Undertaking Nursing Interventions Throughout Europe (UNITE) Study Group. A Survey of Coronary Risk Factors in a Cohort of Cardiac Nurses from Europe: Do Nurses Practise What They Preach?

Preparedness of health care providers for motivaton of the population for leading a healthy lifestyle

Purpose. To assess the commitment to a healthy lifestyle of persons involved in the formation of health conservation (doctors, teachers). Materials and m e t h o d s . A cross-sectional study was conducted, which included 176 people (75 doctors, 101 teachers of higher medical educational institutions), employees of state budgetary institutions in Moscow. At the age of 45,48±15,33 years (from 23 to 78 years), among them 91 women, 85 men. Results. A quarter of the respondents from the group led an insufficiently healthy lifestyle (25,34%); 4% of doctors and 0,9 teachers observed “poorly” the principles of a healthy lifestyle; The main problem was low physical activity, identified in 79,3% of the respondents (95,6% of doctors, 67,56% of teachers), low responsibility for health (9,9%) and poor nutrition among teachers (3,9%), low stress management skills among doctors (5,3%). Conclusions. There is a lack of adherence to the principles of a healthy lifestyle among participants in health preservation. Insufficient commitment of doctors and teachers to adherence to the principles of a healthy lifestyle plays a negative role in the formation of health-saving behavior among the population of the Russian Federation.

A Survey of Coronary Risk Factors and B-Type Natriuretic Peptide Concentrations in Cardiac Nurses from Europe: Do Nurses Still Practice what they Preach?

BACKGROUND

From a previous survey of cardiac nurses attending a scientific conference, we learned that these nurses adopted a healthier lifestyle than the general population.

AIMS

The aim of this study was to determine the overall profile of cardiac risk factors in a similar cohort and determine whether cardiac nurses continue to 'practice what they preach' in this regard. Secondly, we examined the practical value of screening a large cohort of individuals within a short time frame (total of 8 hours screening time) and determined the range of BNP concentrations within a 'healthy' cohort.

METHODS

Data on CHD risk factors were collected with a short self-report questionnaire. The sample consisted of 122 cardiac nurses from 19 countries attending a European cardiac nursing conference held in Stockholm. A venous blood sample was collected into a tube containing potassium ETDA. B-type natriuretic peptide was measured on-site with the use of a portable fluorescence immunoassay kit.

RESULTS

Most participants were female (89%). Participants ranged in age from 23 to 60 years with a mean age of 41 (S.D. 9.4). Eleven percent - all female - reported they were current smokers, 27% (34) had a BMI >25 and 27% of the sample stated they did not exercise regularly. Almost half (48%) of the sample reported a family history of CHD. As expected, all BNP-values were within the normal range. There were significant differences in BNP on the basis of sex (P<0.05) and age (P<0.05) and a trend towards increasing BNP concentrations with progressively higher BMI scores (P=0.06).

CONCLUSION

This study reconfirms the likelihood that many cardiac nurses heed their own advice on lifestyle modification to reduce cardiovascular risk and therefore provide a good role model for the promotion of primary and secondary prevention initiatives.

The Impact of Perceived Stress and Coping Adequacy on the Health of Nurses: A Pilot Investigation

Stress and coping abilities influence the health and work performance of nurses. However, little is known about the combined influence of stress perception and perceived coping adequacy and its impact on the health of nurses. This study examined the relationship between stress, coping, and the combined influences of perceived stress and coping abilities on health and work performance. A valid and reliable questionnaire was completed by 120 nurses in a Midwestern hospital in the USA. In general, the nurses were not healthy: 92% had moderate-to-very high stress levels; 78% slept less than 8 hours of sleep per night; 69% did not exercise regularly; 63% consumed less than 5 servings of fruits and vegetables per day; and 22% were classified as binge drinkers. When confronted with workplace stress, 70% of nurses reported that they consumed more junk food and 63% reported that they consumed more food than usual as a way of coping. Nurses in the "high stress/poor coping" group had the poorest health outcomes and highest health risk behaviors compared to those in other groups. The combined variables of perceived stress and perceived coping adequacy influenced the health of nurses. Therefore, worksite health promotion programs for nurses should focus equally on stress reduction, stress management, and the development of healthy coping skills.

The influence of healthcare workers' occupation on Health Promoting Lifestyle Profile

To compare the adoption of healthy lifestyle behaviors, including: spiritual growth, nutrition, physical activity, interpersonal relations, health responsibility, and stress management, of healthcare workers with workers of other professions. Cross-sectional observational study among a convenience sample of 285 healthcare workers and 137 of other professions. The Health-Promoting Lifestyle Profile-II (HPLP-II), a 52-item measure regarding the six components of healthy lifestyle. Demographic characteristics, education, income, work duration and self-rated health were also collected. Multivariable linear models were specified for each of the components of healthy lifestyle. Both groups were comparable in their age, family status, income and self-rated health. Results of multivariable linear models revealed that healthcare workers adopt better nutrition (β=0.228, p<0.001), more physical activity (β=0.133, p=0.049), and greater health responsibility (β=0.131, p=0.016), compared to other professions. Such differences were not found with regard to spiritual growth (β=0.097, p=0.121), interpersonal relations (β=0.039, p=0.444), or stress management (β=0.053, p=0.299). Healthcare workers adopt better healthy lifestyle only in components that may be perceived to have direct influence on health outcomes, namely nutrition, physical activity, and health responsibility. Further research that will explore the reasons for the observed differences may enable designing health-improving interventions.

