Linda A. Bernhard

Health-promoting behaviors of African American women.

Limited information exists concerning health behaviors of African American women. The purposes of this study were to describe health-promoting lifestyle behaviors among a sample of 187 African American women and to compare finding to other published reports on the Health-Promoting Lifestyle Profile (HPLP) instrument. Subscales with the highest means in this study were interpersonal support and self-actualization. However, when compared to reports of HPLP scores for other groups, total HPLP and subscale scores of women in this study were generally lower. Readability and applicability of the HPLP instrument may affect its validity and reliability in a diverse sample.

Consequences of hysterectomy in the lives of women

A longitudinal study of 63 adult, premenopausal women of low socioeconomic status who underwent hysterectomies is reported. Face-to-face in-depth interviews with the women were conducted on the day before hysterectomy and 4 weeks and 3 months after hysterectomy. After the interview, each woman completed the Derogatis Sexual Functioning Inventory (Derogatis & Melisaratos, 1979). The Responses to Hysterectomy tool was mailed to the women about 2 years after hysterectomy. Before their hysterectomies, most of the women had both positive and negative feelings about the hysterectomy. By 3 months posthysterectomy, most women had fairly positive general and sexual outcomes. However, by 2 years posthysterectomy, there were less positive outcomes. Most women reported at least sometimes having negative symptoms that they associated with their hysterectomy. More research must be conducted to fully understand the experience of hysterectomy in womens lives.

Smoking behavior, dysphoric states and the menstrual cycle: results from single smoking sessions and the natural environment

A 2-way factorial repeated measures design examined the effects of menstrual cycle phase and smoking on: 1) smoking behavior, 2) mood state, 3) nicotine withdrawal symptomatology, and 4) menstrual symptomatology. Female smokers, aged 20-39, were followed for two consecutive menstrual cycles with two data collection sessions per cycle, which were conducted in the Universitys General Clinical Research Center (GCRC). Participants were randomly assigned to order of smoking condition, which included: 1) smoking ad libitum, and 2) 24-hour abstinence prior to data collection. Data were collected in the mid-to-late follicular (MLF) phase (between days 6 through to 11) and the four days prior to menses in late luteal (LL) phase. Participants completed the Profile of Mood States and Menstrual Symptom Severity List and recorded daily cigarette smoking rate in the natural environment during MLF and LL phases. Nicotine boost and carbon monoxide (CO) boost were measured and the Shiffman-Jarvick Tobacco Withdrawal Questionnaire was administered during GCRC data collection sessions. Results indicated that subjects smoked more cigarettes per day during the LL phase and CO boost was greater during MLF. No difference was noted in nicotine boost by condition or phase. No difference in mood state was noted by either condition or phase. Withdrawal symptomatology and craving for cigarettes were increased after 24 hours of abstinence. No difference was noted in menstrual symptoms by condition or phase. Further investigations are still needed to characterize the importance of cycle phase in the design of smoking cessation interventions for women of reproductive age.

Health Symptoms, Self-Care Dyadic Adjustment in Menopausal Women

Objective: To determine the relationships among perceived health, menopausal symptoms, and self-care responses in perimenopausal and postmenopausal women. Design: Descriptive, cross-sectional survey. Setting: A large midwestern city in the United States. Participants: One-hundred-one menopausal women who were over age 40, used no hormones during the previous 6 months, and had an intact uterus. Main Outcome Measures: Four standardized survey instruments. Results: Significant correlations were found between self-rated health and health perceptions (r = .44, p = .0004), self-rated health and total symptoms (r = -.30, p = .0023), self-rated health and worrisome symptoms (r = -.26, p = .0085), health perceptions and worrisome symptoms (r = .30, p = .0195), health perceptions and self-care responses (r = .43, p = .0009), and total symptoms and worrisome symptoms (r = .38, p = .0001). Conclusions: Health is related to menopausal symptoms and self care. Dyadic adjustment is not related to health, menopausal symptoms, or self care. Healthy menopausal women provide self-care and need not automatically be treated for menopause.

