Will People With Type 2 Diabetes Speak to Family Members About Health Risk?

OBJECTIVE—This study aimed to assess the potential for communication of familial risk by patients with type 2 diabetes.RESEARCH DESIGN AND METHODS—A questionnaire was completed by a random sample of patients with type 2 diabetes registered with a hospital diabetes clinic.RESULTS—Two-thirds of patients (65%) had spoken to at least one sibling or child about diabetes risk. They were more likely to believe their family was at risk, to worry about their family developing diabetes, and to be aware of the seriousness of diabetes. The results revealed greater awareness of family risk of type 2 diabetes compared with those from previous studies.CONCLUSIONS—Many patients with type 2 diabetes had already taken the initiative, without formal prompting, to talk to family members about their risk of diabetes. Discussion of risk and interventions to reduce risk should be encouraged within families.First-degree relatives and spouses of individuals with type 2 diabetes are at increased risk of developing type 2 diabetes (1,2). There is also an established correlation of other cardiovascular risk factors in family members; these include obesity (3), hypertension (4), lipids (5), and smoking (5). Increased family risk is thought to have both an environmental and a genetic basis (6,7), giving scope for decreasing cardiovascular risk through lifestyle modification in individuals with a family history of diabetes (8). Nonetheless, systematic screening of family members is unlikely for logistic and financial reasons. A more modest approach would be to encourage patients with diabetes to discuss risk with family members. However, health beliefs of individuals with type 2 diabetes may lessen their perception of the risk of diabetes among family members (9) and of the seriousness of diabetes (10), raising doubts as to whether they would communicate risk factors to their family members. The Health Belief Model (11) identifies factors likely to increase health-related actions such as speaking with family members. They include perceived susceptibility, perceived severity, perceived benefits and barriers, and cues to action. We explored the beliefs and actions of patients with type 2 diabetes concerning discussion of risk in families.     

People United to Sustain Health (PUSH): A Community‐Based Participatory Research Study

The prevention of weight gain to address the obesity epidemic rather than weight loss involves promoting small changes in food choices and physical activity. People United to Sustain Health (PUSH) was designed to increase fruit and vegetable consumption, physical activity, and food security to prevent weight gain in rural adults. Forty‐nine participants were randomized into a treatment group which received access to a “Rolling Store,” nutrition education and physical activity, and a control group which received family coping classes. Forty‐one (84%) of participants completed the study. At the end of 6 months, weight for all participants was maintained from baseline to completion with no significant differences between the groups. The mean fruit consumption over 6 months for the treatment group increased and was significantly greater than change in the control group (p = 0.01). This community‐based participatory research study was considered successful because weight gain was prevented.     

Forgoing Physician Visits Because of Cost: A Source of Health Disparities for Elderly People With Disabilities?

Lee JC, Heinemann AW. Forgoing physician visits because of cost: a source of health disparities for elderly people with disabilities?

Objective

To examine disparities in having a usual source of care and forgoing physician visits because of cost between elderly people (age ≥65y) with and without disabilities after consecutively controlling for predisposing, enabling, and perceived and evaluated health need factors using the Andersen behavioral model, and to identify the determinants of such disparities.

Design

Cross-sectional analysis.

Setting

Community.

Participants

Nationally representative sample of community-dwelling adults age 65 years or greater in the United States from the 2006 Behavioral Risk Factor Surveillance System (BRFSS) (N=93,933).

Interventions

Not applicable.

Main Outcome Measures

Responses to 2 BRFSS questions: (1) whether the respondent had a health care provider, and (2) whether the respondent had forgone seeing a physician because of cost in the past 12 months.

Results

After controlling for the aforementioned factors, elderly persons with disabilities were more likely than their counterparts without disabilities to have a usual source of care (adjusted odds ratio [AOR]=1.33; 95% confidence interval [CI], 1.08-1.64), and those with disabilities were more likely to forgo physician visits because of cost (AOR=1.64; 95% CI, 1.31-2.04). The unadjusted odds of forgoing physician visits (odds ratio [OR]=2.13; 95% CI, 1.87-2.43) did not decrease after controlling for predisposing factors (AOR=2.32; 95% CI, 1.96-2.75), whereas the odds were attenuated after controlling for enabling factors (AOR=2.18; 95% CI, 1.84-2.59), perceived health need (AOR=1.70; 95% CI, 1.37-2.12), and evaluated health need (AOR=1.64; 95% CI, 1.31-2.04).

Conclusions

Although elderly people with disabilities were more likely than their counterparts without disabilities to have a usual source of care, those with disabilities were more likely to forgo physician visits because of cost. Elderly persons with greater perceived health needs were most likely to experience the disparity.     

Community Health

What are definitions of a community? A community is a collection of people who share some attribute of their lives. It may be that they live in the same locale, attend a particular church, or even share a particular interest, such as skiing. Groups that constitute a community because of common     

Access to Physical Health Care for People with Serious Mental Illness: A Nursing Perspective and a Human Rights Perspective-Common Ground?

Relative to the general population, people with serious mental illness (SMI) experience elevated risks of physical disease and illness and live shorter lives. A human rights perspective argues that people with serious mental illness have a right to equal access to physical health care. Nurses in mental health services can contribute to improving the availability and accessibility of physical health care. This study, involving focus group interviews with nurses in a large regional and rural mental health care district of Queensland, Australia, revealed significant problems in access to physical health care for service users. The current article reports on our exploratory analysis of nurses’ views and perceptions to identify (1) orientation of nurses to human rights, and (2) access of consumers with SMI to general practitioner services. It was rare for nurses to raise the topic of human rights, and when raised, it was not as a strategy for improving access to physical health care services that they felt consumers with SMI greatly needed. Two main themes were identified as causes of poor access: clinical barriers to physical care and attitudinal barriers to physical care. In light of these results, the authors explore a human rights perspective on access and how this provides an inclusive lobbying umbrella under which nurses and other groups can pursue access to physical health services that are adequate, accessible, and non-discriminatory. The article then discusses the implications for these findings for the value of human rights as a perspective and means of increasing physical health of people with SMI.     