An international review of tobacco smoking research in the nursing profession, 1976-2006

Tobacco smoking represents a contentious issue in the nursing profession, and one that has now become an important topic in nursing research. Despite this fact, the epidemiological quality of research varies widely, and it has been difficult to accurately determine the true incidence of smoking among nurses. Given these inconsistencies, we conducted a state-of-the-art review to identify international trends in tobacco usage among nurses, to ascertain how the epidemiological quality of research has improved over the past 30 years, and also to elucidate the directions in which nursing research has evolved. A total of 73 English-language studies that met the inclusion criteria were located and analysed. Overall, our review suggests that, while tobacco smoking among nurses appears to be decreasing in many countries during recent years, the international trend is far from uniform, and some developed nations still report high smoking rates among their nursing staff. From a methodological perspective, the relative epidemiological quality of smoking research has also fluctuated over time, making it difficult to compare the results of one study to the next. Despite these caveats, tobacco smoking remains a key topic in nursing research, as well as a critically important occupational-health issue for the entire nursing profession. In order to make the next generation of tobacco research data as comparable as possible, future scholars should consider devising and implementing a standardised format for conducting international tobacco smoking research within the nursing profession.

Insecurity and shiftwork as characteristics of negative work environment: psychosocial and behavioural mediators

AIM

This paper is a report of an investigation into whether insecure work contract and shiftwork are associated with reduced wellbeing indicators, such as psychological distress, low job involvement and low work ability.

BACKGROUND

Insecure work contracts and shiftwork have repeatedly been found to contribute to the development and continuation of negative outcomes among healthcare professionals. In particular, nurses are generally considered as being at high risk of work-related stress and reduced wellbeing.

METHODS

Cross-sectional survey data from the Finnish Health Care Professional Study collected in 2006 were used. The random sample of Finnish Registered Nurses comprised 2100 women and men aged 22-65 years. Information on the work contract and shiftwork were self-reported. The wellbeing indicators used were psychological distress (GHQ-12), work ability and job involvement. Psychosocial work characteristics were measured using the Job Content Questionnaire and an organizational justice scale.

RESULTS

Variance and linear regression analyses showed that insecure work contract was associated with lower work ability and job involvement. Shiftwork was related to psychological distress, low job involvement and low work ability. Support for a mediating role of job demands and job control and a moderating role of relational justice was obtained.

CONCLUSION

To reduce the negative effects of environmental stressors, such as insecure work contract and shiftwork, it may be better to focus on improving psychosocial work characteristics than on nurses' health-related behaviour.

Situations influencing habits in diet and exercise among nurses working night shift

OBJECTIVES

The aim of the investigation was to describe situations with a significant influence on healthy diet and exercise habits among nurses working night shift.

METHODS

A qualitative descriptive design with a Critical Incident Technique approach was used. Situations were collected by means of interviews with 27 registered/enrolled community nurses.

RESULTS

A total of 143 situations were identified comprising two main areas: coping ability at work and coping ability during leisure hours. Coping ability at work included 81 critical incidents grouped into two categories: the nurses' diet and exercise habits were influenced by social interaction with colleagues at work and by the disruption to their circadian rhythm. Coping ability during leisure hours included 62 critical incidents grouped into two categories: the diet and exercise habits were influenced when the nurses recovered from the disruption to their circadian rhythm and when they took advantage of the freedom of action offered by night work.

CONCLUSIONS

By identifying the factors that influence diet and exercise habits among nurses working night shift, strategies can be developed in order to strengthen the factors with a positive influence.

Cardiovascular risk estimation by professionally active cardiovascular nurses: results from the Basel 2005 Nurses Cohort

BACKGROUND

Nurses play a key role in the prevention of cardiovascular disease (CVD) and one would, therefore, expect them to have a heightened awareness of the need for systematic screening and their own CVD risk profile. The aim of this study was to examine personal awareness of CVD risk among a cohort of cardiovascular nurses attending a European conference.

METHODS

Of the 340 delegates attending the 5th annual Spring Meeting on Cardiovascular Nursing (Basel, Switzerland, 2005), 287 (83%) completed a self-report questionnaire to assess their own risk factors for CVD. Delegates were also asked to give an estimation of their absolute total risk of experiencing a fatal CVD event in the next 10 years. Level of agreement between self-reported CVD risk estimation and their actual risk according to the SCORE risk assessment system was compared by calculating weighted Kappa (kappa(w)).

