Graduate School of Nursing Dissertations

Publication Date


Document Type

Dissertation, Doctoral


Graduate School of Nursing

Dissertation Committee Chair

Carol Bova


Cardiovascular Diseases, Health Behavior, Premenopause, Risk Factors, Primary Prevention

Subject Categories



The number one killer of women in the United States is cardiovascular disease (CVD). Cardiovascular risk factors (CVRFs) include advancing age, cigarette smoking, diabetes, dyslipidemia, family history, hypertension, obesity, sedentary lifestyle and high intake of saturated fats and low dietary fiber. A women’s risk for development of CVD dramatically increases after menopause and with the number of CVRFs. CVD is often preventable. Evidence supports addressing CVRFs reduction early (in the pre-menopausal years) through heart-healthy behaviors such as increasing physical activity, promoting healthy eating, moderate alcohol consumption and not smoking. Therefore, understanding premenopausal women’s CVRFs knowledge is an important area of inquiry. In addition, the Nemcek Wellness Model suggests that self-nurturance, as well as knowledge, may be an important factor for explaining women’s wellness behaviors. Thus, the purpose of this study was to investigate knowledge of CVRFs, level of self-nurturance and the performance of heart-healthy behaviors in women ages 35 to 55 years.

This study used a cross sectional survey design and venue sampling. The survey included demographic questions, the Self Nurturance Survey, the Heart Disease Facts Questionnaire, the Physical Activity Questionnaire, Prime Screen, and questions about financial strain, cigarette smoking, and alcohol use. The sample included 136 women (survey response rate = 57%), the majority of whom were white (94.9%), married (80.1%), did not smoke (80.1%) and rarely drank alcohol (57.4%).

Results indicated that study participants were very knowledgeable about CVRFs. (Mean knowledge score = 19.53, possible range = 0 to 25 with higher scores indicating greater knowledge). Knowledge did not predict physical activity (p = .07), diet (p = .08) or smoking status (p = .11) in this sample. Self-nurturance was moderately correlated (r = .33) with consuming a heart-healthy diet. Hypotheses derived from the Nemcek Wellness Model were not supported in this study. More research is needed to identify factors that will help women translate knowledge into heart-healthy behaviors.



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