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BMC Primary Care

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Open Access 01-12-2013 | Research article

How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: a study in polish primary care

Authors: Ireneusz Szymczyk, Ewa Wojtyna, Witold Lukas, Joanna Kępa, Teresa Pawlikowska

Published in: BMC Primary Care | Issue 1/2013

Abstract

Background

Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women.

Methods

A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual’s CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects’ self-care behavior was examined.

Results

We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most important.

Conclusions

Different predictors of acquisition of health behavior are encountered in men and women. Our results suggest that gender-adjusted motivation models influencing the recognition process need to be considered to optimize compliance in patients with CVR.

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Hunink MG, Goldman L, Tosteson AN, Mittleman MA, Goldman PA, Williams LW, Tsevat J, Weinstein MC: The recent decline in mortality from coronary heart disease, 1980–1990. The effect of secular trends in risk factors and treatment. JAMA. 1997, 227: 535-542.CrossRef

Dwyer JH: Exposure to environmental tobacco smoke and coronary risk. Circulation. 1997, 96: 1403-1407. 10.1161/01.CIR.96.5.1403.CrossRef

Law MR, Wald NJ, Wu T, Hackshaw A, Bailey A: Systematic underestimation of association between serum cholesterol concentration and ischaemic heart disease in observational studies: data from the BUPA study. BMJ. 1994, 308: 363-366. 10.1136/bmj.308.6925.363.CrossRefPubMedPubMedCentral

Polskie Towarzystwo Kardiologiczne [Polish Heart Association]: Standardy postępowania w chorobach układu krążenia [Guidelines for Circulatory Disorders]. Kardiol Pol. 1997, 46 (Suppl 1):

Goldbourt U: Physical activity, long-term CHD mortality and longevity: a review of studies over the last 30 years. World Rev Nutr Diet. 1997, 82: 229-239.CrossRefPubMed

Rodin J, Salovey P: Psychologia zdrowia [Psychology of Health]. Psychologia zdrowia [Psychology of Health]. Edited by: Heszen-Niejodek I, Sęk H. 1997, Warsaw: PWN, 62-109.

Ostrowska A: Styl życia a zdrowie [Lifestyle and Health]. 1999, IFiS PA: Warsaw

Brunner RL: Understanding gender factors affecting self-rated health. Gend Med. 2006, 3: 292-294. 10.1016/S1550-8579(06)80217-2.CrossRefPubMed

Tobiasz-Adamczyk B: Wybrane elementy jakości życia kobiet starszych wiekiem [Selected elements of the quality of life of older women]. Promocja Zdrowia, Nauki Społeczne i Medycyna [Health Promotion, Social Science and Medicine]. 1999, 6: 68-83.

10.

Lim WY, Ma S, Heng D, Bhalla V, Chew SK: Gender, ethnicity, health behaviour and self-rated health in Singapore. BMC Public Health. 2007, 7: 184-10.1186/1471-2458-7-184.CrossRefPubMedPubMedCentral

11.

Leung MY, Alexander M, Chun CJP: Coping and adjustment in Chinese patients with chronic obstructive pulmonary disease. Int J Nurs Stud. 2002, 39: 383-395. 10.1016/S0020-7489(01)00036-0.CrossRef

12.

Malan L, Schutte AE, Malan NT, Wissing MP, Vorster HH, Steyn HS, van Rooyen JM, Huisman HW: Coping mechanisms, perception of health and cardiovascular dysfunction in Africans. Int J Psychophysiol. 2006, 61: 158-166. 10.1016/j.ijpsycho.2005.07.015.CrossRefPubMed

13.

Hamer M, Malan L: Psychophysiological risk markers of cardiovascular disease. Neurosci Biobehav Rev. 2010, 35: 76-83. 10.1016/j.neubiorev.2009.11.004.CrossRefPubMed

14.

Gleiberman L: Repressive/defensive coping, blood pressure, and cardiovascular rehabilitation. Curr Hypertens Rep. 2007, 9: 7-12. 10.1007/s11906-007-0003-9.CrossRefPubMed

15.

