Role Models For Patients Research Articles

Heart health champions: how to develop student nurses as role models for cardiovascular health

Abstract Background Nurses as health promotors are optimally placed to identify cardiovascular disease risk factors and discuss behaviour change strategies for modifiable risk factors, but most undergraduate curriculums lack detailed content regarding these topics. Unfortunately evidence indicates that student nurses often demonstrate risky behaviours such as smoking, physical inactivity, excessive alcohol consumption and poor nutritional choices. As nursing is a pressurised career with long shifts and often challenging emotional encounters, it can be easy to overlook personal health behaviours. Purpose Given that nursing students are our potential health promotors of the future, we aimed to enhance cardiovascular knowledge and behaviour change awareness in their undergraduate education by implementing a co-designed digital educational resource - ASMOSUS. It sought to embed knowledge and risk assessment of cardiovascular disease risk factors, while motivating and sustaining behaviour change within undergraduates, facilitating them to make healthier lifestyle choices themselves and act as role models for patients. We developed roles of ‘Heart Health Champions’ within university and clinical placements, which is novel for both clinical practice and Higher Education Institutes. Methods Any nursing student who had received the ASMOSUS digital educational resource in the first semester of their undergraduate program and had an interest in further knowledge acquisition and health promotion amongst their peers were invited to become a Heart Health Champion. Alongside the recruitment of Heart Health Champions the cohort received cardiovascular risk factor specific educational sessions on physical exercise, smoking and vaping cessation, nutrition and alcohol consumption. Results We recruited 9 Heart Health Champions from the cohort representing all fields of undergraduate nursing. These students have undertaken 30 hours of required participation, leading to a university recognised qualification- FutureReady on graduation. This included attending cardiac risk and prevention training with cardiac rehabilitation nurses. They have taken the initiative to plan activities such as a sponsored walk, a ‘dancercise' class and support for their peers in harnessing healthy lifestyle behaviours through role modelling and motivational interviewing techniques. Results demonstrate that these sessions and student led activities are well attended and positively evaluated, which shows that including cardiovascular prevention techniques in undergraduates is feasible and acceptable. Conclusion Heart Health Champions are a valuable asset and can promote modifiable risk factor change amongst their peers and may help to maintain a healthy lifestyle. Further Heart Health Champions will be recruited over the next undergraduate nursing cohorts with a planned study to explore their effectiveness.

Smokers who were seen by a doctor or other healthcare provider for any health concern in Brazil: what a missed opportunity to encourage smoking cessation!

ObjectivesThis study aimed to examine changes in the proportion of smokers who were advised to quit smoking by health professionals as part of routine consultations or interactions with their patients between 2008 and 2019. Study designSerial cross-sectional study. MethodsData from two nationally representative cross-sectional surveys were used to examine changes over time in the proportions of smokers who were seen by a doctor or other healthcare provider for any health concern and were advised to quit smoking (‘Advice_HP’). An additional dichotomous variable (‘AdviceAccess_HP’) was created and included smokers who were not seen by a doctor or other healthcare provider in the past 12 months in the ‘no advice’ received category. Crude and adjusted absolute differences in prevalence rates of smokers who were advised to quit smoking by health professionals as part of routine consultations or interactions with their patients between 2008 and 2019 were evaluated using a generalised linear model. ResultsThe proportion of smokers who were seen by a health professional for any health concern increased from 58.8% in 2008 to 88.7% in 2019. The proportion of ‘AdviceAccess_HP’ increased from 33.6% in 2008 to 45.2% in 2019; however, the proportion of ‘Advice_HP’ decreased from 57.1% in 2008 to 51.0% in 2019. After adjustment for sociodemographic and smoking behaviour characteristics, differences remained virtually unchanged. In 2019, health professionals missed the opportunity to provide around 10 million smokers with brief advice to stop smoking. ConclusionsMonitoring the actions needed to encourage smoking cessation is critical for achieving the United Nations sustainable development goals. Primary healthcare workers should serve as role models for patients and provide brief advice that increases the likelihood of successfully quitting tobacco use, particularly in low- and middle-income countries.

