Poster Presentation
Monday, November 5, 2007
10:30 AM - 11:45 AM
Monday, November 5, 2007
1:45 PM - 3:00 PM
An evaluation of cardiovascular risk factors during bereavement
Thomas Buckley, RN, BSc, (hons), MN, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia, Sharon McKinley, RN, BAppSc, PhD, Critical Care Nursing, University of Technology, Sydney and Northern Sydney Central Coast Health, Sydney, Australia, Geoffrey Tofer, MBBS, FRACP, FACC, MD, Cardiology, Sydney University and Royal North Shore Hospital, Sydney, Australia, and Roger Bartrop, MBBS, FRACP, DPM, MRCPsyc, Psychiatry, Associate Professor: Sydney University and Royal North Shore Hospital, Sydney, Australia.
Learning Objective #1: identify the known psychological stressors that are associated with fatal and non fatal coronary heart events. |
Learning Objective #2: identify individuals most at risk of fatal and non fatal coronary heart events during bereavement. |
Bereavement is a major psychological stress that most individuals experience at least once. Epidemiological studies have demonstrated an acute and longer term increase in cardiac events following bereavement, especially in bereaved spouses and parents. Despite the fact that bereavement is associated with increased cardiac mortality and morbidity, the exact physiological mechanism remains relatively unexplored during this vulnerable time. Recent reviews on bereavement research have recommend bereavement research priorities focus on explaining the complex interactions between physiological, behavioural and support mechanisms that place bereaved persons at increased cardiovascular risk. The acute cardiac manifestations of bereavement can be considered within the context of plaque rupture and thrombosis leading to myocardial infarction (MI) and sudden death. An area of research has emerged based on evidence that haemodynamic, haemostatic, hormonal, inflammatory and other biochemical changes occurring in response to stressors can trigger disease onset. In the Cardiovascular Health in Bereavement study, adverse physiologic responses to bereavement that may acutely increase risk for MI and sudden cardiac death are prospectively evaluated. The study aims to describe physiological changes (heamodynamic, haemostatic, inflammatory), psychological state (anxiety, depression and anger) and lifestyle changes (diet, smoking and alcohol consumption) in recently bereaved spouses/partners or parents that may result in acute cardiovascular events. The relationships between psychological state and physiological changes will be described to identify the most at risk and describe differences between anticipated and unanticipated bereavement. Through identification of the physiologic changes occurring with bereavement, the results are likely to have profound implications for the care of bereaved with the potential to provide clues to novel preventive measures.