Wood FG: Ethnic differences in exercise among adults with diabetes. West J Nurs Res. 2002, 24: 502-515. 10.1177/019394502400446388.CrossRefPubMed

16.

Ward KD, Vander Weg MW, Kovach KW, Klesges RC, DeBon MW, Haddock CK, Talcott GW, Lando HA: Ethnic and gender differences in smoking and smoking cessation in a population of young adult Air Force recruits. Am J Health Promot. 2002, 16: 259-266. 10.4278/0890-1171-16.5.259.CrossRefPubMed

17.

Opotowsky AR, McWilliams JM, Cannon CP: Gender differences in aspirin use among adults with coronary heart disease in the United States. J Gen Intern Med. 2007, 22: 55-61. 10.1007/s11606-007-0116-5.CrossRefPubMedPubMedCentral

18.

Trudeau L, Spoth R, Randall G, Azevedo K: Longitudinal effects of a universal family-focused intervention on growth patterns of adolescent internalizing symptoms and polysubstance use: gender comparisons. J Youth Adolesc. 2007, 36: 725-740. 10.1007/s10964-007-9179-1.CrossRef

19.

Azevedo MR, Araújo CL, Reichert FF, Siqueira FV, da Silva MC, Hallal PC: Gender differences in leisure-time physical activity. Int J Public Health. 2007, 52: 8-15. 10.1007/s00038-006-5062-1.CrossRefPubMedPubMedCentral

20.

Gibbons SW, Barnett SD, Hickling EJ, Herbig‒Wall PL, Watts DD: Stress, coping, and mental health‒seeking behaviors: gender differences in OEF/OIF health care providers. J Trauma Stress. 2012, 25: 115-119. 10.1002/jts.21661.CrossRefPubMed

21.

Polen MR, Green CA, Perrin NA, Anderson BM, Weisner CM: Drinking patterns, gender and health: attitudes and health practices. Addict Res Theory. 2010, 18: 122-142. 10.3109/16066350903398486.CrossRefPubMedPubMedCentral

22.

Schneider U, Pfarr C, Schneider BS, Ulrich V: I feel good! Gender differences and reporting heterogeneity in self-assessed health. Eur J Health Econ. 2012, 13: 251-265. 10.1007/s10198-011-0301-7.CrossRefPubMed

23.

King KM, Arthur HM: Coronary heart disease prevention. Views on women’s gender-based perception and meanings. J Cardiovasc Nurs. 2003, 4: 274-281.CrossRef

24.

Fleury J, Keller C, Murdaugh C: Social and contextual etiology of coronary heart disease in women. J Womens Health Gend Based Med. 2000, 9: 967-978. 10.1089/15246090050199991.CrossRefPubMed

25.

Blanchard CM, Rodgers WM, Courneya KS, Daub B, Black B: Self-efficacy and mood in cardiac rehabilitation: should gender be considered?. Behav Med. 2002, 27: 149-160. 10.1080/08964280209596040.CrossRefPubMed

26.

Navuluri RB: Gender differences in the factors related to physical activity among adults with diabetes. Nurs Health Sci. 2000, 2: 191-199. 10.1046/j.1442-2018.2000.00056.x.CrossRef

27.

Wojtyna E: Poznawcze, afektywne i społeczne uwarunkowania stosowania się do zaleceń lekarskich przez chorych na cukrzycę typu 2 [Cognitive, affective and social predictors of compliance among patients with diabetes mellitus type 2]. PhD thesis. 2012, University of Silesia in Katowice, Department of Education and Psychology

28.

Bautista-Castaño I, Molina-Cabrillana J, Montoya-Alonso JA, Serra-Majem L: Variables predictive of adherence to diet and physical activity recommendations in the treatment of obesity and overweight, in a group of Spanish subjects. Int J Obes. 2004, 28: 697-705. 10.1038/sj.ijo.0802602.CrossRef

29.

McCreary DR, Newcomb MD, Sadava SW: The male role, alcohol use, and alcohol problems: a structural modeling examination in adult women and men. J Couns Psychol. 1990, 46: 109-124.CrossRef

30.

