Cognitive maps of women with coronary heart disease: Describing the content

Coronary heart disease (CHD) is the leading cause of death for women in the United States. Current research has not fully explored the relationship between cognitive representations of women with CHD and their lived experience. The purpose of this dissertation was to enhance knowledge of how women process and integrate CHD related internal and external stimuli in the contexts of current social and cultural milieu.; Women with CHD were interviewed about their experience. Phenomenology grounded the philosophical orientation and Illness Representation and Cognitive Maps were theoretical frameworks. The Conceptual Content Cognitive Map (3CM) operationalized the theoretical frameworks. Narrative data about cognitive representations were analyzed using QSR NVivo and Leininger's (1985) sequential thematic pattern analyses approach. Bivariate correlations were used to describe relationships between themes.; Themes of individual and system level responses were identified and described. They included physical symptoms, emotional responses, and interactions with the healthcare system, medications, and CHD risk factors. Components of Illness Representation structures ranged from least (duration) to most common (symptom label). Components of cure/control were characterized by strong reliance on health professionals and sanctioned the role of biomedical technology.; Vagueness of women's CHD symptoms often resulted in inabilities to identify a personal symptom pattern expressed as confusion. Health professionals often filled surrogate social support roles. Gender roles were prominent in the content of cognitive maps. Not surprisingly, health and social disparities were identified in the demographic data.; Analyses of theme clusters indicated that negative emotional responses correlated with physical symptoms, modifiable risk factors, and limits to independence. A positive attitude toward medication was correlated with CHD outcomes, but the descriptive focus of this study did not permit determination of causality. The fact that emotional responses affected a wide range of CHD themes supported the hypothesis that emotions play a key, but not clearly defined, role in cognition and behavior. Implications for future research included multiple comparisons of cognitive maps from different perspectives with various samples to explore the emotion-cognition relationship and its causal relationship in CHD.