Enhancing community motivation and participation in control of smoking

@#<p style="text-align: justify;">The aim of this study was to develop strategies for enhancing community motivation and participation in smoking control in one municipality, in the North-eastern part of Thailand. The Participatory Action Research (PAR) approach was used whereby the researchers facilitate and empower a community. Community meetings were set up for exchange of experiences and for volunteers who could participate in a counseling training program. These volunteers were screened to promote group motivation, initiate a culturally relevant medium, and to create a network for community organization. Motivation was enhanced by volunteers among three partners: 1) smokers - to become healthier through counseling about information of the harmful effects of smoking and benefits of quitting smoking; 2) families - encouraged household members to assess their health, expenditure, and outcomes if any of their own family members stopped smoking; and 3) communities - raised awareness toward smoking control among housewives, workers, seniors, and adolescent groups, who founded a sense of caring for one another as their cousins, increased the number of free-smoking zones in temples, schools, health centers, ex-smokers' houses and areas for community activities. Lessons were learned by the communities, health problems and high cost of cigarette were the greatest motivation for success, but suffering from smoking withdrawal symptoms attributed to unsuccessful quitting of tobacco. 10 out of the 19 villages continued those activities for 18 months. These villages enhanced community motivation and participation in smoking control; however, decreasing the number of new smokers remains of considerable concern.</p>

Suboptimal Attainment of Cardiovascular Disease Prevention Guideline Goals in Korean Women

PURPOSE: The purposes of this study were to estimate the distribution of three levels of risk for developing coronary heart disease (CHD; low, moderate, and high risk) and to evaluate the attainment of cardiovascular disease prevention guideline goals by the American Heart Association in a nationally representative sample of Korean women. METHODS: This is a secondary data analysis study using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV. The sample was 3,301 Korean women (representing 15,600,514 women) older than 20 years without cardiovascular disease. Distribution of CHD risk and level of goal attainment were calculated using sampling weights and presented in percentages. RESULTS: Among Korean women without established cardiovascular disease, 7.9% were at high risk for CHD, 20.5% were at moderate risk, and 71.6% were at low risk. The proportion of Korean women who did not meet their goals was substantial, and most women at high risk remained unmanaged for their high blood lipids. CONCLUSION: Korean women at risk for developing CHD need to be managed as soon as possible to attain the guideline goals and to lower their risk for future CHD. Aggressive risk reduction efforts are urgently needed to reduce the public burden of CHD in Korean women.

Cardiovascular Risk Factors and 10-year Risk for Coronary Heart Disease in Korean Women

PURPOSE: The purpose of this study is to describe the prevalence of cardiovascular risk factors and to estimate the 10-year risk for coronary heart disease (CHD) in a nationally representative sample of Korean women. METHODS: This is a secondary data analysis using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV. The sample was 2,998 Korean women (weighted n = 14,420,987) aged 20e79 years without cardiovascular disease or diabetes. Prevalence of cardiovascular risk factors was calculated using sampling weights and presented in percentages. Ten-year risk for CHD was estimated with the Framingham Risk Score, and the proportions for three levels of 10-year risk were presented. RESULTS: About 18% of the sample had hypertension, 7.5% are current smoker, 30.0% had total cholesterol > or = 200 mg/dL, 25.7% had low-density lipoprotein cholesterol > or = 130 mg/dL, and 47.3% had high-density lipoprotein cholesterol 20%. CONCLUSION: Modifiable cardiovascular risk factors are highly prevalent in Korean women, and the combination of risk factors is common. Development and implementation of multifaceted nursing interventions are required to confront the current epidemic rise of CHD in Korean women.

Obesity indices and their relationship to cardiovascular risk factors in young adult group

To study the prevalence of obesity and its relationship to cardiovascular disease [CVD] risk factors among young university students. A total of 403 medical students [273 males and 130 females] aged 20.8[ +/- 1.8] years, from Jordan University during 2007. Anthropometric measures and blood chemistry were obtained. Multivariate analysis was carried out between obesity indices: body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHpR], and waist-to-height ratio [WHtR] and CVD risk factors: blood pressure [BP], fasting blood sugar [FBS],and serum lipoproteins. Among the study population, 32.6% of males and 19.2% of females had BMI >/= 25kg/m[2]. Central obesity [WC >/= 102cm, WHpR >/= 0.95, WHtR >/= 0.5]among males wasfound in 4.4%, 4.4%, and 29.7% respectively. Among females, central obesity [WC >/= 88cm, WHpR >/= 0.85, and WHtR >/= 0.5] was observed in 3.8%, 3.8%, and 14.6% respectively. Students above the obesity indices cut-off points had significantly higher values of CVD risk factors. BMI and WC were the most strongly related indices to hypertension for males. On the other hand, WC was related to elevated serum triglycerides level in females. A substantial proportion of a sample of Jordan University students was overweight or obese. Obesity indices were good markers for the presence of hypertension and dyslipidemia in both males and females.Simple anthropometric indices can be used to identify these CVD riskfactors.Larger epidemiological studies are required to confirm these findings. Furthermore, health promotion programs are urgently needed to reduce the CVD risk factors in young university students, and in the general population with similar risk profiles

Delay times and decision making processes in acute myocardial infarction: a qualitative literature review

High morbidity and mortality rates in patients with Acute Myocardial Infarction [AMI] worldwide are usually related to delays in Seeking Medical Care [SMC]. Improper patient's perceptions and decision making processes contributed to this delay. [1] To review the subjective experiences and decision making processes in patients who delayed in reporting AMI symptoms; [2] To review the gender role regarding the decision making process in regards to delays in SMC for AMI. A literature review search was conducted using CINAHL and MEDLINE. The search was limited to full text, peer reviewed, qualitative studies from 2002 to 2009. Patients with AMI symptoms tended to delay in their decisions to SMC. Decision making processes to SMC were influenced by the experienced symptoms. Patients experienced atypical symptoms were more delayers than those experienced the classical symptoms. When patients perceived their symptoms of cardiac origin they seek medical care with shorter delay times than those perceived them of non cardiac origins. The laypersons and context of the event influenced patients' interpreting and responses to these symptoms. Women predromal and atypical symptoms of AMI, and improper responses toward these symptoms contributed to being more delayers than men. It is substantial to raise public awareness to the factors that impact decision making processes in regards to SMC when experiencing AMI symptoms. Further research is needed to understand the phenomenon of delay from an Arabic cultural and ethnic value

Stroke patients' caregivers: their experiences and needs: a qualitative literature review

Home-care for stroke patients contributes to physical, emotional and social difficulties for the caregivers. To explore the experience and needs of stroke patients' caregivers in qualitative research reports. Understanding the experiences of the caregivers from their own subjective perspective is an initial step for nurses in their way to understand caregivers' needs so that to help provide evidence-based care to improve the quality of life for patients and caregivers. Literature review searches were conducted using CINAHL, and MEDLINE. The key search terms were caregiver, stroke, and qualitative. Full text and peer reviewed qualitative studies were evaluated in this paper. The studies were limited to those published between 2000 and 2008. Fatigue, sleep alteration, exhaustion and pain were the most documented physical complaints of caregivers. Worries, anxiety and uncertainty were the hallmarks of the caregivers' emotional state. Social role changes led caregivers to feelings of social isolation. In general, the caregivers' needs were neglected. They would have liked to access information about the disease, caregiving tasks, and community resources. Quality home management for stroke patients depends on healthy, well prepared and trained caregivers. Nurses play a significant role in carefully listening to their concerns, needs, and positively supporting them throughout their caregiving trajectory