Peer Specialists Can Aid in Suicide Prevention

Peer Specialists Can Aid in Suicide Prevention

Knowledge, Attitude and Practice (KAP) on Oral Health among students of Nepalese Army Institute of Health Sciences

Background: Oral health plays an important role in the overall health of the individual. Both medical and nursing students are expected to possess good oral health awareness and work together for public health promotion especially in developing countries like Nepal. The aim of the study is to assess and compare Knowledge, Attitude and Practice (KAP) on Oral Health among students of Nepalese Army Institute of Health Sciences (NAIHS) Methods: This is a cross sectional questionnaire based study conducted at Nepalese Army Institute of Health Sciences, from 2020.10.15 to 2021.04.15. A total of fourteen standard structured close ended questionnaire was sent to all the medical and nursing students in g- mail to assess and compare KAP on Oral Health. Result: Among 200 MBBS students, 157, 184, 200 had knowledge about sugar, bacteria and not brushing respectively which causes dental caries and 163 had knowledge about benefits of fluoride on dental health. On the other hand out of 200 nursing students 147, 178, 200 had knowledge about sugar, bacteria and not brushing respectively which causes dental caries and 152 had knowledge about benefits of fluoride on dental health. On an average 88% of MBBS students had good knowledge about dental caries whereas 84.62% of nursing students had good knowledge about dental caries. More of nursing students had attitude of visiting dentist in a year than medical students whereas more of medical students had never visited a dentist. Among 200 MBBS students 143 (71.5%) were found brushing twice daily, 121 (60.5%) brushes after every meal (i.e. morning and night), 35 (17.5%) followed proper vertical tooth brushing technique and as for the duration of brushing 104 (52%) brushed for 2 min. On the other hand, among 200 nursing students 152 (76%) were found brushing twice daily, 132 (66%) brushes after every meal, 43 (21.5%) followed proper vertical tooth brushing technique and as for the duration of brushing 116 (58%) brushed for 2 min. Conclusion: Based on the present study the total knowledge on dental caries was found to be significantly higher in MBBS students than nursing students however nursing students had more positive attitudes towards oral health. Oral health practice of nursing students in terms of frequency of brushing, times, method and duration of brushing was also found to be comparatively better than MBBS students. With proper knowledge of oral health behavior, medical and nursing students can play an important role in the oral health education of individuals and groups and act as role models for patients, friends, families and the community at large.

Perception of Oral and Dental Health Awareness and Assessment of Dental Habits in Preclinical Dentistry Students: A Questionnaire Study

Aim: The oral and dental hygiene behaviors of patients are affected by their dentists. Although dental students attend preclinical courses in their first and second years of education, they are expected to be knowledgeable about oral and dental health due to their future position as being role models for patients. In this study, it was aimed to evaluate the oral and dental health awareness and oral health habits of preclinical dental students. Material and Methods: 127 preclinical dental students were included in this study. A questionnaire consisting of 39 questions about oral-dental health habits and knowledge levels was prepared. The results were analyzed with the SPSS 22.0 software. A p-value of smaller than 0.05 was considered statistically significant. Chi-squared and Mann-Whitney U tests were used for statistical analysis. Results: Frequency of daily tooth brushing, gingival bleeding, halitosis, toothpaste preference, satisfaction with tooth color and frequency of dental visits were found to be statistically significant. There was no significant difference between the 1st-year and 2nd-year student groups in terms of their responses to the questions (p> 0.05). A statistically significant difference was found between the male and female groups for their responses to the questions on topics such as toothpaste preference, satisfaction with the color of their teeth, frequency of dental examination, frequency of tooth cleaning and toothbrushing time (p

Knowledge, Attitude and Practices Related to Oral Health Among Nursing Students in Davangere City: A Cross-Sectional Survey.

