Validate women’s risk through education efforts

The COP technique works

Cost Management in Cardiac Care asked Kathleen C. Ashton, RN, PhD, an expert on cardiovascular disease in women, how cardiac nurses and service line managers can make women aware of their cardiovascular risk. Ashton is assistant professor of nursing at Rutgers, the State University of New Jersey, in Camden. Her answer included the COP technique:

C(lear): Communicate clearly what they’re experiencing.

O(bjective): Communicate objectively in terms of what the feeling is — what came before and what happened after.

P(ersistent): Get attention. That may mean changing to another practitioner if yours is not listening.

"First," says Ashton, "we have to validate that, Yes, CVD can and does happen to women of all ages. We have to educate women to recognize that they are at risk. A woman’s chance of developing heart disease is one in two after menopause. Her chances of developing breast cancer are one in nine. Yet most women assume their greater risk is breast cancer.

"Second, we have to enable women to recognize symptoms of CVD." Ashton recommends that health care professionals throw out what they’ve learned about heart disease and help women to realize their symptoms are different from men’s. "In my research," she says, "women would tell me that they didn’t have pain before their cardiac event. They had what they described as ‘chest discomfort,’ ‘a funny feeling,’ or ‘a numbness or tingling.’ A man will say he had ‘crushing pain. . . . It felt like an elephant was sitting on my chest.’ That’s the classic description of cardiac pain — classic because we’ve always interviewed men."

Ashton suggests a third way to raise cardiovascular awareness: Encourage women to be assertive when they seek care. "Women tend to delay in seeking care," says Ashton, "and when they do, they’re often told that their problem is not their heart. ‘It must be psychological or gastrointestinal.’" Women are more likely than men to get a prescription rather than a diagnostic workup for heart disease. "We need to teach women to be businesslike in their approach when seeking help," suggests Ashton. "The histrionic, demonstrative, emotional patient will not be taken seriously."