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Analysis of Ohio Advanced Practice Registered Nurses' Rate of Prescribing Naltrexone for Patients With Alcohol Use Disorder Since Elimination of the X-Waiver. 分析俄亥俄州高级执业注册护士自取消 X-Waiver 以来为酒精使用障碍患者开具纳曲酮处方的比例。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-08-18 DOI: 10.1177/10783903241271273
Morgan Wiggins, Amy Smith, Nathan Helsabeck

Background: Alcohol use disorder (AUD) is common and deadly. Naltrexone is a treatment for AUD. Previous research examined factors that predict Ohio Advanced Practice Registered Nurses' (APRNs) utilization of naltrexone to treat AUD. Inclusion criteria included APRNs' endorsing receipt of the X-waiver, a designation indicating providers' receipt of substance use disorder education. In 2023, the X-waiver was eliminated. The purpose of this study was to replicate the previous research design in respondents without an X-waiver and compare findings.

Aims: The aims of this study were three-fold: (1) assess whether race, age, practice setting, years in practice, or work experience with an addiction specialist physician predicted prescription of naltrexone for AUD, (2) assess whether the goal of abstinence or reduced alcohol use as desired treatment affected the likelihood of naltrexone prescription for AUD, and (3) compare differences between the answers in the current respondent group without X-waiver and the previous study's X-waivered respondents.

Method: All Ohio APRNs were sent surveys. Eighty-eight responses were included in analysis. Descriptive statistics, logistic regression, and chi-square results were reported.

Results: Work experience with an addiction specialist physician was negatively associated with prescribing naltrexone for AUD. Respondents from the previous study of X-waivered APRNs were significantly more likely to prescribe naltrexone for reduced alcohol consumption as a treatment outcome than the respondents in this study.

Conclusion: The recent policy change eliminating the X-waiver provides important context for research, adding to the substance use disorder literature.

背景:酒精使用障碍(AUD)是一种常见的致命疾病。纳曲酮是一种治疗 AUD 的药物。之前的研究考察了俄亥俄州高级执业注册护士(APRNs)使用纳曲酮治疗 AUD 的预测因素。纳入标准包括高级执业注册护士认可接受 X 豁免,这是一种表明医疗服务提供者接受过药物使用障碍教育的称号。2023 年,X-豁免被取消。本研究的目的是在没有 X-豁免的受访者中复制之前的研究设计,并比较研究结果。目的:本研究的目的有三:(1)评估种族、年龄、执业环境、执业年限或与成瘾专科医生合作的工作经验是否会影响纳曲酮治疗 AUD 的处方;(2)评估禁欲或减少饮酒作为理想治疗目标是否会影响纳曲酮治疗 AUD 的处方;(3)比较目前未获得 X 豁免的受访者群体与之前研究中获得 X 豁免的受访者的答案之间的差异:方法:向俄亥俄州的所有 APRN 发送了调查问卷。分析中包括 88 份答复。报告了描述性统计、逻辑回归和卡方结果:与成瘾专科医师的工作经历与为 AUD 开纳曲酮处方呈负相关。与本研究中的受访者相比,上一项针对 X-waivered APRNs 的研究中的受访者更倾向于开具纳曲酮以减少酒精消耗量作为治疗结果:最近取消 X 豁免的政策变化为研究提供了重要背景,为药物使用障碍文献增添了新的内容。
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引用次数: 0
An Empowerment-Based Intervention for Chinese Immigrant Women Experiencing Intimate Partner Violence: Feasibility and Acceptability. 针对遭遇亲密伴侣暴力的中国移民妇女的赋权干预:可行性和可接受性。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-08-18 DOI: 10.1177/10783903241268206
Yang Li, Tina Bloom, Linda F C Bullock, Hyekyun Rhee

Background: Intimate partner violence (IPV) is a significant public health concern, particularly in vulnerable populations such as Chinese immigrant women.