Nurses are the professional group who most often provide care. Studies have shown that oral healthcare is being neglected by general healthcare professionals, including nurses. With proper health-related behaviour, knowledge and attitude, they can play an important role in health education and act as a role model for patients. The aim of the study was to assess knowledge, attitude and practices related to oral health among nursing (Bsc) students in Davangere city, Karnataka, India. A cross-sectional survey was carried out among 365 BSc Nursing students at their college premises in Davangere city. Data was collected using 25 items self-administered questionnaire which was validated. One-way analysis of variance (ANOVA) and Student's unpaired t tests were used considering p ≤0.05 as statistically significant. The mean knowledge scores of final and third year nursing students were significantly higher than the first and second year students (p = 0.01). The majority of the students felt the need for regular visits to dentist (72.6%) and felt that oral healthcare was an important part of nursing care (91.2%). They also felt the need to collaborate with dentists (78.1%). The majority of them brushed their teeth twice daily (74.2%) and had the habit of mouth rinsing (67.4%) and referred their patients to dentists (61.4%). The knowledge related to oral health among nursing students was good. The majority believed that oral healthcare was an important part of nursing care, hence the training of nursing students pertaining to oral health education and upgrade of their academic curriculum should be prioritised.

Knowledge and Attitudes on Khat Use among Yemeni Health Sciences Students

Background: Khat chewing has a negative impact on an individual’s life. Objectives: The study was execute to assess health sciences students’ knowledge and attitudes regarding khat use in Yemen. Methods: This survey involved health sciences students from Aden University. Approximately 500 participants were selected through convenience sampling. The data were collected using a structured and validated self-administered questionnaire. The data were tabulated and descriptively analyzed. Results: The total number of respondents was 500. Almost half of the students reported that they chewed khat (n = 239, 48%). Approximately 66% (n = 330) of the students spent 2000 Yemeni riyals or less (USD1 = YER249.9) per day on khat. The main reasons for chewing khat were ‘it is a social habit’ (n = 155, 31%), followed by ‘it improves my concentration when studying or working’ (n = 140, 28%). Students knew that the effects of khat are similar to those of amphetamines (n = 210, 42.0%) and that khat is addictive (n = 254, 50.8%). Additionally, they knew that cathinone is the dependence-producing constituent of khat leaves (n = 269, 53.8%). The students agreed with the following statements: ‘I will advise people to cease khat use’; ‘Khat chewing is harmful to health’; ‘Children and adolescents should not chew khat’; ‘Khat chewing helps people stay awake’; and ‘Health professionals serve as role models for patients and the public’. Conclusions: Khat chewing is prevalent among Yemeni university health sciences students. Only about half of the students recognized health risks associated with khat use. Also, among those who used khat, students endorsed positive benefits such as improved concentration.

A nurse as a reliable educator? Analysis of selected health behaviors of nurses

Introduction: The nurse, in addition to nurture the patient should shape his awareness of a healthy lifestyle. The aim of the research was to analyze the health behaviors of nurses. Material and methods: The research participants included 100 nurses working in hospital wards. The researcher used his own questionnaire containing questions about selected lifestyle elements. The research included also the measurement of body weight and height, and the calculation of the Body Mass Index (BMI). The results were described with the use of the basic descriptive statistics, the chi2 test, Mann-Whitney U test, and the Spearman’s rank correlation coefficient. The differences were deemed significant when p<0,05. Results: Only 5.0% of nurses devoted at least 150 minutes per week to aerobic activity. More than half of the respondents (58.0%) said that on weekdays they did not perform any strength exercises for major muscle groups. According to the nurses, lack of time (65.0%) was the greatest impediment to their physical activity. A significant percentage of the respondents (40.0%) did not pay any attention to the calorific or nutritional value of their meals. As many as 30.0% of the surveyed nurses indicated that they ate irregularly, and 22.0% of them ate only 1-3 meals during the day. Excessive body weight was observed in almost half of the participants. For the majority of the nurses, their professional work was the main source of stress (46.0%). Conclusions: Despite their knowledge on healthy lifestyle, it seems that nurses do not fully implement its objectives. Therefore, the majority of them are not good role models for patients.

