The Impacts of Exposure to Environmental Risk on Physical and Mental Health in a Small Geographic Community in Houston, TX.

Previous research has shown that communities with low average socioeconomic status (SES) and majority minority populations are more likely to be exposed to industrial buildings, waste facilities, and poor infrastructure compared to white communities with higher average SES. While some studies have demonstrated linkages between exposures to specific environmental contaminates within these communities and negative health outcomes, little research has analyzed the effects of environmental contaminants on the mental and physical health of these populations. A cross-sectional survey collected data from residents of Manchester, a small neighborhood in Houston, TX, that is characterized by industrial sites, unimproved infrastructure, nuisance flooding, and poor air quality. Our study (N = 109) utilized the 12 item Short Form Health Survey version 2 (SF12v2) to assess the general mental and physical health of the community. The community as a whole had reduced physical health scores compared to U.S. national averages. The time residents had lived in the neighborhood was also correlated with a reported reduction in physical health scores (r2 = 0.136; p-value <0.001). The association between time lived in the neighborhood and poorer health scores remained after adjusting for age, race, and gender (coef = -0.27, p-value <0.001). Mental health scores were within national averages and time spent living in the neighborhood did not appear to negatively impact respondent's mental health scores. These findings point to the need for more research to determine the potential for additive physical and mental health impacts in long-term residents in neighborhoods characterized by environmental justice issues.

Género y efectividad de la metodología enfermera en pacientes con insuficiencia cardiaca / Gender and Effectiveness of the Nursing Methodology in Heart Failure Patients / Gênero e efetividade da metodologia enfermeira em pacientes com insuficiência cardíaca

Estudios recientes demostraron que una intervención enfermera de educación sanitaria en la insuficiencia cardiaca (IC) evita descompensaciones. Por otro lado, dado que existen diferencias de género en los patrones de la IC, las intervenciones tendrán también efectos distintos. Objetivos: determinar la existencia de posibles diferencias según el género de los pacientes, en el efecto de una intervención enfermera respecto al autocuidado. Materiales y métodos: se realizó un estudio cuasiexperimental con pacientes atendidos en consulta de IC (129), seleccionados en dos tiempos, primer trimestre año grupo control (62), y segundo trimestre año grupo intervención (67). Todos se evaluaron tres veces: primera consulta, tres y seis meses. Al grupo intervención se aplicó en cada visita una intervención enfermera que consistía en educación terapéutica, control y seguimiento de su IC. Resultados: Inicio: T.A. sistólica hombres 133,90 ± 0,96 (DE 27,77); mujeres 119,64 ± 0,57 (DE 18,72). Cuidador 93 % hombres, 63 % mujeres. Conducta terapéutica 2,07 ± 0,02 (DE 0,20) hombres; 3,04 ± 0,01 (DE 0,31) mujeres. Final: autocuidado -16,00 ± 2,08 (DE 10,99) hombres; -9,68 ± 2,22 (DE 12,92) mujeres. Adherencia terapéutica 1,32 ± 0,35 (DE 1,83) hombres, 2,94 ± 1,87 (DE 10,93) mujeres. Mejoría muy similar de la Nursing Outcomes Classification (NOC) en todos. Conclusiones: en el grupo de estudio participaron más mujeres. Los hombres tuvieron más comorbilidad, consumo de tabaco, alcohol. Inicialmente los hombres presentaban mejor calidad de vida. Después de la intervención mejora el autocuidado en todos los participantes pero el doble en hombres. También mejora adhesión terapéutica en todos, en las mujeres mejora el doble. Todos los pacientes mejoran respecto a la calidad de vida y resultados NOC.

Recent studies show that nurse intervention in health education in Heart Failure (HF) prevents decompensation in Heart Failure (HF). Furthermore, given gender differences in HF patterns, the interventions will also have different effects. Objective: To determine the existence of possible differences in the effects of a nurse's intervention regarding self-care based on the patient's gender. Materials and method: A quasi-experimental study was carried out with HF patients (129). They were selected at two different times: first quarter's control group (62) and second quarter's intervention group (67). They were all assessed three times: first appointment, three and six month check-ups. The intervention group underwent a nurse intervention during each visit, consisting of therapeutic education, control and monitoring of their HF. Results: Beginning: Systolic blood pressure in men 133.90±0.96 (DE 27.77), women 119.64±0.57 (DE18.72). Caregiver 93% male, 63% female. Therapeutic approach 2.07 + 0.02 (DE0.20) men, 3.04+0.01 (DE 0.31) women. Final: self-care -16.00±2.08 (DE10.99) men, -9.68±2.22 (DE12.92) women. Therapeutic adherence 1.32±0.35 (DE1.83) men, 2.94±1.87 (DE10.93) women. Very similar improvements in the NOC of all patients. Conclusions: More women participated in the study than men; [1] the former showed a higher percentage of comorbidity, smoking and alcohol consumption than women and they had an informal caregiver. As to self-care and adherence to treatment, no significant differences were found between genders, while quality of life was better in men. After the intervention, the researchers found that all patients improved in terms of quality of life and NOC (Nursing outcomes classification), as did the self-care and therapeutic adherence of all participants. [2] It is worth noting that men scored twice as high in self-care, while women did so in therapeutic adherence.

Estudos recentes demonstraram que uma intervenção enfermeira de educação sanitária na insuficiência cardíaca (IC) evita descompensações. No entanto, tendo em vista que existem diferenças de gênero nos padrões da IC, as intervenções terão também efeitos diferentes. Objetivo: determinar a existência de possíveis diferenças segundo o gênero dos pacientes, no efeito de uma intervenção enfermeira a respeito do autocuidado. Material e método: realizou-se um estudo quase experimental com pacientes atendidos em consultas de IC (129). Selecionados em dois tempos, primeiro trimestre ano grupo controle (62) e segundo trimestre ano grupo intervenção (67). Todos foram avaliados três vezes, primeira consulta, três e seis meses. Ao grupo de intervenção, foi aplicada, em cada visita, uma intervenção enfermeira que consistia na educação terapêutica, controle e seguimento de sua IC. Resultados: início: TA sistólica homens 133.90±0.96 (DE 27.77), mulheres 119.64±0.57 (DE18.72). Cuidador 93% homens, 63% mulheres. Comportamento terapêutico 2.07 + 0.02 (DE0.20) homens, 3.04+0.01 (DE 0.31) mulheres. Final: autocuidado -16.00±2.08 (DE10.99) homens, -9.68±2.22 (DE12.92) mulheres. Adesão terapêutica 1.32±0.35 (DE1.83) homens, 2.94±1.87 (DE10.93) mulheres. Melhora muito semelhante dos NOC (Nursing Outcomes Classification) em todos. Conclusão: do grupo de estudo, participaram mais mulheres do que homens; contudo, estes últimos tiveram mais comorbidade, consumo de tabaco e de álcool e dispunham de uma cuidadora informal. Com relação ao autocuidado e a adesão ao tratamento, na valoração inicial, não se constatou uma diferença significativa entre ambos os gêneros, enquanto na qualidade de vida, o resultado foi melhor nos homens. Após a intervenção, observou-se que todos os pacientes melhoraram os resultados em qualidade de vida e em Nursing outcomes classification (NOC), bem como no autocuidado e na adesão terapêutica. É relevante destacar que os homens dobraram a pontuação em autocuidado e as mulheres em adesão terapêutica.