Why Do Pregnant Women Smoke?

 “My mother smoked [when she was pregnant] with me and I am fine.”

“I’d rather smoke a cigarette than take a drink of alcohol to relieve stress.”

“So you’re bored, what are you going to do? Sit down and smoke a cigarette.”

“It relaxes me.”

Tobacco use during pregnancy has been associated with many adverse effects, including abruptio placentae, fetal malpresentation, low Apgar scores, stillbirth, and birth defects such as gastroschisis and cleft lip or palate. Most nurses probably see these as no-brainer reasons for women to stop smoking once they become pregnant. Yet a new research study illustrates that the reasons pregnant women might continue to smoke are very individual, and that clinicians are not always skillful in supporting smoking cessation.

In this month’s AJN, researcher Geraldine Rose Britton and colleagues share the results of their qualitative study on the experiences of pregnant smokers and their health care providers. The researchers used a focus group methodology to learn about the smokers’ experiences and to better understand what motivated them to quit or prevented them from doing so.  There were also separate clinician focus groups to explore the approach of the 45 providers (71% RNs, 11% physicians, plus one NP, one nurse manager, four LPNs, and one PA) to pregnant women who smoke.

Not surprisingly, the researchers discovered that the issue is frustrating to both pregnant women and their maternity care providers. Some physicians and nurses felt unprepared to […]

Can Your Fitness Tracker Save Your Life?

Megen Duffy, RN, BSN, CEN, works in hospice case management. She occasionally writes on nursing and digital health topics for AJN.

Fitness trackers and ‘wearables’ are becoming ubiquitous.

Fitness tracker “wearables” have become mainstream, with sales projected to reach $19 billion by 2018. If you don’t have one, many of your patients probably do, particularly this time of year when fitness goals are at the forefront of many New Year’s resolution lists. Wearables can track a lot of things, and people are claiming that they save lives. Are they all that? First, here’s a brief overview of wearables types and their uses.

Popular wearable brands include Fitbit (with 79% of sales), Jawbone, Nike, Apple (Apple Watch is a smart watch that has fitness tracker functionality), Garmin, and Misfit. Prices run from about $50 to as much as you want to spend: an Apple Watch costs from $275 to more than $10,000, depending on the model.

Increased functions. Wearables have far surpassed their pedometer function. They do all count steps, but now they also track sleep and heart rate and have increasingly more bells and whistles. The newer Fitbits and the new watchOS operating system for the Apple Watch even have “breathe” functions, intended to remind the wearer to take a few minutes several times a day and breathe to promote relaxation.

Wearables (including smart watches) now have extra features such as replaceable bands and the ability […]

2017-03-27T09:17:47+00:00 January 12th, 2017|digital health, personal health practices|0 Comments

Metabolic Syndrome: Lifestyle Factors and Prevention

Metabolic syndrome: one-third of U.S. adults.

Cycling Mother and Daughter, Netherlands/via Wikimedia CommonsConversations about health—whether between neighbors or between clinicians and patients—often revolve around weight problems, blood pressure, blood sugar, and cholesterol levels. Taken together, these are the cardiovascular risk factors referred to as metabolic syndrome.

In the United States, more than one-third of all adults have metabolic syndrome. This is an astonishing figure, especially because these risk factors can be modified.

What keeps some who are obese or overweight ‘metabolically healthy’?

In recent years, researchers have learned that some people who are overweight or obese do not demonstrate the other risk factors that are part of metabolic syndrome, and therefore these people have a lower-than-expected risk of cardiovascular disease. In a study reported in this month’s AJN (“Examining the Links Between Lifestyle Factors and Metabolic Syndrome“), a group of Taiwanese nurse researchers set out to learn whether there might be lifestyle factors that keep this subgroup of people “metabolically healthy,” protecting them from the other cardiovascular risk factors that usually come with extra weight.

Lifestyle factors associated with prevention.

Dr. Shu-Hung Chang and colleagues performed community-based physical exams on more than 700 people in northern Taiwan and questioned them about lifestyle factors including smoking, drinking, exercise, and the foods they ate. The researchers found that overweight and obese people who quit smoking, exercised, […]

Remembering a Tough NYC Detective on the 41st Great American Smokeout

Photo of AJN editor-in-chief Shawn Kennedy AJN editor-in-chief Shawn Kennedy

My uncle Joe embodied the persona of the old-time tough NYC Irish detective—he was over six feet tall, had piercing blue eyes and white hair, always wore a tan raincoat, and always had a cigarette in his hand. As a child, my siblings and I were always a little bit afraid of him. That image faded, though, and my last image of him was hunched over, with an oxygen cannula, trying to breathe. All those cigarettes added up, and after a lifetime of smoking, he died from chronic lung disease. This was before the landmark report on smoking and health issued by the U.S. surgeon general in 1964. Tiffany, 35, Louisiana; quit smoking at 34; smoke-free since January 2012. (CDC) Tiffany, 35, Louisiana; quit smoking at 34; smoke-free since January 2012. (CDC)

Today is the 41st annual Great American Smokeout—the day created by the American Cancer Society (ACS) to help encourage smokers to quit smoking. According to the Centers for Disease Control and Prevention (CDC), smoking is the leading cause of preventable death and […]

Nurses, Exercise, Time: Hitting a Nerve

Flickr creative commons/ Richard Masoner Flickr creative commons/ Richard Masoner

Hitting a Nerve. I received several recent emails about an editorial I wrote in the April issue of AJN, in which I discussed nurses’ health practices, including exercise, in conjunction with one of our feature articles, Original Research: An Investigation into the Health-Promoting Lifestyle Practices of RNs.”

The authors found that, for study participants,

physical activity and stress management scores were low for the entire group of RNs.”

Drawing a connection between these findings and recent research by Letvak and colleagues suggesting an association between nurses’ health and job performance, I wrote, “If the nurse caring for you or your loved one is suffering from fatigue and stress, she or he may be more apt to make an error or to sustain a workplace injury.”

Judging from the emails I received, I hit a chord. The writers stressed the difficulty of working full time and, in many cases, caring for a family as well. Often, they said, they had little energy left over for themselves. One writer, though, did say that my editorial was the ‘kick’ she needed to get back to walking! […]