Abstract
A myth persists that myocardial infarction (MI) mainly affects men. This seems to have resulted in women receiving less cardiac rehabilitation than men. The aim of this study was to compare women's self-rated health among those who voluntarily did and those who did not participate in a cardiac rehabilitation programme (CRP) within 12 months after their first MI. A nonrandomised evaluation study design including a pre- and posttest was implemented in 18 acute hospitals in the southwestern part of Sweden. Two hundred and forty consecutively chosen women suffering their first MI were asked to complete two self-rated questionnaires at the onset of the MI and 12 months later. The results showed that about 50% of the women took part in a CRP. Women who participated in a CRP reported more medical problems, such as anginal pain (p < 0.05), and received more interventional cardiology (p < 0.05) 12 months after the MI. Irrespective of participation in a CRP, the women succeeded with behavioural changes, such as giving up smoking, starting exercising, and becoming more diet conscious (all p < 0.001). The only benefits identified, related to CRP participation, were a higher back-at-work rate (p < 0.05) and normalised blood pressure (p < 0.05). The findings indicate that today's CRPs are not female adapted in that they neither offer emotional support in the short term nor support a feeling of belonging in the long term and that the health care professionals involved are not aware of this fact. Consequently, considering the findings and the design procedure, it would be useful to compare, through a randomised clinical trial, a traditional risk-factor-based education CRP and a long-term individual-based supportive CRP performed by well-educated health care professionals targeting women after MI.

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