The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 9: Summary of Current Status, Challenges, Opportunities, and Recommendations.

This final chapter of the Canadian Women's Heart Health Alliance "ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women" presents ATLAS highlights from the perspective of current status, challenges, and opportunities in cardiovascular care for women. We conclude with 12 specific recommendations for actionable next steps to further the existing progress that has been made in addressing these knowledge gaps by tackling the remaining outstanding disparities in women's cardiovascular care, with the goal to improve outcomes for women in Canada.

Dans ce chapitre final de l'ATLAS sur l'épidémiologie, le diagnostic et la prise en charge de la maladie cardiovasculaire chez les femmes de l'Alliance canadienne de santé cardiaque pour les femmes, nous présentons les points saillants de l'ATLAS au sujet de l'état actuel des soins cardiovasculaires offerts aux femmes, ainsi que des défis et des occasions dans ce domaine. Nous concluons par 12 recommandations concrètes sur les prochaines étapes à entreprendre pour donner suite aux progrès déjà réalisés afin de combler les lacunes dans les connaissances, en s'attaquant aux disparités qui subsistent dans les soins cardiovasculaires prodigués aux femmes, dans le but d'améliorer les résultats de santé des femmes au Canada.

Caregiver Distress and Coronary Artery Disease: Prevalence, Risk, Outcomes, and Management.

PURPOSE OF REVIEW: Caregivers of patients with coronary artery disease (CAD) are integral to the health care system and contribute substantially to patients' management. The purpose of this review is to provide a narrative synthesis of existing research on caregiving for patients who experienced an acute coronary syndrome (MI/unstable angina) and/or coronary revascularization (PCI/CABG). RECENT FINDINGS: Thirty-one articles are included in this review. Overall, caregiver distress is low to moderate, ranging from 6 to 67% of caregivers, and seems to dissipate over time for most caregivers. Interventions have demonstrated success in reducing the distress of caregivers of patients with CAD. Due to the heterogeneity in study samples, measurements used, and timing of assessments and programming, these results are far from definitive. Although evidence is accumulating, further advancement in caregiving science and clinical care is required to adequately understand and respond to the needs of caregivers throughout the patient's illness trajectory.

Recovering from spontaneous coronary artery dissection: Patient-reported challenges and rehabilitative intervention needs.

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome that disproportionally affects younger women. The underlying etiology is incompletely understood, postmorbid psychological distress is high, and treatment plans are predominantly based on clinician experience. There remains uncertainty on how to adequately address the needs of patients with SCAD as part of secondary prevention. METHOD: As a Define and Refine phase of the ORBIT model (Phase 1), this study investigated SCAD patients' challenges and rehabilitative intervention needs using a qualitative research design. Patients with SCAD were purposively recruited to participate in structured interviews that were analyzed using inductive thematic coding techniques. RESULTS: Patients with SCAD (n = 15; 86.7% female; mean age = 47.5 years; data saturation reached with patient sample) expressed challenges in (a) navigating uncertainty associated with the disease; (b) living with anxiety; (c) reconciling pre and post-SCAD identities; (d) accurately identifying symptoms and experiencing a sense of isolation in recovery due to gender and young age; and (e) managing changing family dynamics and family members' stress. Intervention needs included (a) addressing unique demographic and cardiovascular profiles when designing programs for cardiac rehabilitation; (b) providing more psychological and peer support resources to address anxiety and sense of isolation; (c) disseminating information on rapidly evolving SCAD research; and (d) acknowledging and providing support to the family system. CONCLUSIONS: The results signal curricula to be included in tailored SCAD programming and underscore the need for further study and dissemination of optimal secondary preventative care for this patient population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Supporting the Health and Well-being of Caregivers: Co-design in Practice at a Canadian Cardiac Care Center.

BACKGROUND: Caregivers contribute substantially to patients' management of and recovery from cardiovascular disease (CVD). Yet, the distress that many caregivers experience in this role continues to be underresearched and their needs undersupported. PURPOSE: Situated within a patient engagement framework and adapted from experience-based co-design guidelines, the process of developing a comprehensive caregiver support resource with joint contributions from caregivers and healthcare providers representing multiple disciplines is described. A discussion of the challenges encountered during the development of the caregiver support resource and recommendations for future sites embarking on co-design work are noted. CONCLUSION: Developing feasible and relevant approaches, such as informational support instruments, to meet the needs of the growing population of CVD caregivers is essential. CLINICAL IMPLICATIONS: Although co-design processes are often complex, take more time and resources to implement, and involve multiple levels of an organization and community than traditional practices, these efforts may help to improve healthcare quality to stem the burden of CVD.