RESULTS

Overall, 109 responders (38%) self-reported having either pre-existing CVD (only 2%), one or more markedly raised CVD risk factors, a high total risk of fatal CVD (> or =5% in 10 years) or a strong family history of CVD. About half of this cohort (53%) did not know their own total cholesterol level. Less than half (45%) reported having a 10-year risk of fatal CVD of <1%, while 13% reported having a risk > or =5%. Based on the SCORE risk function, the estimated 10-year risk of a fatal CVD event was <1% for 96% of responders: only 2% had a > or =5% risk of such an event. Overall, less than half (46%) of this cohort's self-reported CVD risk corresponded with that calculated using the SCORE risk function (kappa(w)=0.27).

CONCLUSION

Most cardiovascular nurses attending a European conference in 2005 poorly understood their own CVD risk profile, and the agreement between their self-reported 10-year risk of a fatal CVD and their CVD risk using SCORE was only fair. Given the specialist nature of this conference, our findings clearly demonstrate a need to improve overall nursing awareness of the role and importance of systematic CVD risk assessment.

Paediatric critical care nurses' attitudes and experiences of parental presence during cardiopulmonary resuscitation: a European survey

BACKGROUND

Although recent resuscitation guidelines are supportive of family presence during cardiopulmonary resuscitation literature from the last decade suggests that it is often discouraged, and the subject remains a controversial issue.

OBJECTIVES

To determine the experiences and attitudes of European paediatric critical care nurses about parental presence during the resuscitation of a child.

DESIGN

A survey design was employed.

PARTICIPANTS

A convenience sample of European paediatric critical care nurses was used.

METHODS

A structured questionnaire was used, which incorporated a series of attitude statements that were rated using a 5-point Likert scale. Differences in attitudes were explored in three areas: decision-making, processes and outcomes of resuscitation.

RESULTS

The results from this survey suggest that European paediatric nurses are very supportive of parental presence during cardiopulmonary resuscitation. Only a few nurses reported that their unit had a policy that covered parental presence during cardiopulmonary resuscitation and most nurses did not support the use of a dedicated nurse to look after the parents during resuscitation.

CONCLUSIONS

Compared with previous studies relating to adult cardiopulmonary resuscitation, paediatric nurses experience family member presence more frequently than adult critical care nurses and appear to be more supportive of relatives' presence. It is recommended that paediatric intensive care units establish local policies that cover parental presence during cardiopulmonary resuscitation.

Building bridges: a partnership between professional nursing and the Centers for Disease Control and Prevention to reduce the burden of heart disease and stroke

The escalating burden of heart disease and stroke in the United States, coupled with the complexity of public health goals to prevent and control chronic diseases, warrant new strategies and partners. The 2.7 million nurses in the United States represent the nation's largest healthcare profession and, through their professional organizations, constitute a strategic partner for the Centers for Disease Control and Prevention (CDC) Heart Disease and Stroke Programs. In addition, because heart disease and stroke rank first and third among leading causes of death in women in the United States, and 95% of nurses are women, nurses represent an important population to target with preventive cardiovascular health approaches. The authors describe a proposed CDC strategic partnership with professional nursing organizations, including goals aimed at improving the capacity of nurses as change agents in the area of heart disease and stroke, as well as promoting change among the change agents to reduce nurses' risk for cardiovascular disease. The primary goals of the partnership between key professional nursing organizations and the CDC Cardiovascular Health (CVH) Programs follow: (1) share information and develop effective communication; (2) link with key professional and community organizations; (3) assess capabilities and expertise that nursing organizations can add to CDC's internal and external partnerships, including the Public Health Action Plan; (4) explore possible linkages with the CDC-funded state-level heart disease and stroke prevention programs and emerging CDC stroke networks; (5) develop, disseminate, and apply evidence-based guidelines to improve outcomes of care; and (6) develop policy and environment strategies in work-site settings to prevent heart disease and stroke in women and among the membership of professional nursing organizations. The development and implementation of a CDC CVH Program Professional Nurse Partnership have strong potential for enhancing collaborative public health efforts to prevent heart disease and stroke, and to improve cardiovascular outcomes for hypertension, high cholesterol, myocardial infarction, stroke, and heart failure.

A European survey of critical care nurses’ attitudes and experiences of having family members present during cardiopulmonary resuscitation

This paper presents the results of a survey into the experiences and attitudes of 124 European critical care nurses to the presence of family members during cardiopulmonary resuscitation (CPR). Nurses from mainland Europe were less experienced and less sure about the consequences of relatives witnessing resuscitation than United Kingdom (UK) nurses. Generally, nurses supported the presence of family members, although UK nurses held significantly more positive attitudes than their non-UK counterparts in the areas of decision-making, processes and outcomes of resuscitation. Differences in attitudes are explored in the discussion. On the basis of results from this study, it is recommended that further policy guidance is required.