Physical proof of cardiovascular disease contains the narrow pulse pressure, cool arms, and legs, and sometimes changed mentation, with supporting proof sometimes provided by reducing serum sodium level and deteriorating renal function. Cardiovascular disease is frequently difficult to recognize through phone contact but may be suspected when previously effective diuretic increases fail, nurses report lower blood pressure, or patients explain improved lethargy. Facilitators and barriers to optimal disorder management and outcomes

Environmental factors and cultural beliefs; motivators and hinders

In this case, the client thought he was suffering from a heart attack and feared to come to the hospital. The symptoms had presented for four days before the patient sought help. The patient had been suffering from similar symptoms for the past six months, but thought that he just out of shape. It was worse upon admission to the hospital. Prior to this, the symptoms disappeared with the rest.

There is proof that cardiovascular patients suffer from social discrimination that is associated with a higher death rate. Although studies outlined that the social assistance is not highly associated with better self-care, a review research mentioned that social assistance was prognostic in cardiac patients. Empirical evidence shows that a supportive atmosphere is crucial for creating positive emotions and enhancing almost all self-care elements in the patient. Patients who have the opportunity to discuss their problems and those who get involved in social activities reveal enhanced self-care. By way an example, eating alone reduces someone's inspiration to cook and share foods resulting in an improved intake of 'microwave dinners' often with high sodium content

Cultural principles might give the patient a misdirected perception of cardiac disease. Majority of cardiac patients think, for example, that cardiac disease results from stress or simply associated with old age. As a result, the patient tries to get over a traumatic situation by not following medical training. In addition, cultural preferences often trigger problems with adherence to a healthy diet plan. However, personal values and cultural beliefs may assist some factors of self-care such as medication adherence. Dickson and her associates revealed that the spirituality influences self-care favorably (Gulanick, 2007).

Psychological factors

Evidence reveals that depressive disorders in patients with cardiovascular disease are more prevalent than in the general population. On the other hand, depressive disorders leading to lack of energy results in negative effects on self-care. Additionally, depressive disorders may increase the risk of death in this group of patients. Whereas experiencing positive feelings allows people to engage in behaviors that secure their positive condition. Previous studies indicate that depression and hopelessness are a serious problem for patients with cardiovascular disease (Miller & Taylor, 2005). This affects self-care confidence, self-care management, though; adherence to medication does not affect depression levels. Offering conditions in which the patient may continue with his leisure activities and supporting him to have a better quality life can result in enhanced moods and self-care ability.

Strategies to overcome the identified barriers

The patient with the cardiac disease is facing a stressful situation and changes in life conditions. As such, they employ a range of defense systems and coping techniques that can either be enabling or not. Common responses of such a patient, suffering from cardiac disease include denial then approval. Denial and avoidance reduce the ability of the patient to take good care of himself. Disavowal helps the patient to deal with his mental stress without neglecting the reality of his disease. Acceptance is a coping strategy that has both positive and adverse effects on the different personality under different cultural environments.

In order to handle contextual problems such as cultural issues, educators, and health providers need to have good interaction abilities such as reflective listening, concern, and recognizing patients' individual principles. Effective interaction abilities and trust have a mutual relationship; by enhancing one, of the variables increases the other variable. However, poor doctor-patient interaction is an important barrier to self-care in cardiovascular patients. Beliefs in medication are the most powerful forecaster of adherence than socio-demographic factors and medical situation. A lack of believe in medical professionals along with individual principles and cultural beliefs may stop patients from looking for help when symptoms intensify because the signs can be culturally recognized to be unmanageable and have to be approved stoically (Bunting-Perry & Vernon, 2007).

Care plans synthesis

Cardiovascular Risk Factors and Healthy Behaviors

Cardiac risk factors are the conditions, actions, or aspects that increase an individual's chance of developing cardiac arrest. Factors such as age, race, or genetics are risk factors that cannot be changed. However, many more risk factors can be changed to prevent damage to the patient's arteries. This plan offers multiple strategies and settings to target these changeable risk factors to be effective in managing cardiovascular health.

Hypertension (high blood pressure)

It causes widespread damage to multiple organs like kidneys, brain, heart, also including the arteries. High blood pressure does not generate symptoms until late when the damage has already happened.
Smoking

Smoking is a key risk factor in patients suffering from cardiovascular diseases. Compared to non-smokers, smokers are double expected to develop a stroke, leading to hemorrhagic stroke. Population strategies like hygienic laws and price increases seem effective in decreasing smoking.

High Cholesterol and Dyslipidemia

Hyperlipidemia refers to high lipid levels in the blood. This term indicates abnormalities in types or quantities of lipids. It seems that the lower the density of lipoproteins or the higher the cholesterol level, the greater the chances of cardiovascular disease. However, the presence of other risk factors is likely to change the acceptable cholesterol level. Intervention for adult cardiovascular patients recommends the detection, evaluation and treatment of high levels of cholesterol (Jacob, 2012). Other risk factors include; Hypercholesterolemia, Type 2 diabetes, Android obesity and Positive family history.

Healthy Behaviors

The above cardiac risk elements are well established. However, studies suggest that many CVD activities occur because of the interaction between several aspects at low levels. In fact, individuals who have a cardiac event only have average or light levels of risk factors. As a result, initiatives have started to recognize health behaviors that promote heart and brain health. A number of characteristics/factors have been shown to be very important to both cardiovascular health and general well-being. Characteristics entail:

Being a nonsmoker; never or stop for at least one year

Being physically active at recommended stages,

Taking healthy diet plans.

To help meet its 2020 objective of enhancing cardiac health in the United States, the American Heart Organization (AHA) has created a new meaning for ideal cardiac wellness. In this meaning, the AHA has recognized various health aspects and behaviors that are helpful of cardiac health. The focus of this objective is to prevent cardiovascular disease and heart stroke by supporting people in making healthy decisions. According to the AHA, this has been the first time the association has implemented better health as a major objective (Gulanick, 2007).

Recommendations for Prevention of CVD

In addition to the recommendations for quitting smoking, physical exercising recommendations, diet, weight-loss and bodyweight maintenance, and hypertension and lipid treatment measures, experts recommend avoidance of smoking cigarettes, consumption of omega-3 body fat, and comprehensive cardiac rehabilitation programs following cardiovascular disease and strokes.

Rehabilitation

Participating in a rehabilitation program immediately after leaving the hospital for cardiac arrest can improve an individual's chance of restoration. Rehabilitation programs are an important step in reducing the death rate, morbidity, and functional impairment due to both cardiovascular disease and stroke. Comprehensive cardiovascular rehabilitation has been shown to decrease re-hospitalization rates, decrease repeated events and abrupt cardiac death, reduce the need for cardiac medications, and enhance the rate of the individual returning to work. Following a stroke, most of the recovery the individual experiences relate to the contribution in stroke recovery. Little, if any, improvement is made when an individual does not participate in stroke rehabilitation. While stroke and cardiac rehabilitation programs are proven effective, they are often underused. Each year two million patients are entitled to cardiac rehabilitation due to acute myocardial infarction or because of coronary revascularization (Kucia & Quinn, 2009).

Conclusion

Self-care is a complicated and multi-faceted phenomenon that needs a comprehensive consideration of patients, such as their psychological situation, psychological characters, physical capabilities, family support, living features, comorbidities (especially intellectual function), and their ability for learning. Inadequate knowledge about cardiovascular disease, symptom identification, and ways of self-care along with despondency and psychological problems limit the capabilities for an efficient self-care. A helpful environment, inspiration and sufficient care programs using efficient academic methods that build self-care skills, should be recommended to medical care providers and family members.