Development of a Questionnaire to Evaluate Knowledge and Attitude of Obesity and Weight Loss in Thai Overweight/Obese Medical Students: The Pilot Study

Background: Medical students who will grow up as physicians will be role models for patients in health behaviors. However, some medical students are still overweight or obese. A weight reduction program can both decrease weight and change attitude about obesity and losing weight. Unfortunately, there is no validated questionnaire to measure knowledge and attitude about obesity and weight loss for our medical students. Objective: To develop a questionnaire for evaluation of knowledge and attitude toward obesity and weight loss in Thai overweight/obese medical students. Methods: We developed the questionnaire using Health Belief Model under consultation of two experts in obesity, biostatistics and epidemiology. Validity of the questionnaire was evaluated by the index of item-objective congruence under supervision of five experts. This pilot study was performed to test the internal consistency and reliability using Cronbach’s alpha coefficient. Twenty-seven medical students who self-reported as overweight or obese were included in this study. Results: A fifty-seven items questionnaire using five-point Likert scale was developed with the index of item-objective congruence of all items in presented questionnaire more than 60%. Cronbach’s alpha coefficients of all domains were in the range of 0.74-0.90 and overall standardized Cronbach’s coefficient of the questionnaire was 0.87. The average inter-item correlation of each domain was in acceptable range (0.21-0.62) although; those of the total scale were 0.12. Conclusion: Validity and reliability of this questionnaire were acceptable to be used for assessment of knowledge and attitude of obesity and losing weight in Thai overweight or obese medical students.

Health Status and Lifestyle Habits of US Medical Students: A Longitudinal Study.

Background:Evidence shows that physicians and medical students who engage in healthy lifestyle habits are more likely to counsel patients about such behaviors. Yet medical school is a challenging time that may bring about undesired changes to health and lifestyle habits.Aims:This study assessed changes in students' health and lifestyle behaviors during medical school.Subjects and Methods:In a longitudinal study, students were assessed at both the beginning and end of medical school. Anthropometric, metabolic, and lifestyle variables were measured at a clinical research center. Data were collected from 2006 to 2011, and analyzed in 2013–2014 with SAS version 9.3. Pearson's correlations were used to assess associations between variables and a generalized linear model was used to measure change over time.Results:Seventy-eight percent (97/125) of participants completed both visits. At baseline, mean anthropometric and clinical measures were at or near healthy values and did not change over time, with the exception of increased diastolic blood pressure (P = 0.01), high-density lipoprotein-cholesterol (P < 0.001), and insulin (P < 0.001). Self-reported diet and physical activity habits were congruent with national goals, except for Vitamin D and sodium. Dietary intake did not change over time, with the exceptions of decreased carbohydrate (percent of total energy) (P < 0.001) and sodium (P = 0.04) and increased fat (percent of total energy) and Vitamin D (both P < 0.01). Cardiovascular fitness showed a trend toward declining, while self-reported physical activity increased (P < 0.001).Conclusions:Students' clinical measures and lifestyle behaviors remain generally healthy throughout medical school; yet some students exhibit cardiometabolic risk and diet and activity habits not aligned with national recommendations. Curricula that include personal health and lifestyle assessment may motivate students to adopt healthier practices and serve as role models for patients.

Health Professionals’ Role in Helping Patients Quit Tobacco Use: Attitudes among Iranian Dental Students

Background. Health professionals play an essential role in tobacco control. Our objective was to assess Iranian dental students' attitudes towards tobacco control. Methods. Eight dental schools were randomly selected, and a survey using Global Health Professions Student Survey (GHPSS) instrument was conducted among dental students in 2010 in Iran. The chi-square test served for statistical analyses. Results. Of the participants (325 students, 66% female), about one-fifth (21%) were current tobacco (including cigarettes and waterpipe) users. A clear majority (over 80%) of the students agreed as to the responsibility of health professionals on serving as role models for patients and the public, routinely advising patients using tobacco to quit, and giving patients advice about smoking cessation. Over 75% believed that cigarette-smoking health professionals are less likely to advise their patients to stop smoking. Current tobacco users were significantly less likely to agree with these beliefs (P&lt;0.05). Conclusion. Future oral health professionals have generally positive attitudes towards tobacco control. However, their own current tobacco use has a significant negative impact on these attitudes, an impact which ought to be taken into account in tobacco control.

