Factors influencing participation of African American elders in exercise behavior

This study was designed to examine factors influencing exercise behavior of older African American adults. Using the Transtheoretical Stages of Change Model and focus group methodology, 103 participants were assigned to gender and stage specific groups of 5 to 12 each. The focus group discussion guide was developed to explore the meaning of health and exercise, and factors that influence exercise behavior for each stage of the model. Responses varied by stage and gender. Men and women alike described health as the ability to remain active and participate in desired activities. The meaning of exercise varied, by stage, from the ability to perform household chores to engaging in aerobic activities. Many factors such as health, social support, efficacy, and motivation influenced the desire and ability to exercise. Women were more likely than men to identify family responsibility as a barrier to participation in exercise activities. Participants identified strategies to recruit and retain African American elders in exercise programs. Findings of the study have implications for health professionals designing exercise health promotion programs for older African American adults in community settings.     

A Survey of the Emergency Department Population and Their Interest in Preventive Health Education

OBJECTIVE: To determine which preventive health information the emergency department (ED) population (patients and visitors) would be most interested in having available to them while they spend time in the waiting area. METHODS: This was a prospective survey of consecutive adults seated in the ED waiting area during a representative week on predetermined shifts. The survey asked them to indicate whether they would be interested in obtaining information about the following preventive health issues: breast cancer, prostate cancer, smoking, obesity, stress reduction, exercise programs, alcohol/drugs, HIV, blood pressure screening, immunizations, referrals to primary care physicians, Pap smears, car safety, smoke detectors, domestic and youth violence, depression, gun safety, and safe sex. RESULTS: Of the 1284 subjects approached, 878 (68%) made up the study group (56% female, mean age = 44 years, 60% white); 406 refused. The information people were most interested in obtaining was the following: 52% of the respondents were interested in referral to stress reduction programs, 51% in information about exercise programs, 42% in blood pressure screening, 40% in information about breast cancer screening, 33% in depression information/screening, 33% in prostate cancer screening, 26% in immunization against pneumococcus, 24% in immunization against tetanus, 26% in smoking cessation programs, and 26% in safe driving information. Women were most interested in breast cancer screening (64%); and men, in prostate cancer screening (55%). CONCLUSIONS: Of the 878 subjects in the study group, 96% were interested in obtaining information about one or more preventive health issues. An opportunity exists to respond to this interest by providing material for public health education in the waiting area of EDs.     

Primary prevention programs for business and industry. Role of physical therapists

Business and industry are interested in reducing their direct and indirect costs of health services. The answer to reducing these costs for many companies has been to shift their emphasis from subsidizing sickness to promoting health and welfare in wellness, prevention, or fitness programs. Basic certification courses have been developed at a graduate level for fitness instructors, exercise test technologists, exercise leaders, and directors of preventive programs. These courses are open to a broad range of disciplines, including physical therapy. Physical therapists can perform different roles in industrial preventive programs to prevent on-the-job injuries and improve physical fitness. Physical therapists have both the education and the clinical experience to be effective in planning preventive programs. We have divided the comprehensive preventive exercise program into five phases: history questionnaire, evaluation, consultation, performance, and progress assessment. These phases, especially the evaluation of the patient, are discussed from the perspective of the contribution the physical therapist can make. The characteristics of successful company-sponsored exercise programs also are discussed.     

Experiences of Disease and Treatment among Chlamydia Patients

Chlamydia trachomatis infection is a common sexually transmitted disease in Sweden, where counselling and partner notification are tools for prevention. Fifty infected patients (27 women, 23 men) were interviewed at an outpatient department. A majority of the patients felt that they were to blame for getting the disease and had the responsibility to inform partners. Women reacted more strongly against the disease and felt more negatively treated by the health care personnel. Chlamydia was considered a serious disease and 40% expressed fear for HIV/AIDS. Only eight per cent used condoms regularly. The concept ‘casual contact’ was very differently defined by the patients. Health personnel has to be more aware of the difficulties with ambiguous concepts and information need to be improved. More attention should be paid to women and their reactions.     

设立妇幼专科护理门诊社会需求的调查研究

目的探讨设立妇幼专科护理门诊的可行性.方法对491例门诊就诊对象进行护理门诊社会需求调查,应用EPIinfo 6.0软件包进行相关分析.结果 100%调查对象认为医院应该设立护理门诊以满足就医者的健康咨询.结论有病就医已不再是人们到医院的惟一目的.设立护理门诊可满足就诊者多元化的需求;护理学科的发展现状能够满足护理门诊的需求;护理门诊的设立将强化医疗门诊作用.     

