Empirical evidence exists directly relating forgiveness to physiological markers of cardiovascular health based on the manner in which individuals respond to interpersonal offenses. Extant literature has identified the harmful effects of stress in cardiovascular disease and health in general and unforgiveness has been identified as a stressor with potential implications for cardiac health. Understanding cardiac response to the stress of unforgiveness may have favorable implications for heart disease prevention and treatment in women and may prove to be beneficial in reducing allostatic load.

Black women are disproportionately affected by cardiovascular disease (CVD). While chronic stress has been identified as a key contributor to CVD risk, research has not identified the specific mechanisms through which stress influences CVD risk among Black women. Research suggests that in response to stress, Black women who internalize the SBW Schema engage in high effort coping, avoidant coping, postponement of self-care, and other maladaptive health behaviors and experience premature health deterioration. However, it is important to consider that internalization of the SBW Schema may exert differential effects on the physiological profiles of Black women due to varied interpretations of experiences filtered through the Schema and differences in emotion regulation. As emotion regulation has a robust impact on cardiovascular outcomes, individual differences in internalization of the SBW Schema may be explained by this related construct. Given that limited research has examined the impact of psychological factors associated with CVD risk in Black women, the current study examined relations between CVD risk, chronic stress, emotion regulation, and the Strong Black Woman (SBW) Schema. Hypotheses were: 1) internalization of the SBW Schema (i.e., higher levels of endorsement) and chronic stress are unique predictors of CVD risk, 2) the relation between internalization of the SBW Schema and CVD risk will be partially mediated by emotion regulation, and 3) the effect of chronic stress on CVD risk will be moderated by internalization of the SBW Schema. Results provided partial support for the first hypothesis and did not support the second and third hypotheses. Results of exploratory analyses revealed relationships among psychological variables, such that greater endorsement of SBW Schema characteristics (obligation to manifest strength, dedication to care, independence, and emotion suppression) was related to greater overall difficulties with emotion regulation. Additionally, greater dedication to care predicted lower CVD risk and greater emotional suppression predicted higher CVD risk. The relationship between emotional suppression and CVD risk was mediated by emotion regulation. Results stand to inform future research and culturally specific prevention strategies to decrease CVD risk in Black women.

Thesis (M. Sc.)--Memorial University of Newfoundland, 1997. / Bibliography: leaves 130-139.

No / The Hospital Personnel, Nursing Care and Dying Patients study, undertaken in California in the mid 1960s, generated a body of work that continues to be influential in end of life care research. Key points from the study are summarised, as are contributions from researchers who have responded to Glaser and Strauss invitation to examine further settings and, in so doing, provide data that helps refine their theory. The example of people with heart failure in the contemporary UK is considered. Changes since the 1960s in the epidemiology of chronic illness, the pattern of service provision and in social and professional attitudes have reduced the contemporary relevance of Glaser and Strauss's insights into the ceremonial and temporal order of the clinic. However their findings about awareness contexts and a reluctance to discuss prognosis remain highly relevant.

Abstract Fatal coronary heart disease among African Americans is associated with a disproportionate burden of cardiovascular disease (CVD) risk factors. Research has indicated that CVD risk factor knowledge and the prevalence of ideal CVH both persist at suboptimal levels. However, few researchers have investigated the relationship between culturally-tailored community-based heart health sessions, short-term knowledge acquisition of CVD risk factors, and the awareness of the American Heart Association's (AHA's) CVH construct. The purpose of this cross-sectional, secondary analysis study was to examine the interplay between these variables in an urban African American sample. Guided by social cognitive theory, the study analyzed de-identified data (data sets of demographic characteristics and Heart Disease Facts Questionnaire) from participant responses collected at multiple community sites to assist in the planning of future health programs. Multiple community sites were randomized into an intervention (n = 50) or comparison group (n = 57). Pearson's correlation and multiple regression were used to analyze data. Knowledge was higher for intervention group participants (β =.44, p = .001) and tended to be higher for those with more education (β = .20, p = .06) and those with less income (β = -.22, p = .07). Notably, most participants (73%) reported awareness of the AHA construct, CVH. The results support culturally-tailored interventions as a useful strategy for CVD risk reduction. The implication for social change is that initiatives at the community-level may positively impact CVH in minority/ethnic communities and subsequently impact CVD disparities.