Johns Hopkins Nursing researchers focus on PTSD, personal health management, health IT, and more in the June 2012 research news brief.
Coming Home from War: Coping, Resilience and Posttraumatic Stress
Posttraumatic stress isn't always limited to the returning veteran. According to Johns Hopkins University School of Nursing (JHUSON) PhD graduate and Army lieutenant colonel Kristal C. Melvin, PhD, RN, NP; professors Deborah Gross, DNSc, RN, FAAN, and Jacquelyn C. Campbell, PhD, RN, FAAN; and others, civilian spouses and partners of those returning from combat actually may have posttraumatic stress symptoms (PTSS) and trauma histories that rival those of the combat veteran. As with veterans, these symptoms place the entire family at increased risk for marital discord, interpersonal violence, substance abuse, divorce and suicide. Melvin and her colleagues explored the impact of posttraumatic stress symptoms and resilience in military couples in "Couple functioning and post-traumatic stress symptoms in US Army couples: The role of resilience," [Research in Nursing and Health, April 2012]. They found that relationship problems were most often reported by couples when one or both had high PTSS levels, indicative of possible posttraumatic stress disorder. Some couples in their sample were able to strengthen their relationships and thrive, despite high levels of PTSS. According to Melvin, "While we don't yet understand all the factors that make some couples more resilient than others, much can and must be done to invest in military couples' mental health right now. While our study shows the importance of PTSS screening among our returning veterans, concentrating exclusively on the 'wounded warrior' isn't enough. A more holistic, family-focused approach to mental health screening and treatment would be a good start.”
When Illness Threatens Self-Image: Working Within, Not Against, Culture
Associate professor Hae-Ra Han, PhD, RN, FAAN, professor Miyong T. Kim, PhD, RN, FAAN, postdoctoral fellow Hyunjeong Park, PhD, MPH, RN, and others, have concluded when it comes to understanding and managing chronic problems like high blood pressure and Type-2 diabetes in Korean Americans, the need to maintain a strong outward image to family and community can result in personal health disaster. Based on their descriptive study among immigrant Koreans, they highlight the need for nurses and other clinicians to be sensitive to unique cultural issues—including identity and image—when diagnosing and treating chronic illnesses.[“Maintaining an outward image: A Korean immigrant’s life with Type-2 diabetes mellitus and hypertension,” Qualitative Health Research, June 2012.] For any treatment to be successful, a patient must be able to understand and process health information—an ability known as health literacy. For that reason, Kim, Han, postdoctoral fellows Hee-Jung Song, PhD, RN, Soohyun Nam, PhD, RN, Youngshin Song, PhD, RN and Tam Hieu Nguyen, PhD, RN, and others have developed and pilot-tested a promising new tool to measure hypertension-specific print and functional health literacy among Korean Americans This valuable resource may help avoid research and clinical assumptions about consumer health literacy regarding high blood pressure. [“Development and validation of the high blood pressure-focused health literacy scale” [Patient Education and Counseling, May 2012.]
Healthcare Technology: Blessing or Burden?
Portable medical technology helps clinicians have the right information available at the right place: the patient’s bedside. But the plethora of devices now available may be a mixed blessing. JHUSON associate professor Patricia Abbott, PhD, RN, FACMI, FAAN, an early adapter and advocate for new technologies, writing in “The effectiveness and clinical usability of a handheld information appliance” [Nursing Research and Practice, 2012], notes the need for hands-on testing and exploring how clinicians interact with a device is key. It can mark the difference between a technological hit or miss, Abbott says, “The best people to help to design health information management technologies are those who will use it every day when it comes to health IT, nurses and other health professionals are the end-users. If they aren’t asked about what elements work, don’t work or are missing, the new technology runs the risk of becoming a new, expensive paperweight.”
In Other Nursing Research News
Associate professor Joan Kub, PhD, APHN, BC; professor Campbell; postdoctoral fellow Marguerite B. Lucea, PhD, RN; and others examine how a woman’s power in a relationship may affect her risk for HIV and both interpersonal violence in “HIV risk, partner violence and relationship power among Filipino young women: Testing a structural model,” Health Care for Women International, May 2012.] Writing in the Journal of Neurosciene Nursing (April 2012), professor Christine Savage, PhD, RN, CARN, and others explore how continuous monitoring for potential seizures may improve outcomes for patients with brain injuries [“The effectiveness of a staff education program on the use of continuous EEG with patients in neuroscience intensive care units.”] Elsewhere, Savage reviews two articles on the social determinants of health that promote a population focus when crafting programs to address health disparities resulting from alcohol and tobacco use. [“Alcohol and tobacco related health inquiry: A population health perspective,” Journal of Addictions Nursing, February 2012.] Health disparities are also central to “The influence of maternal-fetal attachment and health practices on neonatal outcomes in low-income urban women,” in which postdoctoral fellow Jeanne L. Alhusen PhD, MSN, CRNP; professors ;Phyllis W. Sharps, PhD, RN, CNE, FAAN, and Gross; and others report on how mother-fetus attachment during pregnancy may affect newborn health disparities among low-income, inner-city women. [Research in Nursing & Health, April 2012.] In “What’s new in sexually transmitted infection management: Changes in the 2012 guidelines from the Centers for Disease Control and Prevention,” assistant professors Hayley Mark, PhD, MPH, RN and Elizabeth T. Jordan, DNSc, MSN, RNC, and JHUSON nursing student Jomarie Cruz, BA, highlight updated guidelines for sexually transmitted disease management. [Journal of Midwifery and Women’s Health, May-June 2012.] Professor Laura Gitlin, PhD, and a colleague provide a public health case study of an emerging nation with an aging population in “The Republic of Chile: An upper middle-income country at the crossroads of economic development and aging.” [The Gerontologist, March 2012.] Assistant professor Jason E. Farley, PhD, MPH, CRNP, professor Pamela Jeffries, PhD, RN, ANEF, FAAN, and others explore integrating a new, computer-based, infection control simulation into health facility training and professional education programs. [“Department of Health and Human Services releases new immersive simulation experience to improve infection control knowledge and practices among health care workers and students,” American Journal of Infection Control, May 2012.] Recognizing that embarrassment may deter people from getting colonoscopies, Jeffries and colleagues report on ways to measure that embarrassment and suggest how it may be overcome. [“Development and psychometric testing of the colonoscopy embarrassment scale,” Western Journal of Nursing Research, June 2012.]