Mind Matters In Promoting Health

Main Category: Public Health
Also Included In: Pain / Anesthetics;  Psychology / Psychiatry
Article Date: 03 Oct 2009 - 2:00 PDT

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Research suggests Hippocrates' holistic view of health and illness was right; mind does matter when it comes to health and healing. Nurse researchers and clinicians at the Johns Hopkins University School of Nursing (JHUSON) and the Johns Hopkins Hospital (JHH) share that view and are working at this mind-body intersection. They are exploring how to prevent the damage excessive stress can do to a young child's development and how the mind can help speed or slow healing and help control pain. And they're helping nurses recognize and recover from their own stress-induced behavioral problems.

Key Ingredient to Growing Healthy Kids under Stress: Active Parenting

JHUSON researcher and professor Deborah Gross, DNSc, RN, FAAN, knows unrelenting stress hurts. For young children, that hurt can last a lifetime. Stress causes excessive secretion of the brain's "fight-flight" hormone, cortisol, that can damage a child's growing body and brain. It's a hurt she's working to help stop. Consistent with a recent Institute of Medicine report, she has found that some behavioral disorders in young people are preventable, particularly if resilience is taught and risk factors for stress are reduced. Among the foremost stressors are factors like poverty and unemployment, community violence and family discord facts of life for millions of children across the country. Through her research, Gross has identified a key protective factor that can help reduce the effects of these stressors: parenting. "Parents are a child's entire world," notes Gross. "If parents are preoccupied, or emotionally or physically absent, their child loses out." When parents don't engage their child early and often, brain development related to language and learning may be slowed. If a child doesn't feel safe and protected, the drive toward exploration and to answer the question "what happens if...?" may be lost.

The quality of parenting suggests one reason why some children thrive in a challenging environment while others succumb to the environmental stresses. Through her research, Gross has been examining the benefits of a parenting training program for at-risk families of young children. The goal: to buttress child resilience by improving parents' communications, engagement and involvement. "Does this kind of prevention program in parenting work for these children? You bet it does," Gross asks and responds, "Particularly in these difficult economic times when more families are at risk, we need to safeguard the development of the skills and abilities of infants and young children. After all, those capacities are the foundation for the rest of their lives."

When Nurses Need to Heal their Hurt

"Nurse Jackie," a new television show character, is a caring, compassionate nurse who's managing a lot of pressure in her life. Unfortunately, she's managing it by popping prescription pain pills, and that's not good for her or her patients. Worries about health, money and family issues can be stressful; when problems like these pile up and don't stop, they hurt. Some people seek help; some suffer silently. Still others, including people like the fictional character Nurse Jackie who care for the lives and health of others, reach for drugs or alcohol as a form of self-medication. That is where The Johns Hopkins Hospital (JHH) Nursing Professional Assistance Committee (NPAC) and its advisor Laura Kress, MAS, RN, enter the picture.

The first program of its kind in the nation dedicated to nurses, NPAC enables nurses in need to work through mental or substance use problems in an environment that protects patient safety and nurse wellbeing. "Our concern for our patients sometimes can outweigh attending to our own health," says Kress. "NPAC helps us take care of ourselves as much as we care for our patients."

PAC's work isn't punitive; it's solution-oriented and confidential. Some nurses seek help directly; others are referred for assistance. NPAC may help a nurse buckling under stress explore better ways to manage the competing demands of job, school, and family a real challenge given rotating nursing shifts.

Alternatively, NPAC may work with supervisors to determine how best a nurse might be able to recover while on the job or how to arrange time off needed for treatment and recovery, including ongoing, time-limited care and monitoring when back on the job. A model of what can be done in hospitals around the country, NPAC recognizes that recovery is possible, that every nurse is a valuable asset to health care, and, in Kress's words, that "nurses can and should be in the business of helping other nurses, too."

Mind Over Matter: Laughter and Faith in Coping and Healing

In "Anatomy of an Illness," Saturday Evening Review editor Norman Cousins described an unusual treatment in his battle against a fatal illness: laughter. To control his pain, he dosed himself with video after video of the Marx Brothers in lieu of medications. Anne Belcher, PhD, RN, FAAN, ANEF, a JHUSON associate professor and director of the school's Office for Teaching Excellence, is sure that Cousins was onto something. As a cancer nurse, she has seen the positive health effects of coping mechanisms such as laughter first hand.

Recognizing the growing research on the role of mood on healing, Belcher emphasizes the importance of nursing at the intersection of body and mind. In her nursing lectures, she prescribes the use of humor in liberal doses with patients, knowing it stimulates the release of endorphins that can help control pain and promote better sleep. Research suggests it also may give the immune system a boost.

Laughter is only one useful coping mechanism; there are others, such as faith, belief, and simple optimism. "I am convinced," she notes, "that how we view life and our control over it affect our ability to navigate what life hands us, including illness and even impending death." To Belcher, individuals who find purpose and meaning in what is happening to them and express it with optimism seem better able to get through treatment and to recover from or to live longer with an illness. "It's all about living with hope. It doesn't matter if it's called faith, a sense of optimism, a positive outlook, or a good laugh. Mind does matter when it comes to health. " To her mind, no one is better positioned than nurses to support a patient's body, mind and spirit. "Our job," Belcher recalls, "is to relieve suffering. So, if laughter or spirituality seems to be helping a patient, I counsel my nursing colleagues to just go for it."

The Johns Hopkins University School of Nursing is a global leader in nursing research, education, and scholarship. The School and its baccalaureate, master's, PhD, and Doctor of Nursing Practice programs are recognized for excellence in educating nurses who set the highest standards for patient care and become innovative national and international leaders. Hopkins is the only nursing school in the country with a baccalaureate Peace Corps Fellows Program and is ranked at the top of the enrollment rankings for colleges and universities that are Peace Corps Fellows/USA partners. Among U.S. nursing schools, the Hopkins community public health nursing master's program is ranked second by U.S. News & World Report; the nursing graduate programs overall are ranked fourth. Each year, the School's nursing research program and faculty achieve placement among the top 10 in nursing schools for securing federal research grants and for scholarly productivity.

Source: Johns Hopkins University School of Nursing

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