Goal-Setting Behavior for Physical Activity in Adults With Diabetes: A Pilot Project

In this pilot project, patient-selected SMART (Specific, Measurable, Attainable, Relevant, Time-bound) goals were used a to increase self-reported physical activity and decrease hemoglobin A1C (HbA1C) in patients with type II diabetes (T2DM). We assessed pre- and postintervention physical activity levels and HbA1C at the follow-up visits spaced 3–4 months apart. In this 23-participant study, patients showed a statistically significant improvement in physical activity when SMART goals were met and a statistically significant decrease in HbA1C with increased physical activity.     

Patients on the Move!

Recently, the Surgeon General put out a Call to Action “To Promote Walking and Walkable Communities.” Walking is a powerful health promotion activity that nurse practitioners (NPs) can quickly prescribe as part of a management plan for the vast majority of their patients. NPs are key health care professionals in the promotion of walking and other physical activity for their patients across the life span. NPs should be familiar with physical activity recommendations for all of their patients, including patients with disabilities. NPs need to be able to assess physical activity as well as prescribe individualized physical activity plans.     

Physical Activity and Vascular Dilation Function in Healthy Middle-aged Individuals

Objective: Vascular dilation dysfunction has been linked with risk of cardiovascular disease. This study was undertaken to investigate the relationship between physical activity and vascular dilation function in healthy middle-aged adults to help explaining the effect of physical activity on preventing cardiovascular disease. Method: We recruited 91 healthy middle-aged adults to complete a self-report 7-day physical activity recall questionnaire and an exam of brachial artery flow-mediated dilation(FMD) and Nitroglycerin-mediated dilation (NMD) detected by ultrasound. The relationship between physical activity level (PAL) and FMD and NMD were explored. Result: Physical activity showed a significant and positive relationship with the brachial artery FMD, even after adjustment for possible confounding factors (r=0.363, P<0.01). The group of high physical activity level had the highest FMD. The means of FMD (%) in low, moderate and high PAL groups were respectively 8.70%±3.93％,9.01%±3.22％ and 12.38±5.67％ with significant difference between individuals of low and high PAL and between moderate and high PAL group(P<0.01). The means of NMD (%) is 25.13%±6.52%,24.38%±5.44% and 29.50%±7.25% respectively (P>0.05) and there was no significant difference among three groups. There was no positive relation between PAL and FMD in premenopausal females but in men and postmenopausal females. Although individuals of high PAL have the best FMD, the moderate PAL can also retard FMD decrease with ageing. Conclusion: Maintaining high physical activity level can enhance endothelial-dependent vascular dilation, and moderate or high physical activity level can prevent endothelial-dependent vascular dilation declining with aging, which may contribute to decrease risk of cardiovascular disease in healthy middle-aged adults.     

Physical Activity and Exercise Adherence in People With Hematologic Malignancies

People with hematologic malignancies face serious physical and psychologic adverse health outcomes, such as fatigue and functional impairments, resulting from the underlying cancer, the cancer treatment, or both. Physical activity and exercise are widely recommended to address these concerns and optimize health during and after treatment. People with hematologic malignancies face critical health challenges, such as neutropenia and thrombocytopenia, which affect their ability to initiate or maintain a physical activity or exercise program; thus, adherence becomes problematic. This report discusses these health challenges and identifies potential strategies, such as removing barriers to exercise, to promote physical activity and exercise adherence.     

Perceptions of Barriers and Benefits to Physical Activity Among Outpatients in Psychiatric Rehabilitation

PURPOSE: To explore perceived barriers and benefits to physical activity in people with serious and persistent mental illness (SPMI) who were enrolled in community-based psychiatric rehabilitation. DESIGN AND METHODS: Four focus groups, two for men and two for women, were held with a total of 34 outpatients from two program sites. The investigators used a semistructured interview guide to facilitate the discussions. Audiotapes of the discussions were transcribed and analyzed for concepts and themes. FINDINGS: Significant barriers to physical activity were: mental illness symptoms, medications, weight gain from medications, fear of discrimination, and safety concerns. Being in a psychiatric rehabilitation program offered comfort and belonging, but it also had the effect of leaving activity initiation up to the program staff, which some participants perceived was part of required program compliance. However, participants viewed physical activity positively, and they linked being active to improved mental health. CONCLUSIONS: Outpatients in psychiatric rehabilitation valued physical activity, but mental illness symptoms, medication sedation, weight gain, fear of unsafe conditions, fear of discrimination, and interpretations of program compliance were barriers. Confronting how attitudes and barriers specific to this population can affect activity and reframing program compliance to include the independent initiation of activity as part of improving health might help clients of mental health services to become more active.     

Promoting Physical Activity and Exercise in Patients With Asthma and Chronic Obstructive Pulmonary Disease

Chronic lower respiratory diseases, including asthma and chronic obstructive pulmonary disease, are a significant public health burden owing to their high incidence and prevalence. Nurse practitioners in primary care routinely see patients with these diagnoses. Although inhaled pharmacotherapy is the mainstay of treatment for individuals with these diseases, providing an overall approach to health and wellness, which includes physical activity and exercise, is imperative in optimizing patient outcomes. The purpose of this article is to provide nurse practitioners in primary care with foundational information regarding the promotion of physical activity and exercise for patients with asthma and chronic obstructive pulmonary disease.     

