ROLE CLARITY AND HEALTH PERCEPTIONS: THAI WOMEN WITH VALVULAR HEART DISEASE.
Contributors: University of California, San Francisco.
Published: 1992
Number of pages: 249
Subjects: Health Sciences, Nursing.
Description: There is limited data on how women experience valvular heart disease (VHD) in Thailand. The purpose of this study was to investigate (1) perceptions of VHD; (2) VHD'S impact on role performance; (3) levels of role clarity (the understanding of VHD and its management); and (4) the relationships among role clarity, number of roles, disease severity, psychological symptoms, and perceived health status.

Eighty-three women (mean age = 36) diagnosed with VHD for at least six months were recruited from a university hospital in Thailand. Qualitative data related to each study variable was obtained through semi-structured interviews. Quantitative measures included Women's Roles Interview Protocol (number of roles), New York Heart Association Functional Status Criteria (disease severity), the Brief Symptom Inventory (psychological symptoms), and Perceived Health Status Rung Ladder.

Using grounded theory, findings demonstrated that the heart was symbolically described as health, a life, a thinker, a pumping organ, and a hidden organ. VHD was accordingly described as a distortion of each of these symbolic meanings. Causes of VHD were attributed to karma, worry, hard work, infection, family history, traumatic experience, physiological trauma, and the unknown.

VHD resulted in changes in maternal, work, and wife roles which were central to the subjects' identities as women. Poverty and limited resources also exacerbated these changes. Women felt burdensome to others, less worthy, and uncared for by others.

Ninety-three percent of the women had limited understanding of how to be a VHD patient. Multiple regression was used to describe predictors of psychological symptoms and perceived health status. Role clarity explained 6.5%, income 13%, and severity of VHD 5.5% of the variance in psychological symptoms (p $<$.05), while number of roles were not significant in predicting psychological symptoms. Severity of VHD explained 7.1% of the variance in perceived health status (p $>$.01) while role clarity, number of roles, and income were not significant in predicting perceived health status.

To decrease the impact of the VHD on women's daily lives and identities, health care professionals need to be more attentive to how women experience, interpret, and live with VHD.
Notes: Source: Dissertation Abstracts International, Volume: 54-04, Section: B, page: 1894.

Thesis (D.N.S.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1992.

School code: 0034.