December Nursing News And Research Briefs

High Risk Patients Use Both Conventional Medicine and Alternative Therapies for Asthma; Some Alternatives Pose Risk In depth interviews with a group of low income mostly female African Americans, all of whom had severe asthma, revealed that all participants used some form of complementary and alternative medicine (CAM) in combination with conventional medicine. Writing in this month’s issue of the Journal of General Internal Medicine, Johns Hopkins University School Nursing researcher Maureen George, PhD, RN notes that "While most subjects trusted prescription asthma medicine, there was a preference for integration of CAM with conventional asthma treatment. CAM was considered natural, effective and potentially curative."

Among the reasons CAM was chosen as an addition to or substitute for conventional care were beliefs that treatment was "more natural" than manufactured agents; could reduce the need for conventional pharmacologic treatment such as steroids; provided protection from illness or for relief of systems; and offered some hope of a cure. While participants denied substituting CAM for prescription medication, most (63%) also reported they had not adhered to their conventional therapy in the two weeks prior to the interviews or that they had missed doses, some as many as ten or more.

The researchers also found that many participants did not disclose their CAM use to providers. When CAM therapies were preferred but covertly used, patients could be at increased risk for poor clinical outcomes due to drug-CAM interactions; unnecessary delays in seeking appropriate medical attention; and insufficient adherence to the patient’s medical plan leading to an unnecessary intensification of conventional therapies. George and colleagues also determined that some patients were using herbs and over-the-counter products in ways that could be harmful, including ingesting camphor-based or mentholated topical salves, dissolving cough lozenges as many as ten at a time in herbal tea, and taking Echinacea, an herb that could result in a worsening of asthma due to allergic reactions.

Studies Contribute to Better Understanding Pain, Reducing its Physical, Economic Consequences--Faculty member Fannie Gaston-Johansson, PhD, RN has, in collaboration with researchers at Goteborg University, Sweden, recently published two articles in BMC Nursing focusing on better understanding and managing pain.

In "Pain, psychological distress and health-related quality of life at baseline and three months after radical prostatectomy," Gaston-Johansson, notes that inadequate management of postoperative pain is common and is a risk factor for prolonged pain after surgery. In addition to medical and technical factors, psychological factors may also influence the experience of postoperative pain. The study found that patients who experienced the highest postoperative pain levels also had the longest hospital stay.

A second study examined unexplained chest pain (UCP), an increasing phenomenon often seen in Emergency Departments. In the article "Coping strategies, stress, physical activity and sleep in patients with unexplained chest pain" Dr. Gaston Johansson, examines coping strategies in patients with UCP and examines the relationships between these strategies, negative events, sleep problems, physical activity, stress and pain intensity.

In Other Nursing News:

David A. Thompson, DNSc, RN, and others published an article "Clinical and Economic Outcomes of Post-Operative Hospital Acquired Pneumonia in Patients who Receive Invasive Diagnostic Testing, and Ventilation" in the December issue of the "Journal of Clinical Outcomes Management." The article examines the clinical and economic impact of traditional technologies used in the diagnosis and management of intra-abdominal postoperative surgical patients who develop hospital acquired-pneumonia.

JHUSON doctoral student and clinical instructor Jason Farley MSN, MPH, CRNP, spent Thanksgiving in Namibia, Africa, working with the University of Namibia School of Nursing to complete a needs assessment for the 2007 implementation of a World Health Organization program “Integrated Management of Adolescent and Adult Illnesses.” The program supports a larger role for nursing personnel in developing countries in the care of persons living with HIV/AIDS.

Four JHUSON faculty members and doctoral students presented a variety of posters at the 134th Annual Meeting of the American Public Health Association (APHA) held in Boston, MA last month:

Rosemarie Brager, PhD, CRNP, presented "вЂ˜Guided Care’ for Multi-Morbid Adults," a model that infuses contemporary primary care with state-of-the-art information technology to help address the health care of multi-morbid older Americans in an often fragmented system lacking in quality and efficiency.

Joan Kub, PhD, APRN and SON students Jessica Williams Roberts, Sarah Joyce, Nina Fredland, and Colleen Thornton delivered posters focused on the increasingly recognized public health issue of bullying in the nation’s schools: "Bullying Victimization and Associated Health Outcomes in Elementary School Students," and "No Room for Bullying, an Intervention at a Local School."

Jodi Shaefer,PhD, RN presented “Fetal and Infant Mortality Review (FIMR): Promoting Culturally and Linguistically Competent Health Messages in Multi-Cultural Communities,” and research conducted by Robin Newhouse, PhD, RN, “Developing a Measure of the Impact of Legislation and Organizational Forces on Rural Hospital Nursing.”

The Johns Hopkins University School of Nursing is a global leader in nursing research, education and scholarship and is ranked among the top 10 nursing higher education institutions in the country. The School’s community health program is second in the nation and the nursing research program now holds eighth position among the top nursing schools for securing federal research grants. The School continues to maintain its reputation for excellence and educates nurses who set the highest standards for patient care, exemplify scholarship, and become innovative national and international leaders in the evolution of the nursing profession and the health care system. For more information, visit http://www.son.jhmi.edu/.

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