Promotion of Physical Activity and Cardiac Rehabilitation for the Management of Cardiovascular Disease

National rates of cardiovascular disease continue to increase, whereas levels of physical activity (PA) remain discouragingly low, representing lost opportunity for effective lifestyle management. When equipped with knowledge of recent guidelines and cardiac rehabilitation (CR) options, nurse practitioners will be poised to most effectively manage patients with cardiovascular disease through PA measures. Towards this end, this article will overview the 1) benefits of PA; 2) advantages, safety, structure, and qualifying diagnoses for CR; 3) efforts to increase CR referral and participation; 4) alternatives and supplements to traditional CR programs; and 5) principles and guidance for prescribing PA outside of the CR setting.     

Theory of Planned Behavior: Social Support and Diabetes Self-Management

Diabetes prevalence is increasing in the United States and is strongly associated with obesity and devastating comorbidities. To achieve good health outcomes and quality of life, it is crucial for older adults with diabetes and obesity to have adequate social support to sustain diabetes self-management practices. The theory of planned behavior provides a theoretically guided framework for nurse practitioners to develop tailored strategies that include psychosocial support for diabetes self-management. Nurse practitioners should use theory-guided practice models that include family, friends, providers, and community support in order to improve and sustain diabetes self-management behaviors.     

Association Between Self-reported Physical Activity and Skin Autofluorescence,a Marker of Tissue Accumulation of Advanced Glycation End Products in Adults With Type 1 Diabetes: A Cross-sectional Study

Purpose

The accumulation of advanced glycation end products (AGEs) in local tissue is an important cause of low-grade inflammation and oxidative stress and is linked to late diabetic complications. Physical activity has various beneficial cardiometabolic effects in type 1 diabetes (T1D) and is associated with lower frequency of chronic complications of diabetes, although the specific mechanisms still remain unclear. The present study determines the association between self-reported physical activity and skin autofluorescence (AF), a marker of tissue accumulation of AGEs in adults with T1D.

Role of Physical Activity and Exercise in Alleviating Cognitive Impairment in People With Epilepsy

Many persons with epilepsy (PWE) experience problems with a wide range of cognitive functions, including learning, memory, attention, and executive control. These deficits in cognition result in diminished quality of life for PWE and are related to many factors, including the etiology of their epilepsy, recurrent seizures, side effects of antiseizure medications, or a combination of these factors. Various treatments to ameliorate cognitive deficits experienced by PWE have been implemented, although noninvasive and nonpharmacologic strategies may be more appealing options due to their relatively low cost, reduced risk of side effects, and/or reduced potential interactions with antiseizure medications. Physical activity and exercise may improve cognition in PWE but have not been well researched in this respect. To date only 1 study has directly investigated the effects of exercise on cognition in PWE, and it showed improved performance on tests of attention and executive function. The goal of the present article was to examine how increased physical activity and exercise contributes to 3 strategies (reducing seizure frequency, reducing epileptiform discharges, and decreasing symptoms of depression) that have been described as having a positive impact on cognition in PWE, as well as highlight related findings in experimental models of epilepsy. There is a definite need for more randomized controlled trials to establish greater clinical evidence for the use of physical activity and exercise in ameliorating cognitive impairment in PWE. We also need to better understand the factors contributing to reduced physical activity in PWE, as well as ways to overcome such barriers. With the available research in the area of exercise in epilepsy showing positive results, and a supportive research climate encouraging PWE to engage in greater physical activity overall, further investigations into the relationships between physical activity and cognition in epilepsy are warranted.     

护士促进癌症幸存者体力活动知信行问卷的编制及信效度检验

目的 编制护士促进癌症幸存者体力活动知信行问卷并检验其信效度。方法 以知信行理论为指导,通过文献回顾、查阅指南、头脑风暴、专家函询、预调查后形成初始问卷,便利选取553名肿瘤相关科室护士进行调查,对问卷进行项目分析及信效度检验。结果 问卷由知识、信念、行为3个维度共30条目构成。总问卷的Cronbach α系数为0.950,折半信度为0.682,重测信度为0.900。探索性因子分析提取3个公因子,累计方差贡献率为58.252%。验证性因子分析显示：χ²/df=2.395,RMSEA=0.073,NFI=0.849,IFI=0.906,TLI=0.897,CFI=0.906,模型拟合良好。内容效度分析显示,条目水平内容效度指数(I-CVI)为0.833～1.00,平均量表水平内容效度指数(S-CVI/Ave)为0.969,全体一致量表水平内容效度指数(S-CVI/UA)为0.800。结论 该问卷具有良好的信效度,可用于评估我国肿瘤科护士在促进癌症幸存者体力活动方面的知识、信念和实践水平。     

Physical Activity During Pregnancy: A Prescription for Improved Perinatal Outcomes

Physical activity during pregnancy has significant health benefits for mother and baby that extend beyond the perinatal period. However, the majority of women do not achieve recommended levels of physical activity in either time or intensity. Physical activity tends to decrease even further as pregnancy progresses. Pregnant women have frequent contact with health care providers and may be motivated to engage in behavior changes that improve health. Nurse practitioners should educate women about the benefits of regular physical activity and help them overcome the barriers to achieving recommended physical activity levels to improve perinatal outcomes.