PSYCHOLOGY HELPS HEART DISEASE
Psychological factors influence heart disease. Researchers evaluated whether psychological interventions could improve outcomes of patients with coronary heart disease when combined with a conventional rehabilitation program. The study was a meta-analysis of nine randomized controlled trials. Dr. Zoi Aggelopoulou, a nurse and one of the study authors, said, “The nurses on our coronary care unit observed that patients were less likely to have another heart attack, die, or return to the hospital when we talked to them about their treatment, played music for them, or helped religious patients to say prayers. It made us think that coronary heart disease is not just physical but also has a psychological component.”
“Patients want to know what will happen to them when they leave the hospital, whether or not they can have sex, and how to take their medication. Our research shows that giving them information and providing reassurance decreases the chances of them dying or having another heart attack. Patients can help instigate this new culture of information by asking more questions and getting more involved in decisions about their treatment.”
Aggelopoulou said, “The results of our study strengthen the evidence that psychological factors have a big role to play in heart disease. Not only do they impact on the risk of having a heart attack, but they also affect the future outlook of a patient who has had a cardiovascular event. This validates our view that cardiovascular disease is not just a physical disease but also has a substantial psychological component.”—European Society of Cardiology Press Release, 10/12/2013.
THREE TIPS PATIENTS NEED TO KNOW
Patient advocate Ruth Fenner Barash warns that the U.S. healthcare system is not the safety net many people believe it to be. “Patients and their loved ones cannot blindly turn themselves over to this massive, technology-based system and trust that it will care—or take care of them.”
Based on her extensive experience with the illness and subsequent death of her husband, Barash offers suggestions for patients and their loved ones navigating through the healthcare system.
- Avoid the emergency room. Emergency rooms were developed for emergencies and limited use. As healthcare costs have increased, the ER has become a primary care facility for those without insurance or the ability to pay for out-of-pocket services. “Patients and their families were not expected to spend a long time in the ER. Presumably, they would be seen quickly and either admitted to the hospital or treated and released. ER.'s have become very crowded, especially in cities, and patients might wait for hours.... For someone who's sick or injured, this can be torture,” states Barash.
- Be skeptical—question everything. “If you have the luxury of time, take some of that time to think things through, to research and get second opinions,” states Barash. Research your physician's connections. Ask questions about why a particular specialist was chosen, how many times he or she has performed a procedure, and with what success rate. Ask other healthcare providers for recommendations of those with the best reputations.
- Ask what it costs—no matter who's paying. Regardless of who is paying the bill, ask questions about the necessity of the test or procedure. “Part of the blame for having the most expensive healthcare system in the world goes to us, the individuals, who don't question purchases or shop for prices as we would for groceries, clothing, or furniture,” Barash says. “If a test or consultation is ordered, understand why. Is it really necessary? You can say no!”
Finally, Barash reminds us of the fact that death is a given. “My husband's problem, and the problem many of us may be doomed to face, is the seemingly endless getting there—a dying we don't want.”—News and News Experts Press Release, 9/30/2013.
VERBAL ABUSE IS CONTAGIOUS
A recent study by the RN Work Project found that newly licensed registered nurses (NLRNs) who were verbally abused by nursing colleagues reported lower job satisfaction, unfavorable perceptions of their work environment, and greater intent to leave their current jobs. Those who experienced the most frequent abuse also perceived poor collegial relations between RNs and physicians, poor workgroup cohesion, and more work–family conflict. Higher levels of verbal abuse from physicians also were correlated with more verbal abuse among nurse colleagues.
The RN Work Project is a 10-year study of NLRNs that began in 2006. It is the only multistate, longitudinal study of new nurses' turnover rates, intentions, and attitudes—including intent, satisfaction, organizational commitment, and preferences about work. The study draws on data from nurses in 34 states, covering 51 metropolitan areas and nine rural areas.—http://www.nyu.edu/about/news-publications/news/2013/08/06/nyucn-researchers-kovner-and-budin-find-high-levels-of-physician-verbal-abuse-are-closely-associated-with-more-negative-work-environments.html Accessed 10/21/2013.
CELIAC DIAGNOSES ON THE RISE
Researchers analyzed data on a small but representative sample of people living in Olmsted County, Minnesota, and found that between the years 2000 and 2010, the number of new cases of celiac disease increased from about 11 people per 100,000 to about 17 per 100,000. “We're finding a lot more celiac disease,” said Dr. Joseph Murray, the study's senior author from the Mayo Clinic in Rochester, Minnesota.
For 1% of Americans, the immune system reacts to gluten, a protein found in wheat, barley, and rye. Consuming foods with gluten damages the small intestine and keeps it from absorbing nutrients. Previous studies have noted an increase in the condition over time, but few studies looked at the number of new cases being diagnosed in recent years.
During the study, 249 people were diagnosed with celiac disease in Olmsted County over 10 years; 63% of the new cases were women.
This increased incidence may come from more awareness of the signs and symptoms of celiac disease and increased screening of those at risk. Murray suggested that patients consult a physician if they have a family history of celiac disease, or are experiencing common symptoms—including iron deficiency, weakness, tiredness, diarrhea, passing gas, and weight loss.—http://www.reuters.com/article/2013/03/29/us-celiac-study-idUSBRE92S0F920130329 Accessed 10/14/2013.
A note from the physician has new meaning with the development of a patient communication tool called Dear Doctor (DD). This bedside notepad was developed at the University of Michigan Health System. The notepad includes space for questions in three categories: diagnostic and treatment, tests and procedures, and medications. There also is a miscellaneous question option.
From July 2009 through September 2009, 65% of the inpatients who received a DD notepad took notes regarding their hospital stay, compared with 22% of patients who did not receive a notepad. Of patients who used the DD notepads, 99% asked questions, 82% kept track of tests and procedures, and 54% reported their family and friends also used the notepad.
Patients who used the DD notepad had their questions answered by their physician more often than the control patients. Although an intention-to-treat analysis found no difference in overall communication ratings between the intervention and control groups, all patients who used the DD notepads reported that communication with their physicians improved, according to the study.—http://www.beckershospitalreview.com/quality/how-a-simple-notepad-enhances-patient-centered-care.html Accessed 10/14/2014.
UNFORCED RHYTHMS OF GRACE
I love my job as the director of NCF Student Ministries, but last spring I was approaching burn-out. It had been a great year of ministry with nursing students, but I knew I needed a break. My sabbatical in May arrived just in time!
Throughout the summer God reminded me of his amazing invitation to rest. These words of Jesus were particularly fitting: “Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you'll recover your life. I'll show you how to take a real rest. Walk with me and work with me—watch how I do it. Learn the unforced rhythms of grace” (Matthew 11:28-30, The Message).
I am tempted each day to focus only on all I need to do in my work, but I need to remember what I learned in my sabbatical. Now I consciously ask the question, “What does it look like to walk through the day with Jesus?”
I encourage you to reflect on this question as well. What does it look like for you to walk through the day with Jesus?—Renee Lick, NCF Student Ministries Director, http://ncfnurses.wordpress.com/ Accessed 10/21/2013.
—PulseBeats compiled by Cathy Walker, JCN Associate Editor