic educator

Smoking cessation therapist

Physical trainer

Advanced practice nurse

REFERENCES

Alspaugh, L. (2012). A guide for nurses: Teaching healthcare effectively to patients. Health Careers Journal. Retrieved from http://

www.healthcareersjournal.com/a-guide-for-nurses-teaching-healthcare-effectively-to-patients /

American Heart Association (2012). Heart disease and statistics – 2012 update : A report from the American Heart Association. Cirulation, 125, e2- e220. doi:10.1161/CIR.0b013e31823ac046

Bircher J. (2005). Towards a dynamic definition of health and disease. Medicine, Healthcare and Philosophy, 8, 335-341. doi:10.1007/s11019-005-0538-y

Centers for Disease Control and Prevention (2012). Heart disease. Retrieved from http://www.cdc.gov/heartdisease/index.htm

Centers for Disease Control and Prevention, (2012). Men and heart disease fact sheet. Retrieved from http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_men_heart.htm

Family Health International, (2002). Behavior change: A summary of four major theories. Retrieved from http://www.fhi360.org/nr/rdonlyres/ei26vbslpsidmahhxc332vwo3g233xsqw22er3vofqvrfjvubwyzclvqjcbdgexyzl3msu4mn6xv5j/bccsummaryfourmajortheories.pdf

Hayden, J. (2009). Health belief model. Introduction to Health Behavior Theory. (pp. 31-35). Retrieved from http://www.jblearning.com/samples/0763743836/chapter%204.pdf

REFERENCES CONTINUED

Healthy People 2020 (2012). Heart disease and stroke. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=21

Pender, N. (2011). The health promotion model: Manual. Retrieved from http://deepblue.lib.umich.edu/bitstream/2027.42/85350/1/HEALTH_PROMOTION_MANUAL_Rev_5-2011.pdf

Prochaska, J. O. & Di Clemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy, 19, 276-288. Retrieved from http

://psycnet.apa.org/journals/pst/19/3/276.pdf

Sartorius, N. (2006). The meaning of health and its promotion. Croatian Medical Journal, 47, 662-664. Retrieved from http://

www.ncbi.nlm.nih.gov/pmc/articles/PMC2080455/pdf/CroatMedJ_47_0662.pdf

Seeleman, C., Suurmond, J., & Stronks, K. (2009). Cultural competence: A conceptual framework for teaching and learning. Medical Education, 43, 229-237.

doi:10.1111/j.13652923.2008.03269.x

World Health Organization (2012). Cardiovascular diseases. Retrieved from http://www.who.int/mediacentre/factsheets/fs317/en/index.html

World Health Organization (2012). Definition of health. Retrieved from https://apps.who.int/aboutwho/en/definition.html