Health Care Student Attitudes toward the Prevention of Cardiovascular Disease
McFall, Marsha, Nonneman, Ruth, Rogers, Laura Q., Mukerji, Vaskar, Nursing Education Perspectives
ABSTRACT Enhancing successful counseling for cardiovascular disease prevention remains a challenge for health professionals and nursing and medical educators. To gain insight into the attitudes of health care professional students toward cardiovascular prevention strategies, this study examined the associations among prevention attitudes and health professional student demographics and health habits. Based on a self-administered survey completed by nursing and medical students from two Midwestern institutions, healthier personal lifestyle choices were independently associated with more positive attitudes toward cardiovascular prevention, but demographic factors were not. Educational experiences that encourage reflection on student lifestyles may enhance the counseling abilities of both nurses and physicians.
RESEARCH AND PRACTICE DURING THE PAST DECADE HAVE DEMONSTRATED THE SIGNIFICANT IMPACT OF LIFESTYLE BEHAVIORS ON HEALTH, ESPECIALLY REGARDING THE PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE (KASHANI ET AL., 1992; McPHERSON, SWENSON, PINE, & LEIMER, 2002). The control of risk factors for cardiovascular disease reduces disease incidence and progression. Most Americans are aware of these risks, some of which include uncontrolled high blood pressure, high cholesterol levels, physical inactivity, long-term stress, obesity, smoking, diabetes, and excessive alcohol intake (Dismuke & McClary, 1990; Frisch, Kurtz, & Shamsuddin, 1999; Greenland et al., I988; Greenland & Derby, 1992; Haq et al., 2000; Kashani et al., 1993; Lynn, 2000; Reeve, Adams, & Kouzekanani, 1996; Sherman & Hershman, 1993 ; Steptoe, Doherty, Kendrick, Rink, & Hilton, 1999; Ziglio, Hagard, McMahon, Harvey, & Levin, 2000). Americans also express a need for health care professionals, including physicians and nurses in various settings, to convey information to them regarding healthy lifestyles (Greenland et al.; Greenland & Derby; Steptoe et al.). * Although physicians understand the importance of healthy lifestyle components, many feel that they are unsuccessful in altering client behaviors. Thus, their attitudes toward counseling patients are frequently pessimistic (Greenland et al.; Sherman & Hershman, 1993). Furthermore, physician attitudes and personal habits are strongly associated with patient counseling outcomes (Greenland et al.; Greenland & Derby, 1992) and have the potential to inhibit adequate health promotion counseling (Rogers et al., 2006).
Nurses have also been studied with regard to counseling patients from the perspectives of efficacy and their own personal lifestyle habits (Engler, Engler, Davidson, & Slaughter, 1992; Geirsson, Bendtaen, & Spak, 2005; Hoppe & Ogden, 1997; McPherson et al., 2002; Reeve et al., 1996; Sherman & Hershman, 1993; Steptoe et al., 1999; Wilt, Hubbard, & Thomas, 1990). Studies revealed that most nurses understood the connection between personal health and illness. But, as with physicians, they often were not optimistic about the effectiveness of their efforts toward preventive behaviors. Studies assessing the connection between counseling attitudes and smoking (Reeve et al.) or body weight (Hoppe & Ogden) demonstrated that nurses who engaged in the studied addictive behavior were less likely to address it with patients.
Researchers have reported that exposing medical students to the cardiovascular curriculum has led to changes in their attitudes toward their own counseling ability and effectiveness. However, changes have often been modest or difficult to prove statistically (Dismuke & McClary, 1990; Greenland et al., 1988; Greenland & Derby, 1992; Kashani et al., 1992; Rogers et al., 2005; Sherman & Hershman, 1993). Two studies done in the 1990s demonstrated that medical students were able to lower their own personal risks after introduction to pertinent materials and an analysis of their own health (Greenlee, Castle, & Woolley, 1992; Kashani et al. …