Workplace bullying in the OR: Results of a descriptive study.

This study describes the incidence of workplace bullying among perioperative RNs, surgical technologists, and unlicensed perioperative personnel in two academic medical centers. The study sought to determine whether the demographic variables of gender, ethnicity, hospital, years of experience on the unit, years in the profession, and job title predict the experience of workplace bullying; whether a relationship exists between workplace bullying and emotional exhaustion; and whether bullying is associated with perceptions of patient safety in the OR. The cross-sectional design included perioperative nurses, surgical technologists, and unlicensed perioperative personnel (N = 167). Fifty-nine percent of the study participants reported witnessing coworker bullying weekly, and 34% reported at least two bullying acts weekly. Having ones opinion ignored is the most common bullying act, with 28% of respondents experiencing being ignored. Differences in the experience of bullying can be found between hospitals and among ethnicities. Emotional exhaustion also was correlated with bullying. The participants did not perceive bullying as affecting patient safety.

Comparison of Stress and Stress Management Strategies Between Lesbian and Heterosexual Women

Stress is said to be part of life, but stress may be uniquely experienced by different groups of women. We conducted this study to compare the experiences of stress and the methods of stress management used by lesbian and heterosexual women. A convenience sample of 215 (136 lesbian and 79 heterosexual) urban women was used. All women reported generally good mental health; however, more than 80% of the women reported moderate or severe stress. There were more similarities than differences between the groups, but lesbians reported more stress due to sexual identity, being female, and mental problems, and heterosexual women reported more stress due to parents and children. Both groups used a wide range of stress management strategies, although lesbians more frequently used meditation and therapy.

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.

Health care dilemmas for women with serious mental illness.

Women with serious mental illness are a population at risk because of their invisibility. A comprehensive and critical literature review documents the issues and gaps in this aspect of the health care environment for women. A conceptual model outlines the current health-related risks for women with serious mental illness. Use of a feminist perspective challenges the underlying assumptions and opens new arenas for research and practice. The speculative, theoretical context thus created encourages and supports the questioning process that is the precursor to change.

The surgeon's role in wound healing

Fashioning health out of insults to the human body is the surgeon’s principal goal. William S Halsted, the famous chief surgeon at Johns Hopkins Hospital, Baltimore, taught that a major operation is simply a composite of many small details, carefully, attentively, and tediously orchestrated by a surgeon. Each of these details, out of context, may seem minor. In unison, they mean good results or survival, as in the radical neck dissections or pelvic exenterations, the results of which were dismal not long ago. The surgeon’s friends in the process of wound healing are good approximation of tissues, appropriate use of good suture materials, and good vascularity. The enemies are devitalized tissue, tension on suture lines, bleeding, and infection. Putting these basic principles to-

Clinical StudiesHealth Symptoms, Self-Care Dyadic Adjustment in Menopausal Women

Objective: To determine the relationships among perceived health, menopausal symptoms, and self-care responses in perimenopausal and postmenopausal women. Design: Descriptive, cross-sectional survey. Setting: A large midwestern city in the United States. Participants: One-hundred-one menopausal women who were over age 40, used no hormones during the previous 6 months, and had an intact uterus. Main Outcome Measures: Four standardized survey instruments. Results: Significant correlations were found between self-rated health and health perceptions (r = .44, p = .0004), self-rated health and total symptoms (r = -.30, p = .0023), self-rated health and worrisome symptoms (r = -.26, p = .0085), health perceptions and worrisome symptoms (r = .30, p = .0195), health perceptions and self-care responses (r = .43, p = .0009), and total symptoms and worrisome symptoms (r = .38, p = .0001). Conclusions: Health is related to menopausal symptoms and self care. Dyadic adjustment is not related to health, menopausal symptoms, or self care. Healthy menopausal women provide self-care and need not automatically be treated for menopause.