Aim: This study aimed to assess the feasibility and acceptability of an empowerment-based intervention integrated with relaxation and self-compassion techniques for Chinese immigrant women experiencing IPV.

Methods: The present study was a part of a pilot randomized controlled trial (RCT). A total of 50 Chinese immigrant women who had experienced IPV in the past year were recruited online and randomized to either the intervention or the control group. The intervention group engaged in seven weekly sessions delivered with a phone call and a mobile application. Quantitative and qualitative data were collected through surveys and interviews to evaluate intervention adherence, participants' perceptions, and areas for improvement.

Results: 64% of the participants completed each weekly session, demonstrating favorable intervention adherence. The intervention was perceived to be helpful by most participants, with reported decreases in stress, anxiety, fatigue, pain, and family conflicts, and with reported improvements in emotion regulation and self-compassion. However, technical issues with the mobile platform and lack of personalization were identified as limitations.

Conclusion: This study demonstrates the feasibility and acceptability of the intervention for Chinese immigrant women experiencing IPV and warrants a full-scale RCT to determine its efficacy. It will be essential to personalize the intervention and reduce any barriers to participation.

背景:亲密伴侣暴力(IPV)是一个重大的公共卫生问题,尤其是在中国移民妇女等弱势群体中。目的:本研究旨在评估一种以赋权为基础、结合放松和自我同情技巧的干预措施对遭受 IPV 的中国移民妇女的可行性和可接受性:本研究是随机对照试验(RCT)的一部分。本研究是随机对照试验(RCT)的一部分。研究人员在网上招募了 50 名在过去一年中遭受过 IPV 的中国移民妇女,并将她们随机分为干预组和对照组。干预组每周通过电话和移动应用程序进行七次治疗。通过调查和访谈收集定量和定性数据,以评估干预措施的坚持情况、参与者的看法以及需要改进的地方:结果:64%的参与者完成了每周的课程,显示出了良好的干预依从性。大多数参与者认为干预很有帮助,压力、焦虑、疲劳、疼痛和家庭冲突有所减少,情绪调节和自我同情有所改善。然而,移动平台的技术问题和缺乏个性化被认为是限制因素:本研究证明了针对遭遇 IPV 的中国移民妇女进行干预的可行性和可接受性,因此有必要进行全面的 RCT 研究以确定其有效性。将干预措施个性化并减少参与障碍至关重要。
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引用次数: 0
Cyberbullying and Bullying Reports Among Youth in a Behavioral Health Inpatient Unit: Insights From Youth and Parent Intake Surveys. 行为健康住院部青少年中的网络欺凌和欺凌报告:从青少年和家长入院调查中获得的启示。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-07-28 DOI: 10.1177/10783903241265888
Michelle Drouin, Kelley Kardys, Mindy Flanagan, Jessica Pater, Connie Kerrigan

BACKGROUND: Limited studies have examined the extent to which cyberbullying and offline bullying are factors related to youth admissions to behavioral health inpatient units. However, considering the rising use of technology and prevalence of youth bullying, intake procedures require adaptation to account for modern-day psychological pressures facing youth. AIMS: Our aims were to pilot and analyze results from a novel intake form, assessing offline bullying and cyberbullying, in a youth inpatient behavioral health facility. METHODS: Upon admission at an inpatient behavioral health facility in the Midwestern United States, 622 youth (ages 10 and older) and their parent/guardian completed intake forms including questions about their experience of bullying, cyberbullying, and feelings of safety in different environments, and feelings about whether bullying contributed to their inpatient admission. RESULTS: Overall, 21.50% (134/622) of youth self-reported being a cybervictim, 6.10% (38/622) reported being an offline bully victim, and 8.04% (50/622) reported mixed bullying. Bullied youth felt significantly less safe in all environments than non-bullied youth, and bullied youth who felt unsafe were more likely to attribute their hospitalization to bullying. Troublingly, only about one-third of parents were aware of cyberbullying. CONCLUSION: Using traditional standards of care that do not address offline bullying/cyberbullying, mental health care workers may be missing critical factors that contribute to youth inpatient hospitalization for mental health issues. Behavioral health units should consider adapting intake forms to include offline bullying/cyberbullying questions and developing programming for parents and adults to address issues of online and offline safety.

