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Johns Hopkins Nursing Research News -- July 2010

Posted: 7/21/2010

Lifelong Money Worries Take Health Toll
Whatever one's economic status, when income doesn't meet need the result is financial strain that can lead to disability, emotional distress, and chronic illness. Does the same kind of strain pose even greater health risks if it begins in childhood and continues throughout a lifetime? JHUSON assistant professor Sarah Szanton, PhD, CRNP, asked that question in a study about finances and health among 699 mid-to late-life African Americans. She found that, without regard to education or income, individuals whose financial strain began in childhood and continued into adult life were at much greater risk for depression, chronic physical ailments, and cognitive difficulties than their non-stressed counterparts. Those individuals who first experienced financial strain as adults had significant mental and physical problems, but did not experience the cognitive difficulties associated with childhood financial strain, according to the findings reported in "Life-course financial strain and health in African-Americans" [Social Science & Medicine, July 2010]. Szanton notes, "Even in adulthood, these problems can be prevented if we can help change the equation between financial strain and need, for example by making social supports more readily available -- from healthcare to food stamps to an improved minimum wage." In future research, she hopes to learn if the cognitive deficits associated with childhood financial strain are from the cumulative effect of poverty, environmental factors like the quality of education, or a combination of these or other factors.

Nursing Helps Heal the Heart
While heart disease remains the leading cause of death in the U.S., many people with this diagnosis can live longer and better with the help of a nurse. In a systematic review of existing research, JHUSON professor Jerilyn K. Allen, ScD, RN, FAAN, and associate professor Cheryl R. Dennison, PhD, RN, ANP, FAHA found that when nurses provide a combination of patient education, behavioral counseling, and support, they can effectively help heart patients change behaviors such as poor diet, obesity, smoking, and a lack of exercise, all of which hurt the heart. It will take additional research to determine which combinations of specific interventions work best for whom, over what period of time, and at what price. And cost is a significant issue that most of the studies didn't discuss. Allen notes, "In this era of health reform, to integrate these successful interventions into daily nursing practice, we must demonstrate that they are both beneficial to heart patients and cost effective. Simply put, we need insurers to realize that preventive care is an investment that pays dividends." [Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review, Journal of Cardiovascular Nursing, May/June 2010].

In Other Nursing Research News
Operating through the National Healthy Mothers, Healthy Babies Coalition, Text4Baby -- a 51-character text message delivered by cell phone three times a week -- has just launched in Baltimore City to help promote healthy pregnancies and babies. Assistant professor Elizabeth Jordan, DNSc, RNC, who sits on the coalition board and facilitated the Baltimore launch, notes that the Text4Baby program harnesses the power of texting to provide new and expectant mothers simple information on topics like prenatal vitamins, healthy diet, breastfeeding, and immunizations. According to Jordan, texting can reach young, low-income, and minority women who are in greatest need for this information.  Thanks to a coalition that includes City government, the JHUSON and both public and private funders, these free, health-smart text messages are now reaching Charm City's new and expectant mothers.

The transmission of health information through new technologies has the capacity to go viral in a good way for global health. In a June 2010 editorial in Knowledge Management and E-Learning, associate professor Patricia Abbott, PhD, RN, FAAN, calls the growth of information and communications technology a healthcare "game-changer," with the power to alter health practice, research, and patient knowledge in ways only beginning to be realized.

Treating illnesses shouldn't make you sick. That's the premise driving the research of JHUSON doctoral candidate Carrie Tudor, MPH, RN in South Africa where tuberculosis (TB) is a leading cause of illness and death, including among healthcare workers. By identifying and altering TB risk factors among hospital workers, such as poorly fitting respirators and insufficient staff screening, she hopes to help rewrite TB health policy to better protect healthcare workers and the people they treat.

In a guest editorial, assistant professor Elizabeth Sloand, PhD, CRNP, paints a haunting picture of the plight of Haitian children with ongoing health needs following the January earthquake in that island nation. A pediatric nurse with long-time connections to Haitian healthcare, she urges ongoing international attention, support, and volunteerism to improve the health and wellbeing of that nation's children and families. [The children of Haiti, Journal of Pediatric Health Care, July-August 2010.] 

Additional Publications of Note
Assistant professor Jason E. Farley, PhD, MPH, NP, Cheryl R. Dennison, PhD, RN, ANP, FAHA, and Carrie Tudor, MPH, RN, Improving cardiovascular risk management among human immunodeficiency virus-positive individuals [Journal of Cardiovascular Nursing, July/August 2010]; Professor Deborah Gross, DNSc, RN, FAAN, and others, Measuring implementation fidelity in a community-based parenting intervention, and assistant professor Matthew Hayat, PhD, Understanding Statistical Significance" [both in Nursing Research, May/June 2010]; and Hayat and others, Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction [BMC Cardiovascular Disorders, June 2010].