Educational needs and altered eating habits following a total laryngectomy.

PURPOSE/OBJECTIVES: To describe eating-related experiences and informational needs of people following total laryngectomies. DESIGN: Descriptive study. SETTING: Internet-based laryngectomy support group in the United States. SAMPLE: 34 people with a laryngectomy (68% total laryngectomy, 29% with total plus radical neck dissection, and 3% with partial laryngectomy with radical neck dissection): 29 males, 5 females; mean age of 62 years. METHODS: Members of a laryngectomy support group completed a Food Eating Experiences and Diet Questionnaire designed by the investigators. Both quantitative and qualitative data were collected. MAIN RESEARCH VARIABLES: Effect of laryngectomy on food choice, eating habits, and overall enjoyment of eating: perceptions of teaching received from healthcare professionals regarding potential eating difficulties as a result of laryngectomy. FINDINGS: 90% of the participants experienced a change in one or more aspects of eating. The most prominent changes were decreased sense of smell, decreased taste, decreased enjoyment of eating, and an increase in the length of time required to eat meals. Most participants were not satisfied with the information they received from healthcare professionals. Topics requiring emphasis during patient teaching were identified from participants' comments. CONCLUSIONS: Total laryngectomy produced significant changes in factors related to eating that can affect nutritional intake and quality of life. Participants reported that most healthcare providers did not adequately prepare them for potential alterations in eating that can occur following a total laryngectomy. IMPLICATIONS FOR NURSING PRACTICE: Data from this study can be used to raise awareness of incidence and severity of changes in eating that occur after total laryngectomy and to improve patient preparation to cope with these changes.

Exercise training and smoking cessation as the cornerstones of managing claudication.

Based on research, the classic recommendation to prevent progression of lower extremity peripheral arterial disease (PAD) is "start exercising and stop smoking." Unfortunately, a paramount problem for clinicians is motivating targeted individuals to begin and adhere to an exercise regimen and quit smoking. The purpose of this review is to provide the most current information regarding exercise training and smoking cessation. It is hoped that this article will help health care professionals present accurate information to their patients with PAD, address the difficulties in lifestyle change, and intervene effectively.

Continuous handrail support, oxygen uptake, and heart rate in women during submaximal step treadmill exercise.

Past research suggests that continuous handrail support during exercise attenuates physiologic responses to exercise and reduces aerobic benefits; however, this phenomenon has not been systematically studied in women exercising on the step treadmill. The effects of three levels of handrail support (continuous light, continuous very light, or no handrail support) on oxygen uptake and heart rate during step treadmill exercise were examined in 15 healthy women. Measures were obtained during 6 bouts of exercise, 3 bouts at 25 steps/min followed by 3 bouts at 33 steps/min. At both step rates, mean oxygen uptake was significantly reduced during continuous light and continuous very light handrail support as compared with no handrail support, and mean heart rate was significantly reduced during continuous light versus no handrail support. At 25 steps/min only, mean heart rate was significantly reduced during continuous very light versus no handrail support. Findings indicate that women who use even continuous light or continuous very light handrail support attenuate physiologic responses during step treadmill exercise, thereby reducing aerobic requirements and gaining suboptimal benefits from exercise.

Stepping as an exercise modality for improving fitness and function.

This article describes three stepping modes, summarizes research on stepping in healthy adults and patients with peripheral vascular disease, and discusses clinical implications and directions for future research. Stepping exercise has been shown to increase cardiorespiratory fitness in healthy adults and increase physical function in patients with peripheral vascular disease. Although further research is warranted, stepping exercise has potential value as a nursing intervention to correct alterations in physical mobility in selected populations. Stepping is proposed as an alternative exercise strategy; one which adds variety to exercise routines and may enhance long-term exercise adherence.

Step treadmill exercise training and blood pressure reduction in women with mild hypertension.

Stepping as an exercise modality has gained increasing popularity. The step treadmill is an exercise machine which simulates actual stair-climbing. The purpose of this study was to determine the effectiveness of a 16-week supervised aerobic step treadmill exercise training protocol in reducing resting blood pressure in women with unmedicated mild hypertension. During the training protocol, subjects exercised during a self-selected appointment three times a week on the step treadmill, increasing from 20 minutes up to 60 minutes per session, at a target heart rate corresponding to 70-80% heart rate reserve for 16 weeks. Utilizing paired t-test analysis, mean resting systolic blood pressure decreased from 142.2 +/- 9.1 to 132.7 +/- 8.2 mm Hg (p < .01) and mean resting diastolic blood pressure decreased from 93 +/- 4.9 to 87.4 +/- 5.4 mm Hg (p < .01) during the 16-week protocol. Mean maximal oxygen uptake was significantly increased, whereas mean body weight did not change significantly over the 16-week period. Large scale trials are needed to further delineate the effectiveness of stepping as a health care intervention in adults with unmedicated mild hypertension, especially in women.