Occupational health surveillance strategies for an ethnically diverse Asian employee population.

1. Implementation of a medical/health surveillance program can prevent the damaging effects of lead toxicity. Lead toxicity may be a result of acute or chronic exposure and can affect the hematopoietic, nervous, renal, and reproductive systems. 2. Minority groups tend to be overrepresented in lead industries. Further, an increase in high lead levels can be compounded by cultural influences. Education must be geared toward the specific employee populations. 3. Successful programs require assistance from all team members--occupational health nurse, safety engineer, industrial hygienist, and environmental engineer. Occupational health nurses play an important role in implementation of medical/health surveillance programs by scheduling regular blood testing, monitoring results, and educating employees.     

Experiences of perioperative care among ethnically diverse older adult patients: An integrative review

BackgroundOlder people from Culturally and Linguistically Diverse (CALD) backgrounds are increasingly admitted to hospital for acute care reasons, such as surgical procedures. However, there is limited evidence on the perioperative (surgical) experiences and needs of ethnically diverse older adults.AimTo synthesise evidence about the perioperative experiences of older adults from ethnically diverse backgrounds.MethodsAn integrative review methodology.FindingsEighteen articles were included in the review. Three main themes emerged from the review of the literature; (i) Culturally related factors as drivers to decision-making preoperatively; (ii) Providing culturally responsive and appropriate perioperative information; and (iii) Culturally related considerations for effective self-management postoperatively.DiscussionThe perioperative needs of ethnic groups are contextualised or informed by culture, ethnicity and linguistics. These needs are not necessarily exclusive to those of ethnically diverse backgrounds. For example, the perceived need for understandable information to make an informed decision would be considered as an essential aspect of perioperative care for any patient. However, the need for understandable information and the complexities of effective communication in perioperative settings are compounded by nuances of culture and language.ConclusionThere needs to be culturally appropriate perioperative processes of care, which build on the standard practice. While patient needs are addressed by universal processes, there is a need to expand and utilise approaches that are culturally and linguistically responsive to older adult patients and their family caregivers. The availability of appropriate mechanisms to engage with healthcare in a culturally meaningful way has the potential to reduce health inequities and improve patient experience.     

Underdiagnosed and undertreated depression among racially/ethnically diverse patients with type 2 diabetes

OBJECTIVE

To examine racial/ethnic differences in the prevalence of depressive symptoms and in provider recognition of depression among Latino, Asian, and non-Hispanic white patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Patients (n = 1,209) with type 2 diabetes were recruited from five university-affiliated primary care clinics for an observational study.

RESULTS

Vietnamese American (133, 59.4%) and Mexican American (351, 50.2%) patients were more likely to report symptoms consistent with clinical depression (Center for Epidemiological Studies Depression [CES-D] scale score ≥22) than non-Hispanic whites (119, 41.6%; F [2, 1206] = 8.05, P < 0.001). Despite comparable diabetes care, Vietnamese and Mexican patients with high depressive symptoms were less likely to be diagnosed and treated than non-Hispanic whites (all P values < 0.001). Minority patients who reported low levels of trust in their provider were less likely to have been diagnosed or treated for depression (adjusted odds ratio 0.65, 95% CI 0.44–0.98, P < 0.05).

CONCLUSIONS

Innovative strategies are needed to improve recognition of depressive symptoms in minority patients.Although routine depression screening of adults in primary care is recommended (1), only about half of the depressed patients who present for care are recognized (1,2). Linguistic and cultural barriers (3,4) may exacerbate this underdiagnosis and undertreatment of depression in the 21 million Americans who have limited English-language skills (5). Untreated comorbid depression can have serious clinical implications for patients with diabetes, as depression contributes to poor self-care, less treatment-related adherence, and poor glycemic control (6,7). Given the paucity of information on the mental health status of type 2 diabetic patients with limited English proficiency, this study examined racial/ethnic differences in the prevalence of depressive symptoms and in provider detection of clinical depression. We hypothesized that minority patients would be more likely to report symptoms indicative of clinical depression, but would be less likely to have been diagnosed and treated compared with non-Hispanic whites.     

Moderate alcohol consumption and unappreciated risk for alcohol-related harm among ethnically diverse,urban-dwelling elders

The purpose of this cross-sectional survey was to gather data describing how older adults define moderate alcohol consumption and how they have interpreted media reports of the health benefits of moderate alcohol consumption. Results showed that many older adults define moderate alcohol use at levels above Federal guidelines, and a notable number of older adults agree that moderate use is good for health. The disparity between older adults' definition of moderate drinking and Federal guidelines for low-risk drinking may contribute to the underrecognition of problem drinking by nurses and other health care providers and place older adults at an unappreciated level of risk for alcohol-related harm.     