背景:有关网络欺凌和线下欺凌在多大程度上与青少年入住行为健康住院病房相关的研究十分有限。然而,考虑到技术使用的不断增加和青少年欺凌现象的普遍存在,需要对入院程序进行调整,以适应现代青少年所面临的心理压力。目的:我们的目的是在一家青少年行为健康住院机构试用一种新的入院表格并分析其结果,该表格用于评估离线欺凌和网络欺凌。方法:622 名青少年(10 岁及以上)和他们的父母/监护人在美国中西部一家住院行为健康机构入院时填写了入院登记表,其中包括有关他们在不同环境中遭受欺凌、网络欺凌和安全感的问题,以及对欺凌是否导致他们入院的感受。结果:总体而言,21.50%(134/622)的青少年自称是网络受害者,6.10%(38/622)自称是线下欺凌受害者,8.04%(50/622)自称是混合欺凌受害者。与未受欺凌的青少年相比,受欺凌的青少年在所有环境中的安全感都明显较差,而感到不安全的受欺凌青少年更有可能将其住院治疗归咎于欺凌行为。令人担忧的是,只有约三分之一的家长了解网络欺凌。结论:由于传统的护理标准并不涉及离线欺凌/网络欺凌,因此心理健康护理人员可能会忽略导致青少年因心理健康问题住院的关键因素。行为健康科室应考虑调整入院表格,加入离线欺凌/网络欺凌问题,并为家长和成年人制定方案,以解决在线和离线安全问题。
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引用次数: 0
Investigation of Posttraumatic Stress and Depression Symptoms in Children Who Experienced the Kahramanmaraş Earthquake. 卡赫拉曼马拉什地震儿童创伤后压力和抑郁症状调查
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-07-27 DOI: 10.1177/10783903241257631
Mehmet Emin Düken, Sibel Küçükoğlu, Fethiye Kiliçaslan

Background: Trauma is important in the etiology of many problems including childhood anxiety, somatization, hostility and sleep disturbance.

Aims: This research was conducted to examine the posttraumatic stress and depression symptoms of children who experienced the Kahramanmaraş earthquakes in Türkiye.

Methods: The research, designed as a descriptive and relational type, was conducted with 636 children in the 10 to 18 age group who experienced the earthquake. Data were obtained through the Child Information Form, the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI), and the Depression Inventory for Children.

Results: According to the scale scores, 100% of the children had depression symptoms, while 23% had severe trauma and 77% had very severe posttraumatic stress symptoms. It was revealed that children's posttraumatic stress reactions explained 71% of their depression (p < .001). It has been determined that the most important triggers affecting children's posttraumatic stress reactions are being trapped under debris and the problems they experience in reaching shelter and assistance (B: -3.706; B: -1.547; B: 3.969).

Conclusions: It was determined that there was a strong relationship between posttraumatic stress reactions and depression symptoms of children who experienced the earthquake. It has been observed that the experiences of children during and after the earthquake can have an impact on their trauma situations.