Transnational nursing programs: models,advantages and challenges

Conducting transnational programs can be a very rewarding activity for a School, Faculty or University. Apart from increasing the profile of the university, the conduct of transnational programs can also provide the university with openings for business opportunities, consultative activities, and collaborative research. It can also be a costly exercise placing an enormous strain on limited resources with little reward for the provider. Transnational ventures can become nonviable entities in a very short period of time due to unanticipated global economic trends. Transnational courses offered by Faculties of Business and Computing are commonplace, however, there is a growing number of health science programs, particularly nursing that are being offered transnational. This paper plans an overview of several models employed for the delivery of transnational nursing courses and discusses several key issues pertaining to conducting courses outside the host university's country.     

HIV/AIDS family care-giving in Switzerland in the context of silence

Based on critical hermeneutics, this qualitative study presents insights about care giving experiences of HIV affected families in the German speaking part in Switzerland. Eleven families (12 women, 5 men) were interviewed, and members of different families participated in group-conversations. Critical reflection of the results highlighted that these HIV-families offered family caregiving in a context of silence. Two perspectives of this silence are presented: 1. HIV-families do not share their experiences in their closer and larger environments because of stigmatization, changing family constellations, and traditional images of family care. Instead, HIV-families create silent circles. 2. Professional discourses about family care are almost absent in the Swiss health care system because of its focus on the needs of individual patients with health care providers, in particular nurses, offering no systematic health services tailored to family caregivers. The results highlight, that it is paramount for nurses to take responsibility and to create programs that will better serve HIV-families.     

Health-promoting behaviors of elderly korean immigrants in the United States

The purpose of this study was to explore health-promoting behaviors among elderly Korean immigrants, and to examine the relationships of their health-promoting behaviors with self-efficacy and perceived health status. One hundred ten elderly Korean immigrants residing in the United States were interviewed using a structured questionnaire. The mean score of health promoting behaviors of elderly Korean immigrants was 2.54 on the 5-point Likert scale. Nutrition was the subdomain with the highest mean score (M=3.01) and exercise was the subdomain with the lowest mean score (M=1.92). Both self-efficacy (r=0.49, p=0.01) and perceived health status (r=0.19, p=0.043) were significantly related to health-promoting behaviors. Education (F=3.61, p=0.016) and economic status (F=3.01, p=0.034) were significantly associated with health-promoting behaviors. This study showed poor practices of healthy lifestyles of elderly Korean immigrants. Low exercise scores indicated the need for community based exercise and health promotion programs for the elderly Korean immigrants population.     

Childcare health and health consultation curriculum: trends and future directions in nursing education

Purpose. The purpose of this study was to identify graduate and undergraduate nursing courses in health and health consultation in childcare and early education, and faculty awareness and interest in federal resources. Design and Methods. A questionnaire was sent electronically to 140 faculty in 45 schools of nursing. Results. Fifty‐nine faculty from 45 schools (42%) participated, and 80% reported at least one course related to childcare health and safety. Most faculty were not aware of federal initiatives to support childcare health and safety, and the role of nurse childcare health consultants; however, many were interested in receiving instructional materials. Practice Implications. Utilizing federal resources to augment nursing education in childcare health and safety curriculum may strengthen the workforce of nurses providing health consultation to early childhood programs.     

杭州市成人慢性病相关知识、态度和行为危险因素调查分析

目的 明确杭州市成人主要慢性病相关行为危险因素的分布和流行情况,为开展生活方式相关疾病的综合防治提供可靠依据.方法 采用多层随机抽样方法,对杭州市2个县和2个区1010名15～69岁常住人口进行入户面访.调查内容包括居民健康状况及慢性病相关行为危险因素等.结果 人群吸烟率和30 d饮酒率分别为57.64%和41.20%,男性吸烟和饮酒现象较普遍.居民对烟草危害认识不够深入;被调查者测量过血糖和血脂的比例分别占28.61%和55.68%;居民膳食结构不合理;只有21.02%的男性和28.88%的女性在过去30 d内参加过体育锻炼;超重和肥胖率分别为28.19%和4.98%.结论 居民正面临不健康的生活方式的威胁,进一步丰富居民健康相关知识及针对慢性病相关行为危险因素的综合防制工作具有重要的现实意义.     

