         
|
|
|
|
1st appeared
18
December
2000
Chance to Get Women with Heart Disease to Kick Habit Smoking cessation programs for women hospitalized with heart disease may have lasting effects, according to a UCSF researcher. Not only is the medical event a stimulus to quit smoking, but patients are forced to comply with nonsmoking policies of hospitals. This creates a teachable moment that may lead to long-term abstinence, according to Erika Froelicher, RN, PhD, UCSF professor of physiological nursing and epidemiology and biostatistics. Froelicher’s intervention, which is described in the November/December issue of Heart and Lung, is one of the first to focus on smoking cessation in women recovering from heart disease. The Women’s Initiative for Nonsmoking (WINS) is testing the short and long-term effectiveness of nurse-managed relapse prevention programs for women who are forced to abstain from smoking for 48-72 hours during hospitalizations. "The program has been successfully implemented in more than 140 women and has proven to be feasible and well-accepted by women and their health care providers," said Froelicher. The intervention begins when physicians come to the bedside to strongly urge patients to quit smoking. The next step includes a 45-minute one-to-one counseling session at bedside. Nurse managers offer relapse prevention training and information about weight gain, alcohol use, exercise, stress management, social support, and nicotine replacement therapy (NRT). Nurses monitor progress by telephoning patients at home 2, 7, 21, 28 and 90 days following the initial session. Because the average smoker attempts to quit three times before achieving success, nurses stress urge control methods and how to deal with "slips," or brief relapses. "The program allows women to develop and practice tools that help them avoid smoking in risky situations," said Froelicher. Patients are taught to recognize situations in which they are at high risk to smoke. Risky situations include social situations (when drinking an alcoholic beverage with friends or when someone offers them a cigarette); emotional or negative mood situations (when feeling anxious, depressed or uncomfortable); crutch situations (when needing more energy or wanting to keep slim); self-image situations (when wanting to feel more mature or attractive); time-structuring situations (when feeling bored); and restless situations (when wanting to relax or when waiting for someone or something). Tests for gender differences in smoking cessation have not been a major focus of research. Data for men and women have generally been pooled and sample sizes for women have been too small to draw conclusions, according to Froelicher. However, evidence from other studies has helped WINS researchers tailor the intervention for women. Fear of weight gain is one of the most frequent excuses women use for not quitting, and weight gain is a key relapse trigger, said Froelicher. Up to 75 percent of women report an unwillingness to gain five or more pounds as a result of smoking cessation, and more than half of women younger than 25 and 39 percent of women over 40 state they are unwilling to gain any weight, according to previous research. Study participants are briefed about maintaining a diet low in fat and cholesterol and given lists of low-fat snacks and sweets that can assist them through their early efforts. These lists, and other important smoking cessation information, are taken from the American Heart Association’s Active Partnership for the Health of Your Heart workbook. The workbook is given to patients (along with an audio and video series) during the initial counseling session. Exercise is encouraged as an aid in coping with stress. Study participants are also referred to the stress management section of the workbook and the relaxation audiotape. Women are encouraged to listen to the 15-minute tape daily for the first month after hospital discharge and then as needed. Because women have heart attacks at a later age, they are more likely to be widowed, single or living alone. Therefore, special emphasis is placed on social support provided by the nurse in the hospital and in follow-up telephone calls, said Froelicher. Links: Heart and Lung -- Journal of Acute Critical Care Source: Maureen McInaney, News Services |
||
|
DAYBREAK | ARCHIVES
| CALENDAR
| CAMPUS NOTES Copyright ©2000 Regents
of the University of California. All rights reserved. |
||
