Nursing Haiti to Health: Fathers’ Clubs Part of the Cure—Even before the recent earthquake, Haiti was one of the world’s poorest nations, with a public health system to match. For a decade, Johns Hopkins University School of Nursing (JHUSON) assistant professor Elizabeth Sloand, PhD, CRNP, has helped bring primary and public health services to Haitian children and their families. Partnering extensively with the Haitian Health Foundation (HHF), which provides primary care in the small town of Jérémie and surrounding areas in the country’s southwest, and working with Haitian health care providers, Sloand, colleagues, and nursing students have taught and implemented practices to prevent acute illnesses like diarrhea and pneumonia. In “The impact of fathers’ clubs on child health in rural Haiti”[American Journal of Public Health, February 2010], Sloand describes how health education provided through local “fathers’ groups” boosts adoption of important public health practices, such as vitamin A supplementation and vaccination. These and other community-based health promotion programs and organizations have taken on added importance following the earthquake in January. Sloand, who recently returned from a tour as a Johns Hopkins medical relief team member in Haiti, reports that the already fragile local health system is struggling to treat earthquake-related injuries as well as to respond to basic public health concerns like sanitation and nutrition. She says, “Relief and development are at the heart of our efforts and those of ongoing programs, like HHF with its network of village health workers, and health promotion clubs of fathers, mothers, and youth. With the loss of countless Haitian health professionals in the earthquake, the value of these and other local, participatory public health programs cannot be overestimated.” Sloand is now organizing two Hopkins Nursing teams to go to Haiti in early March to work with the International Medical Corps in providing medical relief.
Getting to the Heart of Diabetes—Over two-thirds of deaths among people with diabetes in the U.S. are the result of cardiovascular disease (CVD); a rate two to four times that for nondiabetics. Many of these deaths could be prevented with behavioral changes in diet, exercise, smoking, and blood pressure management. However, according to a study published in the January Journal of Health Care for the Poor and Underserved, “Perceptions of cardiac risk among a low-income urban population,” unrealistic pessimism can impede adoption of measures to lower CVD risk and to improve diabetes control among urban, low-income minorities with diabetes. The authors, JHUSON professor and associate dean for research Jerilyn Allen, ScD, RN, FAAN, associate professor Cheryl Dennison, PhD, RN, ANP, and assistant professor Sarah Szanton, PhD, CRNP, RN, report that despite no known cardiovascular issues, as many as 75% of the study population thought they would likely develop heart disease within five years. Risk factors like high cholesterol, blood pressure, and smoking had little to do with the perception. The authors found undiagnosed depression to be a sentinel factor driving pessimism about developing CVD and potentially also breeding fatalism about complying with diabetes control regimens and about the risk for diabetes-related cardiac problems. Allen notes “Our findings suggest that depression can’t be ignored if we want to improve a diabetic patient’s overall health. When we treat the depression, we reduce hopelessness and empower a patient to take charge of his or her health and future.”
Selling the Message: Breastfeeding is Good Medicine—Low-income, urban women have the lowest rates of breastfeeding practices in the U.S. (67% compared with 75% of all women). In a program to promote breastfeeding among newborns of low-income mothers, a JHUSON research team including professor Phyllis W. Sharps, PHD, RNC, CNE, FAAN, and led by former faculty member Linda Pugh, PhD, RN, CNE, FAAN, used a matched sample of 328 new mothers from two urban hospitals to implement a 24-week breastfeeding promotion program. Half participated in the study; the balance received usual care. Reporting in “A randomized controlled community-based trial to improve breastfeeding rates among urban low-income mothers,”[Academic Pediatrics January/February 2010], the team found that after six weeks of intensive home visits and telephone support with 24-hour access, the study group moms were more likely to be breastfeeding than those in the usual care group. Little difference between the groups was found at 12 or 24 weeks. Sharps says, “This study shows that intense breastfeeding support can help increase the practice among low-income women during their children’s first weeks of life. The challenge is to find ways to reach out to all new mothers with this public health initiative. It’s a short-term investment in lifelong health.”
Intimate Partner Violence Happens to Nurses, Too—Nurses aren’t immune to intimate partner violence (IPV), according to JHUSON professor Jacquelyn Campbell, PhD, RN, FAAN and associate professor Joan Kub, PhD, APHN, BC. In “Intimate partner violence and abuse among female nurses and nursing personnel” [Issues in Mental Health Nursing January 2010], they report that rates of IPV and Intimate Partner Abuse (IPA) among the nearly 2,000 nurses studied are comparable to those in the general population, and the risk factors remain the same: childhood trauma, increased age, not being married, and the presence of children living in the home. IPV among nurses also has implications for the workplace, such as higher absenteeism and reduced concentration and focus, issues that can affect the quality of patient care. The study highlights the fine line between the supportive nursing workplace that promotes recovery and one that may place patient safety at risk. In related IPV research, “Women with protective orders report failure to remove firearms from their abusive partners,” [Journal of Women’s Health, January 2010], Campbell found that despite laws to remove firearms from the hands of IPV perpetrators as part of protective orders against domestic violence, more often than not weapons either were not confiscated or courts didn’t inform victims of the status of the weapons.
In Other Nursing Research News—In “Knowledge, attitudes and cultural, social and spiritual beliefs on health-seeking behaviors of Gambian adults with HIV/AIDS,” [International Journal of Culture and Mental Health, December 2009], postdoctoral student, Veronica Njie-Carr, PhD, SPRN, BC, reports on the effect of spirituality, culture, and social beliefs on Gambians’ healthcare decisions. Doctoral candidate Rhoda Redulla, MSN, RN, suggests how patient-centered, information-rich communications can help in the presentation of sensitive news to patients in “Physician-Patient Communication,” Gastroenterology and Hepatology [January 2010]. Johns Hopkins Hospital’s (JHH) Kristina H. Hoerl, RN, BSN, describes in “Reducing the trauma of voiding cystourethrograms without sedation” [Journal of Radiology Nursing, September 2009] simple techniques to calm children during tests requiring medication-free catheterization, and in “Implementing Peer Review” [Nursing Administration Quarterly July/September 2009], JHH nurses Karen K Davis, MS, RN; Joe Capozzoli, RN; and Joyce Parks, PMHCNS-BC, explore the role of nurse peer review in staff performance appraisals.
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