Universal screening for domestic violence in a department of obstetrics and gynaecology: a patient and carer perspective

BEN NATAN M., BEN ARI G., BADER T. & HALLAK M. (2011) Universal screening for domestic violence in a department of obstetrics and gynaecology: a patient and carer perspective. International Nursing Review 59 , 108–114 Aim: This study aimed to examine the effect of knowledge, department routine, and attitudes of physicians and nurses on the identification of female victims of domestic violence in Israel, as well as the patients' attitudes regarding the screening process. Background: Every seventh woman in Israel is reported to have been victimized by her intimate partner at least once in her lifetime. Routine screening for intimate partner violence is endorsed by the Ministry of Health in Israel; however screening rates in healthcare settings remain low. Methods: Correlative, cross‐sectional design was utilized based on a sample of 100 physicians and nurses from an obstetrics and gynaecology department in a central Israel hospital and a stratified simple random sampling to recruit 100 former female patients. Findings: Both medical and nursing staffs were reluctant to screen women for domestic violence, although the patients interviewed for the study claimed that screening is crucial for preventing domestic violence. Past experience with assessing violence and intention to screen were the most significant predictors of screening behaviour. Several factors impede screening by medical and nursing staff, although it is legally mandated. Discussion: Nurses' and physicians' screening of women about domestic violence is a fundamental intervention with implications for health care in general and basic human rights in particular; however attitudes and beliefs must also be considered. Conclusions: Screening women about domestic violence is an intervention not usually implemented by physicians and nurses. Understanding barriers to screening may help form feasible policies for improving the quality of services offered to women.     

Comparing incarcerated and community-dwelling older men's health

The purpose of this study is to compare incarcerated and community-dwelling older men's self-efficacy for health management, health-promotion behaviors, and health status. Social cognitive theory was the guiding framework. A sample of 51 incarcerated and 33 community men (age 50 and older) were surveyed. Frequencies and independent samples t tests were computed. Inmates reported significantly less participation in health-promotion behaviors (p < .01) and attended fewer programs (p < .05). The two groups did not demonstrate significant differences in self-efficacy or health status. The latter finding is important because the community men were on average 15 years older. Finding that prisoners attended significantly fewer programs and engaged less often in health-promoting behaviors may be because of lack of availability or awareness of programs to build self-care skills, perceptions that there is not much they can do about their health, a knowledge deficit in regard to health, or insufficient motivation.     

糖尿病护理门诊发展现状

综述糖尿病护理门诊在糖尿病病人健康管理中的作用及国内外发展史,提出国内糖尿病护理门诊发展中存在的问题及建议。指出目前我国的糖尿病护理门诊仍处于发展阶段,今后应探索病人对其的认知情况、分析影响病人就诊的原因,从而制定相关策略,以提高病人的了解度及认可度,从而推动糖尿病护理门诊的发展。     

Maternal and child health services for medically indigent children and pregnant women

Millions of low-income children and women of childbearing age are completely uninsured. Medicaid, the nation's largest public health financing program for the poor, is an inadequate resource for uninsured families with children. By 1984, the program served only 46% of the poor and near-poor, down from 65% in 1976. To assess the availability of maternity and pediatric services for low income uninsured women and children, a survey of 51 Title V Maternal and Child Health agency officials was conducted in 1986. While nearly all states (48) offer some prenatal care programs for indigent women, restrictive eligibility requirements and limited distribution meant that these programs reached only a small proportion of those in need. Only one state, Massachusetts, offered a truly statewide program to all uninsured pregnant women with incomes under 185% of the poverty level. Twenty-three states reported the existence of inpatient maternity programs for indigent women. Yet these, too, were extremely limited. Sixteen programs restricted funds either to women who participated in certain designated maternity programs or else only to those who were identified as high risk prior to the labor and delivery period. Fifteen state agencies reported that hospitals were denying admission to women about to deliver. Another 13 reported that hospitals were denying admission to women not yet in "active" labor. Six additional states were aware of patient dumping but did not identify the specific populations that were affected. Forty-six states reported the existence of pediatric outpatient programs. However, the majority (30) offered only "well-child" care. Seven states maintained pediatric programs limited to only certain ages of children; three of these imposed an age requirement as low as 2 years or younger. Only two states reported the availability of any pediatric inpatient programs financed or administered by Title V agencies other than those for children with special health care needs.     

Colostomy patients: psychological adjustment at 10 weeks and 1 year after surgery in districts which employed stoma-care nurses and districts which did not

Two hundred and fifteen colostomy patients were interviewed at 10 weeks after surgery from a stratified random sample of 12 health districts in which stoma-care nurses were employed and eight other districts: 85 survivors who did not have restorative surgery were reinterviewed 1 year later. The Present State Examination (PSE) was used to assess the prevalence of affective disorder on both occasions. Analysis of covariance of the 10-week PSE scores revealed that age was unrelated to psychological adjustment after controlling for the extent and severity of patients' symptoms and that patients in districts which employed stoma-care nurses had significantly lower PSE scores. Single and widowed males appeared to enjoy better emotional health than married men and than women. Analysis of covariance of PSE scores obtained 1 year later also revealed that age was unrelated to psychological adjustment after controlling for the patients' physical state. No difference was found between patients who had access to a National Health Service stoma-care nurse and patients in other districts, many of whom had seen a representative from one of the appliance companies. The finding that single and widowed males appeared to fare better than married men was repeated. Ten per cent of patients who felt completely well were anxious or depressed. Psychiatric referral may be inappropriate for the majority of depressed patients who may instead benefit from medical treatment or from nursing intervention to deal with physical symptoms such as pain or urinary incontinence.     

