I was intrigued by the article title on the cover of the July issue, "Interventions to Promote Physical Activity in Chronically Ill Adults," but surprised by the photo on the article's first page, depicting a bicycle rider not wearing a helmet. This is the equivalent of showing a procedure in which nurses aren't wearing proper protective equipment.
The article is about how to motivate these patients to move and exercise, and it focuses on this point quite specifically. However, safety also needs to be addressed when promoting physical activity to this population. For example, is the woman riding the bicycle on warfarin (Coumadin)? Clopidogrel (Plavix)? Taking an aspirin each day to prevent heart disease? Chronically ill adults who are on anticoagulants have a higher risk of traumatic brain injury and need to heed safety recommendations, particularly in regard to wearing a helmet. Safety instruction and motivational techniques are necessary when caring for these patients, many of whom didn't grow up wearing helmets.
A great follow-up article would describe how to teach chronically ill patients to be safe when being physically active.
Marcia S. Cornell, MSN, RN-BC, EMT-P
Akron, OH