背景:目的:本研究旨在调查土耳其卡赫拉曼马拉什(Kahramanmaraş)地震灾后儿童的创伤后压力和抑郁症状:本研究为描述性和关系型研究,对象为经历过地震的 10 至 18 岁年龄组的 636 名儿童。数据通过儿童信息表、儿童创伤后应激障碍反应指数(CPTSD-RI)和儿童抑郁量表获得:根据量表评分,100% 的儿童有抑郁症状,23% 的儿童有严重创伤,77% 的儿童有非常严重的创伤后应激症状。结果显示,儿童的创伤后应激反应占其抑郁症的 71%(P < .001)。经确定,影响儿童创伤后应激反应的最重要诱因是被困在废墟下以及他们在获得庇护和援助时遇到的问题(B:-3.706;B:-1.547;B:3.969):结论:可以确定,经历过地震的儿童的创伤后应激反应和抑郁症状之间存在密切关系。据观察,儿童在地震中和地震后的经历会对其创伤状况产生影响。
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引用次数: 0
Gaining Recovery in Addiction for Community Elders (GRACE) Project: The Impact of Age-Specific Care on Clinical Outcomes and Health Care Resource Utilization in Older Adults With Substance Use Disorder in an Interprofessional Addiction Clinic. 社区老年人戒毒项目(GRACE):在跨专业成瘾诊所中,特定年龄护理对患有药物使用障碍的老年人的临床结果和医疗资源利用的影响。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-07-24 DOI: 10.1177/10783903241261694
Kathleen A Schachman, Catherine A Macomber, Matthew L Mitchell, Jill M Brown, Jennifer L Scott, Rachel L Darr, Mindy A Fabbro, William R Morrone, Kari A Peckham, Trisha K Charbonneau-Ivey

Background: The prevalence of substance use disorders (SUDs) in older adults has been increasing, necessitating tailored and effective addiction care for this aging demographic.

Aims: The purpose of this study was to assess the impact of age-specific, interprofessional addiction care on clinical outcomes and health care resource utilization in older adults with SUD.

Methods: This quasi-experimental study directly compares patients enrolled in the Gaining Recovery in Addiction for Community Elders (GRACE) Project, an interprofessional age-specific addictions treatment program, with age-matched older adults who received conventional "treatment as usual" (TAU). Through retrospective comparative analysis, substance use outcomes, mental and physical health improvements, and inappropriate use of emergency services were examined among 78 older adults with SUD.

Results: Clinical outcomes and health care resource utilization were superior for older adults who received age-specific addictions care through the GRACE Project, as compared to mixed-age conventional "TAU." GRACE patients had improved treatment adherence, fewer relapses, and longer treatment engagement. While both groups exhibited significant reductions in depression and anxiety scores, GRACE patients showed greater improvements. This group demonstrated superior control of both hypertension and diabetes. Importantly, they had fewer inappropriate emergency department visits and avoidable hospitalizations than conventional "TAU."

Conclusions: Addiction treatment delivered by an interprofessional team to meet the unique strengths and needs of older adults has the potential to improve treatment adherence and more favorable long-term outcomes in substance use, mental health, and chronic medical conditions. Nurses are poised to lead interprofessional teams to meet the growing demand for specialized addiction treatment and integrated care for older adults.