Li Y, Jiang Y, Zhang M, Yin P, Wu F, Zhao W: Drinking behaviour among men and women in China: the 2007 China Chronic Disease and Risk Factor Surveillance. Addiction. 2011, 106: 1946-1956. 10.1111/j.1360-0443.2011.03514.x.CrossRefPubMed

31.

Roberts SCM: Whether men or women are responsible for the size of gender gap in alcohol consumption depends on alcohol measure: a study across the United States. Contemp Drug Probl. 2012, 39: 195-212.CrossRefPubMedPubMedCentral

32.

Babwah F, Baksh S, Blake L, Cupid-Thuesday J, Hosein I, Sookhai A, Poon-King C, Hutchinson G: The role of gender in compliance and attendance at an outpatient clinic for type 2 diabetes mellitus in Trinidad. Rev Panam Salud Publica. 2006, 19: 79-84.CrossRefPubMed

33.

Lusk SL, Ronis DL, Kerr MJ, Atwood JR: Test of the health promotion model as a causal model for workers’ use of hearing protection. Nurs Res. 1994, 43: 151-157.CrossRefPubMed

34.

Ahmad K, Jafar TH, Chaturvedi N: Self-rated health in Pakistan: results of a national health survey. BMC Public Health. 2005, 19: 51-CrossRef

35.

Leinsalu M: Social variation in self-rated health in Estonia: a cross-sectional study. Soc Sci Med. 2002, 55: 847-861. 10.1016/S0277-9536(01)00221-0.CrossRefPubMed

36.

Hobfoll S: Conservation of resources. A new attempt at conceptualizing stress. Am Psychol. 1989, 44: 513-524.CrossRefPubMed

37.

Hobfoll S: Stress, culture and community: The psychology and philosophy of stress. 1998, New York: Plenum PressCrossRef

38.

Endler NS, Parker JDA, Summerfeldt LJ: Coping with health problems: developing a reliable and valid multidimensional measure. Psychol Assess. 1998, 10: 195-205.CrossRef

39.

Lazarus R, Folkman S: Stress, appraisal and coping. 1984, New York: Springer-Verlag

40.

Folkman S, Lazarus R: Coping as mediator of emotion. J Pers Soc Psychol. 1984, 54: 466-475.CrossRef

41.

Endler NS, Parker JDA: Assessment of multidimensional coping: task, emotion and avoidance strategies. Psychol Assess. 1994, 6: 50-60.CrossRef

42.

Włodarczyk D: Rola i miejsce oceny poznawczej w radzeniu sobie ze stresem [The association between cognitive assessment and coping]. Nowiny Psychologiczne [Psychological News]. 1999, 4: 57-72.

43.

Ellis A, Dryden W: The practice of rational emotive behavior therapy. 2007, New York: Springer Publishing Company, 2

44.

Maultsby MC: Rational behavior therapy. 1990, Rational Self-Help Books/I’ACT: Appleton

45.

Clark DME, Fairburn CG: Science and practice of cognitive behaviour therapy. 1997, Oxford: Oxford University Press

46.

Lopez CR, Antoni MH, Fekete EM, Penedo FJ: Ethnic identity and perceived stress in HIV+ minority women: the role of coping self-efficacy and social support. Int J Behav Med. 2012, 19: 23-28. 10.1007/s12529-010-9121-x.CrossRefPubMed

47.

Day AL, Livingstone HA: Gender differences in perceptions of stressors and utilization of social support among university students. Can J Behav Sci. 2003, 35: 73-83.CrossRef

48.

Ptacek JT, Smith RE, Dodge KL: Gender differences in coping with stress: when stressors and appraisal do not differ. Pers Soc Psychol Bull. 1994, 20: 421-430. 10.1177/0146167294204009.CrossRef

49.

Krajewski HT, Goffin RD: Predicting occupational coping responses: the interactive effect of gender and work stressors context. J Occup Health Psychol. 2005, 10: 44-53.CrossRefPubMed

50.