Becoming a Doctor

To improve understanding of the impact of the third year on medical student wellness and help educators improve approaches to promoting wellness. The authors used an interpretive description approach to conduct a qualitative analysis of required essays written by 173 third-year medical students as part of a May 2011 final exam at the Albert Einstein College of Medicine of Yeshiva University. In these essays, students reflected on how the transition to clinical responsibilities during the third year of medical school had affected their own health and wellness behaviors. Four themes emerged. Students described the difficulty of making healthy choices in the face of time challenges, the effect of becoming a role model for patients, and the impact of information on their view of their own health and wellness. A subset reflected on the tension between self-care and dedication to work that is inherent in developing a professional identity as a physician. Some students characterized these as challenges that encouraged them to be more active and effective in managing their own health; others viewed them as insurmountable obstacles that prevented them from making healthy choices. The new responsibilities in the third year of medical school comprise a unique set of opportunities and challenges that affect how students make choices regarding health and wellness. Educators should develop strategies for identifying and supporting students who are likely to experience the transition as difficult, and for capitalizing on learning opportunities by framing these challenges as part of students' professional development.

Psychiatry Emergency Service Can Do More Than Triage

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessPsychiatry Emergency Service Can Do More Than TriageAaron LevinAaron LevinSearch for more papers by this authorPublished Online:2 Nov 2012https://doi.org/10.1176/pn.47.21.psychnews_47_21_16-aAbstractRecovery—isn’t that something that takes lots of time to bring to reality for a patient? Mark Winfrey/ShutterstockNot when it happens in the emergency department (ED), Anthony Ng, M.D., said last month at APA’s Institute on Psychiatric Services in New York.“The ED is the gateway to care,” said Ng, chief medical officer of Acadia Hospital and chief of the psychiatry service at Eastern Maine Medical Center in Bangor, Maine. “This is where they’ll get their first impression of psychiatry, so even if they’re not ready to accept treatment, we can prepare them for that moment.”Traditionally, ED psychiatry worked on a “triage-and-refer” model. Now an alternative approach (at least for some patients) involves receiving the first stages of treatment there, although not without some adjustments.For instance, the practical concerns of operating an ED—urgency, safety, and throughput—create an ethos at odds with the usual paradigm of psychiatric care, said Ng.“You have to do recovery work in minutes or hours versus days or months,” he said. But there can be a payoff if that effort reduces use of restraints or leads to fewer readmissions and return trips.Psychoeducation, case management, and even a little cognitive-behavioral therapy can all happen in the ED, said Ng. “These are possible with many patients, but not all.”Engaging patients long enough to figure out what they really want when they approach the hospital may reveal that alternatives like day hospitals, crisis teams, or even phone calls may meet their needs and cut unnecessary usage. That can open up beds needed for other patients in the ED.“Needing a medication refill is not a crisis,” said Ng. “We try creating a ‘crisis card’ for each patient, giving him or her a list of alternatives to the ED. We also try to involve families and the patient’s other medical professionals in treatment planning. There is a dynamic relationship, in flux all the time, between partnership and paternalism” that needs adjustment with each patient and at different times.Making a decision to hospitalize or discharge patients after an examination in the ED is a careful balancing act that benefits from experience in the emergency setting, said Jon Berlin, M.D., recently retired as director of the psychiatric emergency services in Milwaukee.“We can help long-term practitioners with cases when their patients are in crisis,” said Berlin. “We put much weight on their point of view if they request that a patient be hospitalized, and we can also serve to consult them about risk tolerance.”In fact, emergency-service psychiatrists have very high risk tolerance and are less risk averse than their community psychiatric colleagues, he said. “We’re less likely to hospitalize.”Treating patients in the hospital can go a long way toward mitigating the risks of coercive care and the damage to the therapeutic alliance, said Berlin. “But not a lot is being done now in the hospital when stays are short and patients are quickly released on medications.”The ED evaluation should not only weigh risk and protective factors and ways to eliminate risk, but also document the reasoning process behind a decision to admit to the hospital or discharge to other forms of care, he said.Berlin also discussed how peer support in the ED can help patients and staff. “Peer specialists remind staff on a daily basis of the patient’s point of view,” he said. “They are role models for patients, instilling hope of recovery. Peers are ready to engage the patient right away, even in the waiting room, lessening hostility.” To access an audio interview with Ng, go to www.psychnews.org/update/audio/IPS-12-TonyNg.mp3. ISSUES NewArchived

