Frances J. Kelley

Living with an implantable cardioverter-defibrillator: a review of the current literature related to psychosocial factors.

Sudden cardiac death (SCD) is responsible for 300,000 deaths annually. Lethal ventricular dysrhythmias account for the majority of SCDs. Implantable cardioverter-defibrillators (ICDs) are the emerging treatment for lethal dysrhythmias. Although reductions in SCD mortality with ICDs are clear, the psychologic and social consequences of these devices reveal a mixed success. Patients with ICDs have high levels of anxiety and depressive symptoms. Conversely, most studies of quality of life in patients with ICDs report that the device is well accepted despite fears of being shocked. The ICD shocks are a unique aspect of treatment and have the potential to cause psychologic distress. Nursing needs to provide care from a holistic perspective. Support groups provide reassurance and allow patients to discuss expectations and fears related to the ICD. Research needs to be conducted to explore the impact of these devices on the lives of patients and their families.

Caught in the Middle: Experiences of Tobacco‐Dependent Nurse Practitioners

Purpose To explore how tobacco‐dependent nurse practitioners (NPs) describe their experiences with health promotion and disease prevention practices with patients who smoke. Data Sources Twelve NPs who completed a graduate level NP program of study participated in face‐to‐face interviews and/or online chat room interviews. Conclusions Participants’ responses revealed three themes relevant to their experience as tobacco‐dependent clinicians with health promotion responsibilities. These themes centered around (a) living as an insider in the world of tobacco addiction, (b) having the outside‐in view of living with a tobacco addiction, and (c) being caught in the middle of a tobacco addiction. Implications for Practice All of the tobacco‐dependent participants described limited smoking‐cessation interventions with their patients. A barrier to implementation of more aggressive interventions, perhaps, is the providers own tobacco addiction. With increasing evidence that tobacco‐dependent health care professionals are not adequately intervening with tobacco‐dependent patients, effective strategies are needed to assist and/or support not only tobaccodependent patients but providers as well.

Health risk behaviors in smoking and non-smoking young women.

Purpose To compare the health, health risk behaviors and stress levels of college female smokers and non‐smokers. Data Sources Forty‐one college women, ages 18–21 years, participated in an interview and completed a health survey and the Derogatis Stress Profile. Conclusions The smokers perceived themselves to be more overweight (Chi square, p= <.001). Smokers used more marijuana (Chi square, p= <.003) and had higher scores on depression {t (39) = 2.29, p= .028}, hostility {t (39) = 2.562, p= .014} and perceived quality of health {t (39) = 2.72, p= .01}. In the interview, smokers identified social situations involving alcohol as the time they would most likely smoke. Smokers did not smoke when ill and all were interested in quitting. The non‐smoking women support smoking cessation for their peers. Implications for Practice College alcohol and substance use prevention and treatment programs should address tobacco cessation. The majority of college women are not smokers and could be resources to encourage smoking cessation among their peers. Smoking cessation at this age has dramatic implications for futurehealth.

Second language learning in a family nurse practitioner and nurse midwifery diversity education project

PurposeTo describe the Clinical Communication Program developed to integrate second language learning (L2), multimedia, Web-based technologies, and the Internet in an advanced practice nursing education program. Data sourcesElectronic recording devices as well as audio, video editing, Web design, and programming software were used as tools for developing L2 scenarios for practice in clinical settings. ConclusionsThe Clinical Communication Program offers opportunities to support both students and faculty members to develop their linguistic and cultural competence skills to serve better their patients, in general, and their students who speak a language other than English, in particular. The program provided 24 h on-demand access for using audio, video, and text exercises via the Internet. Implications for practiceL2 education for healthcare providers includes linguistic (listening, speaking, reading, and writing) experiences as well as cultural competence and practices inside and outside the classroom environment as well as online and offline the Internet realm.