Nursing Students’ Attitudes Towards People Diagnosed with Mental Illness and Mental Health Nursing: An International Project from Europe and Australia

The stigma associated with a diagnosis of mental illness is well known yet has not reduced significantly in recent years. Health professionals, including nurses, have been found to share similar negative attitudes towards people with labelled with mental illness as the general public. The low uptake of mental health nursing as a career option reflects these stigmatised views and is generally regarded as one of the least popular areas of in which to establish a nursing career. The aim of the current project was to examine nursing students’ attitudes towards the concept of mental illness and mental health nursing across four European countries (Ireland, Finland, Norway and the Netherlands), and Australia, using the Opening Minds Scale and the Mental Health Nurse Education survey. The surveys were distributed to students prior to the commencement of the mental health theory component. Attitudes towards mental health nursing were generally favourable. Differences in opinion were evident in attitudes towards mental illness as a construct; with students from Australia and Ireland tending to have more positive attitudes than students from Finland, Norway and the Netherlands. The future quality of mental health services is dependent on attracting sufficient nurses with the desire, knowledge and attitudes to work in mental health settings. Understanding attitudes towards mental illness and mental health nursing is essential to achieving this aim.     

How Much Public Health in Public Health Nursing Practice?

Public health nursing (PHN) practice is defined by an emphasis on population health issues rather than individually focused clinical interventions, but the actual scope and focus of PHN practice have not been well documented. The purpose of this survey was to investigate the practice activities, priorities, and education of public health nurses in California. Public health nurses in five counties were surveyed about interventions targeted at individual-family, community, and system levels. Summary scales (range: 1-4) were created to measure self-rated PHN activity, importance, and education at each level. Staff were most likely to perform individual-family level interventions (mean score, m=2.55), followed by community (m=1.86) and system-level interventions (m=1.46). Managers rated individual-family level interventions as most important (m=2.91) and community-level interventions (m=2.42) as more important than those at the system level (m=1.99). Individually focused case management was the most frequently performed and highly valued intervention. Staff and manager-directors deemed individual-family interventions as the area in which public health nurses were best educated, followed by community and then system interventions. Results indicate that the population health focus of public health nursing is not reflected in the practice activities, management priorities, or educational preparation of public health nurses.     

Carestream Health公司开始全球运营

Carestream Health公司作为一家拥有8100多位员工并为全球150个国家的数万客户提供服务的公司，5月1日起开始正式独立运营。同日，该公司在中国成立的锐珂（上海）医疗器材有限公司和锐珂（厦门）医疗器材有限公司也正式开始运营。     

What Is the Impact of Targeted Health Education for Mental Health Nurses in the Provision of Physical Health Care? An Integrated Literature Review

Individuals with a severe mental illness have a gap in life expectancy of up to 20 years in comparison to the general population. Nurses who work in mental health services have been identified as best placed to improve the physical health outcomes of individuals with mental illness. The literature identifies a lack of nursing knowledge related to physical health care and the presence of metabolic syndrome which is impeding nurses in providing essential physical health care to patients. An integrated literature review was carried out due to the dearth of research evidence pertaining to the impact of targeted education specifically with psychiatric/mental health nurses in the provision of physical healthcare. A search for literature included the following databases: CINAHL, Medline, PsycINFO, Embase and Web of Science revealed nine studies: seven quantitative, one qualitative and one mixed method. Qualitative synthesis has shed light on the value of targeted education on improving knowledge and skills in providing physical health care that can then be translated into clinical practice. Targeted education in physical healthcare grows psychiatric/mental health nurse's confidence and develops the skills necessary to enable them to screen and monitor and offer range of physical health interventions to individuals with severe mental illness.

Accessible summary ? The poor physical health outcomes and premature death of individuals with severe mental illness is of growing concern; a contributing factor is a lack of knowledge and confidence amongst psychiatric/mental health nurses to providing physical health screening and intervening in preventable diseases such as cardiovascular disease, stroke cancer, and type 2 diabetes mellitus.

? An integrated literature review was used to ascertain if targeted education on physical health care can improve the knowledge base of psychiatric/mental health nurses within physical health care.

? Nine studies were critically appraised, and the data reduced using a narrative synthesis that tells a story of the findings from these research studies.

? The review found that targeted education with psychiatric/mental health nurses does result in a statistical increase in knowledge This review finds that nurses have not been regularly supported with physical health education to alter existing practices. This lack of knowledge within physical healthcare is hindering psychiatric/mental health nurses to fully engaging in physical health care activities in practice.

     

How Do People Perceive the Disclosure of Emotion?

The purpose of the current study was to examine how individuals high or low in social anxiety perceive the disclosure of anxiety as compared to the disclosure of other emotions, and how one’s own level of social anxiety influences these perceptions. Participants low (n = 78) or high (n = 83) in social anxiety watched one of four videos in which the target individual either did not disclose an emotion, disclosed feeling anxious, disclosed feeling sad, or disclosed feeling happy. Participants then rated the target individual on various characteristics. It was found that participants rated the target individual who disclosed anxiety as more awkward and less socially skilled, as compared to when she did not disclose an emotion. No differences were found among ratings of the target individual who disclosed other emotions; hence, it appears that these negative judgments may be specific to the disclosure of anxiety when one does not appear anxious.