Selected School Health-Education Topics in Grades 7 Through 12: An Exploratory Study

The purpose of this exploratory study was to gather school health-education data that could be used collaboratively by various disciplines in planning comprehensive community health-education programs. The theoretical framework for the study was based on Dunn's theory of high-level wellness (Ardell, 1977). School nurses, community health nurses, and nurse practitioners need to be aware of what is happening in school health education so that they can be available as resource persons, and-through their knowledge and interest in health education-complement existing programs. The research questions referred to health topics that are taught in grades 7-12, and to the variables which influence selection and presentation of health education content. A Cooperative Educational Service Agency (CESA) in Wisconsin served as the setting for the study. The area was comprised of 20 school districts. Of these 20 districts, 17 administrators participated. Data was obtained through a self-designed questionnaire sent to 222 teachers of health-education courses or courses which can include such content. There were 140 respondents to the questionnaire. It was concluded that the greatest percentage of school health education in grades 7-12 occurs in science courses. Students receive a total of 44 hours of health education per year. There are 36 additional hours of health education content available through elective courses. The involvement of nurses and physicians in school health education reflected minimal participation. Community health nurses provided the majority of nursing services in schools. Relatively few barriers were reported as influencing variables.     

Promoting health among perimenopausal women through diet and exercise

PURPOSE: To review the literature related to health promotion during the perimenopausal years and suggest methods for integrating those changes into the lifestyles of women in primary care. DATA SOURCES: Selected scientific literature and guidelines for exercise programs. CONCLUSIONS: The transition into perimenopause presents an opportunity for addressing health promotion issues, such as diet and exercise. As a woman senses perimenopausal changes, health awareness emerges. Such personal insight motivates the woman to implement lifestyle changes. IMPLICATIONS FOR PRACTICE: Considering the average women will spend approximately one third of her life past menopause, a concerted effort is needed to ensure her well-being. Diet and exercise represent two modifiable areas of concern for perimenopausal women. Dietary selections of phytoestrogens, calcium, fiber and fat along with exercises plans are relatively simple interventions to begin the process of change.     

Health status and preventative behaviors of immigrants by gender and origin: A Portuguese cross‐sectional study

Migration has been associated with a greater vulnerability in health. Migrants, especially women, go through several experiences during the migration process and in the host countries that ultimately put their health at risk. This study examines self‐reported health status and preventive behaviors among female and male immigrants in Portugal, and identifies sociodemographic and behavioral factors underlying gender differences. A sample of 1375 immigrants (51.1% women) was studied. Data were analyzed through logistic regression. Good health status was reported by 66.7% of men and by 56.6% of women (P < 0.001). Gender differences were also found across preventative behaviors. Among women and men, reported good health was associated with younger age, African and Brazilian origin (compared to Eastern European), secondary/higher education, no chronic disease, and concern about eating habits. Among women, good health was also associated with perceived sufficient income, no experience of mental illness, and regular physical exercise. When developing health programs to improve immigrants’ health, special attention must be given to existing gender inequalities, and socioeconomic and cultural context, in accordance with their experience of living in the host country over time.     

脑卒中后患者及陪护者抑郁发生因素的1年后社区随访

目的分析影响脑卒中发病后产生抑郁的因素。方法将脑卒中患者及其陪护者(照料患者日常生活的人)分成4组(总数为1048例)。其中423例幸存者中的321例患者和195例陪护者在脑卒中发生后3个月和12个月时以接受和不接受康复活动分组。390例幸存者中的311例患者和184名陪护者于12个月时仍以是否接受康复活动分组。接受为康复组,不接受为对照组。追踪调查2年。结果3个月时康复组患者出现抑郁者少于对照组(差异率0.59),12个月时仍保持差异(差异率0.55);3个月时康复组与对照组的陪护者之间没有明显差异,12个月时结果相同。然而12个月时在对照组中,有比康复组患者更明显的严重抑郁陪护者。结论脑卒中幸存者及其陪护者在3个月时普遍存在抑郁,它的几率在以后的1年中没有下降,康复组比对照组抑郁的发生率低,由此可见参加康复活动是降低脑卒中后抑郁发生率的有效方法。