Gender differences in use of prayer as a self-care strategy for managing symptoms in African Americans living with HIV/AIDS.

The objective of this study was to explore the association of gender to use of prayer as a self-care strategy for managing the HIV-related symptoms of fatigue, nausea, depression, and anxiety among African American men and women who are HIV-seropositive. To accomplish this, data were determined using convenience sampling from a sample of 448 African American men and women from the United States who were participants in a national study on self-care symptom management of HIV/AIDS. Chi-square analyses were used to examine the potential relationships between gender and the use of prayer for managing the four symptoms. The mean age of the sample was 42.69 +/- 7.93 years (range, 20-66). Results showed the following gender differences in the use of prayer as a self-care strategy: fatigue-men 46% (n = 62), women 54% (n = 74); nausea-men 52% (n = 33), women 48% (n = 30); depression-men 55% (n = 90), women 45% (n = 73); and anxiety-men 77% (n = 83), women 87% (n = 73). Chi-square analyses determined that significant differences exist between African American men and women in the frequency of the use of prayer for managing HIV-related fatigue (chi(2) = 14.81, 1 df, p = .000), nausea (chi(2) = 4.10, 1 df, p =.043), and depression (chi(2) = 5.21, 1 df, p = .022). There was no gender difference in the use of prayer to manage anxiety. Prayer was reported as a self-care strategy by over 50% of the respondents for three of the four symptoms and was rated highly efficacious. The authors conclude that the African American men and women differed in their selection of prayer as a self-care strategy for managing HIV-related depression, fatigue, and nausea. A higher proportion of women than men used prayer to manage fatigue, and more men than women reported using prayer to manage nausea and depression.     

Social comparison as a coping strategy among caregivers of eating disorder patients

The aim of the study was to determine any gender differences in the social comparisons made by caregivers of eating disorder patients and to analyse the relationship between social comparison and personality, age of caregivers, self-esteem, duration of illness, duration of treatment and perceived health and quality of life. We also explored the possibility of classifying caregivers according to these variables. Comparison strategies were analysed in a sample of 96 caregivers of eating disorder patients. The social comparison during illness scale, visual analogue scales of health and quality of life, self-esteem scale of Rosenberg and Eysenck Personality Questionnaire were used. In order to explore possible groupings a cluster analysis was performed. A significant correlation between the use of more unfavourable strategies, neuroticism and low self-esteem was found. Women adopted worse strategies and the cluster analysis revealed two sub-groups with respect to comparisons, personality, self-esteem, self-perceived health status and quality of life. The finding of subgroups associated with worse comparison strategies, higher neuroticism, lower self-esteem and a poorer self-perception of health and quality of life could have repercussions as regards the prognosis of eating disorders and, at all events, should be taken into account during therapeutic work with families.     

Alternative health care as a control strategy

What does it mean when a patient desires to be in control of an uncontrollable illness or an uncontrollable hospital situation? This paper explores the theme, desire for control, a theme emerging from a recent ethnographic study on the use of alternative health care in a hospital setting While it may be argued that choosing an alternative practice may be a patient's strategy to control a perceived uncontrollable situation, there are many other ways of looking at the control issue The data derived from the conceptual reality of the informants in this study are examined in the light of research and theories of perceived control, locus of control and illusion of control     

不孕症患者健康信息需求调查分析与对策

目的：了解不孕症患者的健康需求。方法：对515名不孕症患者的健康信息需求进行调查。结果：（1）不孕症患者对护士的要求以讲解疾病知识最多，占97％；（2）患者对疾病相关知识需求；不孕病因，检查目的，治疗方法疗效，用药作用及注意事项的需求均在79％以上；（3）患者对健康信息获得方法以医务人员讲解最多，占95％。结论：患者望了解不孕症的各类知识，希望医务人员给予支持和帮助。护士应从心理护理，宣教疾病知识，为病人保守秘密等方面进行护理。     

Developing a shared language: interdisciplinary communication among diverse health care professionals

Multidisciplinary teams of nurses, physicians, and other professionals may have difficulty communicating because of inconsistent theoretical underpinnings. A theoretical base that spans both clinical outcomes and professional boundaries is needed. The web of causation is a theoretical framework that provides a platform of communication connecting issues related to infant mortality among various health-related professions. It includes professional, community, and institutional issues relevant to pregnant women and new mothers as infant caregivers. The article discusses how the web was used for interdisciplinary health care professional interaction and how it was used to develop a series of research protocols that will affect the care of mothers and infants in the District of Columbia.     