背景:目的:本研究旨在评估针对特定年龄段的跨专业成瘾治疗对患有药物滥用性障碍(SUD)的老年人的临床结果和医疗资源利用率的影响:这项准实验性研究将参加 "社区老年人戒毒项目"(GRACE)的患者与接受传统 "常规治疗"(TAU)的年龄相匹配的老年人进行直接比较。通过回顾性比较分析,研究了 78 名患有药物滥用成瘾症的老年人的药物使用结果、身心健康改善情况以及急诊服务的不当使用情况:结果:与混合年龄的传统 "TAU "相比,通过 GRACE 项目接受特定年龄成瘾治疗的老年人的临床治疗效果和医疗资源利用率更高。GRACE患者的治疗依从性更好,复发率更低,参与治疗的时间更长。虽然两组患者的抑郁和焦虑评分都有明显降低,但 GRACE 患者的改善幅度更大。该组患者对高血压和糖尿病的控制效果更佳。重要的是,与传统的 "TAU "相比,他们的不当急诊就诊次数和可避免的住院次数更少:由跨专业团队提供的戒毒治疗可满足老年人的独特优势和需求,有可能提高治疗的依从性,并在药物使用、心理健康和慢性疾病方面取得更有利的长期疗效。护士可以领导跨专业团队,满足老年人对专业成瘾治疗和综合护理日益增长的需求。
{"title":"Gaining Recovery in Addiction for Community Elders (GRACE) Project: The Impact of Age-Specific Care on Clinical Outcomes and Health Care Resource Utilization in Older Adults With Substance Use Disorder in an Interprofessional Addiction Clinic.","authors":"Kathleen A Schachman, Catherine A Macomber, Matthew L Mitchell, Jill M Brown, Jennifer L Scott, Rachel L Darr, Mindy A Fabbro, William R Morrone, Kari A Peckham, Trisha K Charbonneau-Ivey","doi":"10.1177/10783903241261694","DOIUrl":"https://doi.org/10.1177/10783903241261694","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of substance use disorders (SUDs) in older adults has been increasing, necessitating tailored and effective addiction care for this aging demographic.</p><p><strong>Aims: </strong>The purpose of this study was to assess the impact of age-specific, interprofessional addiction care on clinical outcomes and health care resource utilization in older adults with SUD.</p><p><strong>Methods: </strong>This quasi-experimental study directly compares patients enrolled in the Gaining Recovery in Addiction for Community Elders (GRACE) Project, an interprofessional age-specific addictions treatment program, with age-matched older adults who received conventional \"treatment as usual\" (TAU). Through retrospective comparative analysis, substance use outcomes, mental and physical health improvements, and inappropriate use of emergency services were examined among 78 older adults with SUD.</p><p><strong>Results: </strong>Clinical outcomes and health care resource utilization were superior for older adults who received age-specific addictions care through the GRACE Project, as compared to mixed-age conventional \"TAU.\" GRACE patients had improved treatment adherence, fewer relapses, and longer treatment engagement. While both groups exhibited significant reductions in depression and anxiety scores, GRACE patients showed greater improvements. This group demonstrated superior control of both hypertension and diabetes. Importantly, they had fewer inappropriate emergency department visits and avoidable hospitalizations than conventional \"TAU.\"</p><p><strong>Conclusions: </strong>Addiction treatment delivered by an interprofessional team to meet the unique strengths and needs of older adults has the potential to improve treatment adherence and more favorable long-term outcomes in substance use, mental health, and chronic medical conditions. Nurses are poised to lead interprofessional teams to meet the growing demand for specialized addiction treatment and integrated care for older adults.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903241261694"},"PeriodicalIF":1.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Association Between Proneness to Smartphone Addiction and Social Anxiety Among School Students and the Mediating Role of Social Support: A Call to Advance Jordanian Adolescents' Mental Health. 在校学生智能手机成瘾与社交焦虑之间的关联以及社会支持的中介作用:促进约旦青少年心理健康的呼吁》。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-07-23 DOI: 10.1177/10783903241261047
Abdallah Abu Khait, Austin Menger, Nijmeh Al-Atiyyat, Shaher H Hamaideh, Hanan Al-Modallal, Harshita Rayapureddy

Background: Social anxiety is an emerging public health issue associated with significant impairment of social functioning during adolescence. Among many determinants of social anxiety, proneness to smartphone addiction may significantly contribute to the development of social anxiety. To cope with the consequential development of social anxiety, adolescent school students may rely on various forms of social support. Particularly in the Middle East, including Jordan, the relationship between proneness to smartphone addiction and adolescent social anxiety is understudied.

Aim: To examine the mediating role of social support in the relationship between proneness to smartphone addiction and social anxiety in a sample of adolescent school students.

Methods: In this cross-sectional study, 432 adolescents were recruited via a random cluster sample from public schools across three provinces in Jordan. The data were collected face-to-face using the Social Anxiety Scale for Adolescents, the Smartphone Addiction Proneness Scale, and the Multidimensional Scale of Perceived Social Support.