Tamres LK, Janicki D, Helgeson VS: Sex differences in coping behavior: a meta-analytic review and an examination of relative coping. Pers Soc Psychol Rev. 2002, 6: 2-30. 10.1207/S15327957PSPR0601_1.CrossRef

51.

Greenglass ER, Burke RJ: Work and family precursors of burnout in teachers: sex differences. Sex Roles. 1988, 18: 215-229. 10.1007/BF00287791.CrossRef

52.

Juczyński Z: Narzędzia pomiaru w promocji i psychologii zdrowia [Assessment tools in health promotion and psychology]. 2001, Pracownia Testów Psychologicznych: Warsaw

53.

Conroy RM, Pyorala K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetiere P, Jousilahti P, Keil U, Njolstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM: Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003, 24: 987-1003. 10.1016/S0195-668X(03)00114-3.CrossRefPubMed

54.

Szczepaniak P, Strelau J, Wrześniewski K: Diagnoza stylów radzenia sobie ze stresem za pomocą polskiej wersji kwestionariusza CISS Endlera i Parkera [Diagnosis of coping styles based on Polish version of CISS questionnaire by Endler & Parker]. Przegląd Psychologiczny [Psychological Review]. 1996, 39: 187-210.

55.

Kobiet RCP: Kobiety w Polsce w latach 90-tych [Polish Women in 90s. The Report of Centre for Women’s Rights]. 2000, Warsaw: Fundacja Centrum Praw Kobiet

56.

Oleksy EH: Selected proceedings of the Women's Studies Conference, Łódź, Poland, May 17–21. Womens Stud Int Forum. 1995, 18: 3-8.CrossRef

57.

Firkowska-Mankiewicz A: Czy tak samo wychowujemy dzieci [Are our children being brought up in the same way]?. Co to znaczy być kobietą w Polsce [What does it mean to be a woman in Poland]. Edited by: Titkow A, Domański H. 1995, Warsaw: PAN

58.

Dabic M: Women and Academic Careers in Poland. Equality and Partnership towards Higher Education, Employment/Entrepreneurship and Environmental Management in Central and Eastern European Countries. Future Strategic Goals and Objectives. Conference Publication, 1–3 September 1994. 1994, Wolfheze, Holland,

59.

Łopuszańska M, Szklarska A, Jankowska EA: Zachowania zdrowotne dorosłych mężczyzn i kobiet w Polsce w latach 1984 i 1999 [Health Behaviours of adult men and women in Poland in 1984 and 1999 year]. Zdrowie Publiczne [Public Health]. 2004, 114: 23-28.

60.

Viswesvaran C, Sanchez JL, Fisher J: The role of social support in the process of work stress: a meta-analysis. J Vocat Behav. 1999, 54: 314-334. 10.1006/jvbe.1998.1661.CrossRef

61.

Spendel Z: O pewnych niebezpieczeństwach nadużywania etykiet zastępczych. Niespecyficzne Zmienne Zagregowane (NZZ) w badaniach psychologicznych [About some dangers concerning overusing of substitution labels. Non-specific Aggregated Variables]. Kryzysy, katastrofy, kataklizmy w kontekście narastania zagrożeń [Crises, catastrophes and disasters with regard to overwhelming threats]. Edited by: Popiołek K, Bańka A. 2007, Poznań: Stowarzyszenie Psychologia i Architektura

62.

Ludwick-Rosenthal R, Neufeld WJ: Preparation for undergoing an invasive medical procedure: interacting effects of information and coping style. J Consult Clin Psychol. 1993, 61: 156-164.CrossRefPubMed

63.

Miller SM, Mangan CE: The interacting effects of information and coping style in adapting to gynecologic stress: should the doctor tell all?. J Pers Soc Psychol. 1983, 45: 223-236.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2296/14/165/prepub

Title: How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: a study in polish primary care
Authors: Ireneusz Szymczyk
Ewa Wojtyna
Witold Lukas
Joanna Kępa
Teresa Pawlikowska
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Primary Care / Issue 1/2013
Electronic ISSN: 2731-4553
DOI: https://doi.org/10.1186/1471-2296-14-165

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: a study in polish primary care

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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