Tobacco use among medical students in Europe: Results of a multicentre study using the Global Health Professions Student Survey

To examine smoking prevalence, knowledge and attitudes, and tobacco cessation training among university students attending European medical schools using the Global Health Professional Students Survey approach. A cross-country, cross-sectional study was performed among 12 medical schools in four countries in Europe (Germany, Italy, Poland and Spain). The survey was performed during the second semester of the third year of study from March to May 2009. In total, 2249 subjects entered the study (overall response rate 92%). The overall prevalence of smoking among medical students was 29.3% (95% confidence interval 28.1-34.7), with percentages ranging from 28% in Germany to 31.3% in Italy. This study found that more than two-thirds of medical students believe that health professionals are role models for patients, with different beliefs in Poland (89.6%) and Germany (77.7%) vs Italy and Spain (57.2% and 54.4%, respectively) (P<0.001). Smoking cessation training at medical school was only reported by 16.5% of students (lowest proportion in Italy, 3.5%) (P<0.001). In terms of smoking cessation methods, the vast majority (89.8%) of medical students were aware of nicotine patches and gum (highest prevalence in Spain, 96.3%), and 24.4% were aware of the use of antidepressants (highest prevalence in Germany, 33.6%). This European survey found that the prevalence of smoking was higher among medical students than the general population. There is a strong need to provide medical students with training in smoking cessation techniques.

Consumo de álcool entre estudantes universitários

Consumption of alcoholic beverages is widely encouraged by the mass media, despite the related health risks. Today's students in the health fields are the professionals of tomorrow who will be providing advice and serving as role models for patients. The aim of this study was to analyze alcohol consumption and related factors among these students. A total of 608 male and female university students from Maceió, the capital of Alagoas State, Brazil, completed a self-administered questionnaire. Data analysis included Poisson regression and multinomial logistic models. Prevalence of lifetime use of alcohol was 90.4%. Prevalence of alcohol abuse was 18.3% in men and 6.1% in women. Heavier alcohol consumption and alcohol abuse were observed in males, older students, non-natives of Maceió, smokers, and those exposed to alcohol advertising. The results emphasized the vulnerability of these young people to risky health behaviors. Their future social role highlights distinct needs in their university education to enable them to act professionally in this area.

Smoking and Its Determinants among Iranian Dental Students

Objective: The objective of the present study was to investigate smoking habits of Iranian dental students in relation to their background characteristics and oral self-care (OSC). Subjects and Methods: A survey in the form of a questionnaire was conducted of 327 senior dental students in seven randomly selected state dental schools in Iran. In addition to smoking habits and background characteristics, the students were asked about OSC. A recommended level of OSC was defined as a combination of brushing at least twice a day, frequent use of fluoridated toothpaste, and eating sugary snacks less than daily. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 263 students (113 males and 150 females) completely answered the questions and were included in the analyses. Results: Of the 263 students, 59 (23%, 37 males and 22 females) reported current smoking (cigarette, pipe, or water pipe). Current smoking was associated with male gender (OR = 2.9, 95% CI = 1.4–5.6), level of father’s education (OR = 1.4, 95% CI = 1.1–1.8), and OSC (OR = 4.4, 95% CI = 1.3–14.9). Conclusion: Smoking among Iranian dental students is similar to their socioeconomic group, and is associated with the characteristics of their background, such as gender and father’s level of education, as well as the quality of OSC. The results indicate a need to include smoking cessation education and public health activities in the dental curriculum to provide future health care professionals and role models for patients with adequate training in up-to-date patient management to control smoking.

