An Occupation-Based Protocol Designed for Women with Cardiac Conditions

Coronary heart disease is the leading cause of death in women worldwide as well as the number one cause of death in the United States (American Heart Association [AHA], 2010). Women are not adequately represented when entering phase II of cardiac rehabilitation due to the numerous barriers that they may experience. The purpose of this scholarly project is to help meet women’s unique needs and facilitate their return to meaningful life roles and occupations after experiencing a cardiac event. This protocol provides guidelines for occupational therapists to use during phase II of cardiac rehabilitation and addresses the implementation of occupation-based treatment. Elements of the protocol include: evidence-based occupational therapy assessments, a home evaluation, as well as group-based intervention sessions and individual reflective assignments on stress and anxiety management, assertive communication with others, activity MET-level modification, and home environment adaptation. Analysis of findings from the literature review revealed several factors that are important to the process of cardiac rehabilitation for women including: quality of life, psychosocial, physical, and social aspects as well as consideration of barriers. The literature review highlighted certain barriers that women experienced when entering cardiac rehabilitation such as: lack of physician referrals, availability of services, and transportation (Rolfe, Sutton, Landry, Sternberg, & Price, 2010). The social context was found to be highly important for women with cardiac conditions and who attend cardiac rehabilitation. Peer, professional and family support also helped encourage and motivate women to continue participating in a cardiac rehabilitation program. The Ecology of Human Performance (EHP) (Dunn, Brown, & McGuigan, 1994) was utilized in development of the protocol because it places emphasis on environment and varying contexts that play an important role in the lives of women with cardiac conditions. Social contexts and home environments were the leading contextual considerations for occupation-based activities suggested in the protocol. Occupational therapists have the potential to play a significant role in Phase II of cardiac rehabilitation