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CVD IN MIDDLE AGE MEN

CVD IN MIDDLE AGE MEN. SHAWN KISE, BSN, RN May 14 th 2012 Wright State University. Background. In 2008, an estimated 17.3 million deaths around the world were due to CVD (World Health Organization (WHO), 2012).

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CVD IN MIDDLE AGE MEN

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  1. CVD IN MIDDLE AGE MEN SHAWN KISE, BSN, RN May 14th 2012 Wright State University

  2. 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)

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

  4. 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).

  5. 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.

  6. 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.

  7. 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.

  8. Overview of theories • Nola Pender’s Health Promotion Model • Health Belief Model • James Prochaska and Carlo Di Clemente’s Transtheoretical Model

  9. 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.

  10. 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).

  11. 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)

  12. Barriers to teaching/learning strategies • Culture • Language • Beliefs and attitudes • Location • Health literacy

  13. 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

  14. 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/ei26vbslpsidmahhxc332vwo3g233xsqw22er3vofqvr fjvubwyzclvqjcbdgexyzl3msu4mn6xv5j/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

  15. 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_MAN UAL_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

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