AJN in September: Predicting Injurious Falls, Military Sexual Trauma, Recognizing MI, More

AJN0916.Cover.OnlineThe September issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Original Research: Predicting Injurious Falls in the Hospital Setting: Implications for Practice

Despite years of research and increasingly evidence-based practice, falls continue to be the most commonly reported adverse events experienced by hospitalized adults. Yet most of the relevant research has focused on predicting and preventing falls in general; there has been little focus on injurious falls. In an attempt to identify which patient factors are associated with injurious falls in hospitalized adults, the authors of this retrospective study analyzed 10 variables. Their findings may help hospital clinicians to identify at-risk patients and create better fall-related injury prevention interventions.

CE Feature: “Military Sexual Trauma in Male Service Members

The experience of military sexual trauma (MST), which can result from assault, battery, or harassment of a sexual nature, may jeopardize the mental health of service members. This article discusses the unique ways in which men may experience MST and examines how social stereotypes of masculinity, myths surrounding sexual assault, and military culture and structure often influence a man’s interpretation of an attack and his likelihood of reporting the incident or seeking treatment. It also describes current treatments for MST-related mental health conditions and addresses implications for nurses and other health care professionals.

August 26th, 2016|Nursing, nursing perspective|0 Comments

The Elusive Strict Diet

By Amy M. Collins, associate editor

Several days ago, we linked on our Facebook page to an abstract of a JAMA article that found that women hospitalized for myocardial infarction were more likely than men to present without chest pain. A few days later, my 59-year-old mother was told by her general practitioner that her ECG had shown an electric “blip” that could be due to scarring from an unnoticed heart attack. My mother—always too lax about these things (unlike her hypochondriac daughter)—calmly told me she always has random chest pains and it could have happened at any time.

A visit to the cardiologist a few days later eased our fears. She hadn’t had a heart attack, but was diagnosed with right bundle branch block and has to undergo further testing. With high C-reactive protein levels, elevated cholesterol, and a history of heart disease in the family, one can’t be too careful. A stress test and cardiac ultrasound have been ordered.

In discussing her cholesterol level, which had increased since my mother’s last wellness exam, the cardiologist suggested she start taking statins. Not keen on medication, and worried by recent reports of adverse effects from these drugs, she said she’d rather only start with that if there were no other options. His suggestion was to maybe try some over-the-counter products to lower the cholesterol, mentioning that there were products that acted liked sponges to absorb cholesterol, but not offering anything specific.

My mother’s general practitioner followed up by letter, giving her a three-month window to try to bring  the cholesterol levels down by following a “strict diet,” with no further information on what that entails or what she could do to accomplish this. Exercise was not mentioned at all.

Today my mother asked me what she should eat to make her cholesterol go down. (She thinks that, as an editor at AJN, I naturally have all the answers!) Already thin and following a low-fat diet, she says she doesn’t know where to start. She also admitted to consulting WebMD to find out what she could do.

Resorting to searching online for answers, to me, raises a huge red flag that communication between provider and patient had broken down somewhere, or wasn’t sufficient. Surely this can’t be the best answer. A phone call and discussion or at least an information pamphlet seems warranted.

I guess we can’t expect physicians to be nutritionists and personal trainers, but it seems strange and all too familiar that the first line of defense always appears to be medication, without a mention of specific lifestyle changes that are within our control (treating the disease instead of possibly preventing it). […]