Common cancer-related symptoms among GP patients Opportunistic screening in primary health care

Objective - To study the occurrence of symptoms related to the five most common forms of cancer among patients regularly visiting primary care. To estimate the proportion of symptoms needing GP examination, and the number of tumours thus diagnosed. Design - Patients with some form of non-malignant chronic disease received a letter with information about cancer-related symptoms along with an invitation to regular check-up. The letter described the most common symptoms of breast, colorectal, lung, prostate and skin cancers. Setting - 12 health centres in Kalmar County, Sweden. Subjects - 5200 patients aged over 40 years. Results - One patient in 13 reported cancer-related symptoms to the GP. Women reported more symptoms than men, and almost half of them had had symptoms at previous check-ups. The GP was able to explain 7 out of 10 patients' symptoms directly. When other symptoms were examined, 8 cancers were diagnosed as well as 6 pre-malignant tumours, corresponding to 3 tumour diagnoses per 1000 check-ups. Conclusion ? While attending regular check-ups, patients may not report symptoms which cause anxiety and sometimes indicate serious diseases. It is possible to widen the perspective and link both primary and secondary prevention of certain cancers to the check-up.     

Response to breast health screening program at a not‐for‐profit clinic for working poor,uninsured, ethnically diverse women

Aims and objectives. Examine the effect of an ongoing breast health screening program, at a not‐for‐profit, non‐government assisted, volunteer clinic, specifically examining mammography usage and to discover variables to improve the rate of mammography. Background. Detection of breast cancer in women of low socio‐economic status, lacking health insurance, can be improved by increasing annual mammography rates, yet little is known about their screening behaviour. Design. Quantitative, retrospective subject‐controlled study. Methods. Subject‐controlled, longitudinal study of English and Spanish‐speaking women 40 years old and over, working poor, and uninsured, who participated in a comprehensive screening program that included a 7‐minute breast health educational DVD (n = 223). Results. Radiology records, breast health behaviours and beliefs indicated 76% of women invited for a second test completed it over a year after viewing the educational DVD. Chi‐square and t‐test indicated two significant findings for completing annual mammography in the 12th month: receiving a reminder postcard and scoring lower on perceptions of breast cancer susceptibility. Two significant findings for completing annual mammography even if late are knowledgeable about screening recommendations and ethnically identifying as Hispanic. Conclusions. This study shows statistically significant actions that can be undertaken to strengthen programs: reminder postcards, assessing susceptibility score and screening recommendation education. Relevance to clinical practice. Simple, inexpensive interventions encourage working, uninsured, Hispanic women to complete mammography.     

Inclusiveness: a mental health strategy for preventing future mental health problems among adolescents orphaned by AIDS

The purpose of this paper is to raise an argument that inclusiveness will lessen the pain of losing a parent among adolescents orphaned by AIDS and as a result, prevent future mental health problems that may occur because of inappropriate grieving and maladaptive coping strategies. Participation of adolescents orphaned by AIDS in decisions pertaining to their parents' illnesses and funeral arrangements, for example, may shorten the grieving process and allow for closure. The paper draws data from focus group discussions that were held with 15 adolescents orphaned by AIDS in urban South Africa. The focus group discussions that were structured around four themes: grieving patterns; coping strategies; experience with loss; and expectations. The results of the study demonstrate inclusiveness as an overarching factor in the healing process. The concept is thus a strong recommendation for mental health practice and further study.     

Psychodrama as a pedagogical teaching strategy about worker's health

This study had the objective to report the experience of using pedagogic psychodrama as a teaching and learning strategy about the worker's health. It was developed with 18 students from the Master Program from the School of Nursing of the University of S?o Paulo at Ribeir?o Preto, during the second semester of 2002. Interactive, dynamic and interpersonal activities, and role playing were initially conducted looking for students and educator's spontaneity. Moreno's psychodramatic theory was the theoretical framework used. Creativity, logical reasoning, involvement with learning, and organization of concepts using their own living experience were observed, contributing to the experience as a whole. Therefore, the experiment was considered successful.     

Could sound be used as a strategy for reducing symptoms of perceived motion sickness?

Background  

Working while exposed to motions, physically and psychologically affects a person. Traditionally, motion sickness symptom reduction has implied use of medication, which can lead to detrimental effects on performance. Non-pharmaceutical strategies, in turn, often require cognitive and perceptual attention. Hence, for people working in high demand environments where it is impossible to reallocate focus of attention, other strategies are called upon. The aim of the study was to investigate possible impact of a mitigation strategy on perceived motion sickness and psychophysiological responses, based on an artificial sound horizon compared with a non-positioned sound source.