Journal of Cardiovascular Nursing Vol. 25, No. 6, pp 433Y443 x Copyright B 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Perceptions of Cardiac Risk Factors and Risk-Reduction Behavior in Women With Known Coronary Heart Disease Leslie C. Moore, MBA, MSN, RN; Laura P. Kimble, PhD, RN, FNP-C, FAHA; Ptlene Minick, PhD, RN Background: Risk factor reduction has been linked to personal perceptions of risk, yet few data exist about women’s personal perceptions of coronary heart disease (CHD) risk, especially women who have experienced a cardiac event or intervention. Objective: The purpose of this study was to explore perceptions of risk for CHD and to examine perceptions of risk-reducing behaviors in women with known CHD. Methods: Because women’s attitudes are conceptualized to be embedded in their everyday practices, an interpretative qualitative approach was chosen to reveal this phenomenon. The purposive sample consisted of 7 women with CHD. Interviews were conducted and transcribed verbatim. Data collection continued until saturation occurred. Efforts were made to increase trustworthiness through participant review of transcripts, peer debriefing, and using field notes. Results: Three major themes emerged from the data: ‘‘out of sight, out of mind,’’ ‘‘why doesn’t he talk to me like that?’’ and ‘‘it’s scary.’’ The women indicated their CHD was currently not a major problem because they were asymptomatic or did not ‘‘feel sick,’’ which led to decreased focus on their CHD, including risk factor reduction. They expressed the desire to return to normal, rather than focus on the chronicity of CHD. Participants felt that physicians treated them differently because they were women and that their concerns were taken less seriously. They perceived that the patient-physician relationship lacked open dialogue. Fear was experienced by all women, and many feared the unknown, especially not knowing when something was wrong with their heart. Conclusions: Data indicated that, during stable periods in the CHD trajectory, women may not understand the chronicity of their disease and may not recognize the importance of reducing their risk for future cardiac events. Helping women understand CHD chronicity even when they may not feel sick may assist them in engaging in risk-reducing behaviors. KEY WORDS: coronary heart disease, perceptions, qualitative, risk A wareness and perception of risk factors for coro- nary heart disease (CHD) are an important focus of study, as these can influence women’s health- promoting behaviors. Empirical evidence suggests that women have knowledge of their risk factors for CHD; however, few data exist about women’s perceptions of their own CHD risk and the need for risk-reduction behavior, especially among women with known CHD. 1Y4 Women’s attitudes and feelings about reducing their risk for CHD are embedded in their everyday practices, and these experiences are often taken for granted by women themselves and their healthcare providers. Through interpretive phenomenology, the meaning of everyday practices can be uncovered. The purpose of this study was to explore perceptions of risk for CHD among women with known CHD and to examine perceptions of risk-reducing behaviors in women with known CHD. Background Among women, 1 in 30 deaths results from breast cancer, whereas 1 in 6 deaths result from CHD, making CHD the No. 1 killer of women in the United States. 5 In 2005, approximately 7.3 million women were living with a history of myocardial infarction, angina pectoris, or both. There were a total of 217 800 CHD deaths for US women in 2004, which is more than the total deaths caused by all cancer types. 5 433 Leslie C. Moore, MBA, MSN, RN PhD Student, Assistant Professor, School of Nursing, Georgia College and State University, Milledgeville. Laura P. Kimble, PhD, RN, FNP-C, FAHA Professor, Piedmont Healthcare Endowed Chair in Nursing, Georgia Baptist College of Nursing of Mercer University, Atlanta. Ptlene Minick, PhD, RN Associate Professor, Byrdine F. Lewis School of Nursing, Georgia State University, Atlanta. Correspondence Leslie C. Moore, MBA, MSN, RN, School of Nursing, Georgia College and State University, 231 W Hancock St, Milledgeville, GA 31061 (Leslie.Moore@gcsu.edu). DOI: 10.1097/JCN.0b013e3181defd58 Copyright @ 20 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 10