A Physician Fitness Program: Enhancing the Physician as an "Exercise" Role Model for Patients

Background: Physically active physicians are more apt to counsel patients about exercise.Purposes: The purpose of this study was to determine the effect of a physician fitness program on resident physician cardiovascular fitness, physical activity behavior/stage of change, and physical activity counseling behavior/attitudes.Methods: A prospective, intervention study with measurements at baseline (before intervention), 3 months (immediately after intervention), and 6 months (3 months after intervention) evaluated a multifaceted exercise program for 48 internal medicine residents. Resident physician cardiovascular fitness, energy expenditure, physical activity stage of change, knowledge, attitudes, and counseling behavior were measured.Results: Resident physician fitness significantly declined over time (baseline VO2-170 = 29.1 ml/kg/min, first follow-up VO2-170 = 27.3 ml/kg/min, and second follow-up VO2-170 = 26.2 ml/kg/min; p =. 001). Although there was no change in overall energy expenditure, the number of resident physicians in the precontemplation or contemplation stage of change significantly declined with a corresponding increase in the number in a "higher" stage of change at first (p =. 0034) and second follow-up (p =. 024). There was a nonsignificant increase in self-reported patient counseling. Resident physician counseling confidence and perceived success significantly improved at first follow-up only (p =. 01 and p =. 03, respectively).Conclusion: Although resident physician fitness and energy expenditure did not improve after intervention, a significant improvement in resident physician physical activity stage of change and attitudes toward patient counseling was noted. Randomized controlled trials are needed to confirm whether these changes are attributable to the intervention.

Relationship of job stress with nicotine dependence of smokers--a cross-sectional study of female nurses in a general hospital.

The degree of nicotine dependence is an important predictor of successful cessation of smoking among smokers. Some investigators reported a possible relationship between reducing job stress and successful smoking cessation . This may be attributable to the effect of job stress on nicotine dependence. That is, high levels of job stress could produce and/or maintain high levels of nicotine dependence among smokers, and could result in difficulty in smoking cessation. If this hypothesis were true, workplace smoking cessation programs should take account of the influence of job stress on nicotine dependence, and measures to curb nicotine dependence resulting from coping with job stress should be introduced into the programs. There are, however, few reports that deal with the influence of job stress on the nicotine dependence of smokers in the workplace. Tobacco dependence is a multi-dimensional addiction that includes psychological and behavioral aspects of dependence on smoking or nicotine as well as physiological dependence 7, . It is important to measure various aspects of nicotine dependence separately. Two short and easyto-apply self-reporting questionnaires are frequently used to screen for nicotine dependence. They are the Fagerstrom Test of Nicotine Dependence (FTND) 2) and the Tobacco Dependence Screener (TDS). They evaluate different aspects of nicotine dependence. The FTND assesses the physiological aspects of nicotine dependence and is positively associated with the number of cigarettes smoked per day and the plasma level of nicotine and cotinine 2, . On the other hand, the TDS is closely correlated with the psychological aspects of nicotine dependence; a TDS score of 6 or greater indicates nicotine dependence diagnosed according to the International Classification of Diseases, 10 revision (ICD-10), and the Diagnostic and Statistical Manual of Mental Disorders, third edition revised (DSM-III-R), with sensitivity values of 95% and 79%, and specificity values of 81% and 66%, respectively. In addition, previous studies reported a poor concordance between the FTND score and the DSM-III-R diagnosis; Moolchan et al. showed that the highest kappa (at a cutoff of the FTND=7 or greater) was .205. The objective of this cross-sectional study was to examine the relationship between perceived job stress and nicotine dependence assessed with two self-reporting questionnaires (i.e., the FTND and TDS) completed by workers who smoked tobacco. Nurses were chosen as subjects in this study. They are health professionals with a reportedly high prevalence of smoking ; in addition, they are expected to act as role models for patients with a desire to quit smoking. Elkind has reported that certain peculiar characteristics associated with the hospital environment and the nursing process may contribute to the smoking habits of nurses. Nurses deserve special attention in developing a smoking cessation program which considers the influence of job stress on the smoking habit.

Starting Out - Romini Somerset-Butler learns how to be a role model for patients

My first placement was on a low-secure rehabilitation unit. I tried to be friendly, but I found that direct eye contact and questions often intimidated these vulnerable clients. I began to be more sensitive to their needs - one liked to sit with me and listen to the radio, another liked to ask me questions and tell me about herself. My confidence began to grow as these clients turned to me for advice and direction.

Health practices of critical care nurses: are these nurses good role models for patients?

Health practices of critical care nurses: are these nurses good role models for patients?