Results: Significantly higher levels of social anxiety were associated with females of lower economic status who reported more gaming hours and higher levels of proneness to smartphone addiction. Familial social support significantly mediated the relationship between proneness to smartphone addiction and social anxiety, controlling for the other covariates in the social anxiety model.

Conclusions: Familial social support reduced the impact of proneness to smartphone addiction on social anxiety. Nurses may supplement treatment for reducing social anxiety in adolescents suffering from proneness to smartphone addiction by fostering sources of familial social support.

背景:社交焦虑是一个新出现的公共健康问题,与青少年时期社交功能的严重受损有关。在社交焦虑的众多决定因素中,智能手机成瘾可能会在很大程度上导致社交焦虑的发展。为了应对由此产生的社交焦虑,青少年学生可能会依赖各种形式的社会支持。特别是在包括约旦在内的中东地区,智能手机成瘾倾向与青少年社交焦虑之间的关系还未得到充分研究。目的:以青少年学生为样本,研究社交支持在智能手机成瘾倾向与社交焦虑之间关系中的中介作用:在这项横断面研究中,我们从约旦三个省的公立学校中随机分组抽取了 432 名青少年。采用青少年社交焦虑量表、智能手机成瘾倾向量表和感知社会支持多维量表面对面收集数据:经济地位较低的女性的社交焦虑水平明显较高,她们报告的游戏时间更长,智能手机成瘾倾向更高。在控制了社会焦虑模型中的其他协变量后,家庭社会支持对智能手机成瘾倾向与社会焦虑之间的关系起到了明显的中介作用:结论:家庭社会支持降低了智能手机成瘾对社交焦虑的影响。护士可以通过促进家庭社会支持的来源来辅助治疗,以减轻智能手机成瘾青少年的社交焦虑。
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引用次数: 0
The RANA Model Revisited: How a Primary Nursing Model for Professional Psychiatric Nursing Practice Has Withstood the Test of Time. 重温 RANA 模式:精神科专业护理实践的初级护理模式如何经受住了时间的考验。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-07-01 Epub Date: 2023-04-08 DOI: 10.1177/10783903231166669
Stacey M Meyers, Patricia Roberts, Maureen Slade

Objective: This article revisits the responsible, accountable nurse with authority (RANA) model and its continued application to psychiatric-mental health nursing care nearly 30 years after its development. It will ascertain key elements of the model that remain in use today, while identifying parts of the model that have transformed over the years.

Methods: This article will also explore the theoretical underpinnings of the model, including Peplau's interpersonal relations theory. The impact of the primary nursing and relationship-based care models that influenced the RANA role will also be explored.

Results: Specific examples of how the RANA model has affected unit outcomes will be identified, such as improved patient safety measures and satisfaction with care.

Conclusions: The nurse-patient relationship and therapeutic alliance is fundamental to the RANA model and directly affects patient outcomes.

目的:本文重新审视了负责任的责任护士(RANA)模式,以及该模式在发展近 30 年后在精神心理健康护理中的持续应用。文章将确定该模式中至今仍在使用的关键要素,同时找出该模式中多年来发生变化的部分:本文还将探讨该模式的理论基础,包括佩普劳的人际关系理论。方法:本文还将探讨该模式的理论基础,包括佩普劳的人际关系理论,以及影响 RANA 角色的初级护理和基于关系的护理模式的影响:结果:将举例说明 RANA 模式如何影响科室成果,如改善患者安全措施和护理满意度:结论:护患关系和治疗联盟是 RANA 模式的基础,直接影响患者的治疗效果。
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引用次数: 0
Alcohol Withdrawal Assessment Tool (AWAT) Reliability and Validity: Implications for Nurses Caring for Inpatients With Mental Health Disorders. 酒精戒断评估工具(AWAT)的可靠性和有效性:对护理精神疾病住院患者的护士的启示。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-07-01 Epub Date: 2023-06-30 DOI: 10.1177/10783903231183910
Carmen R Davis, Alyson Keen, Lauren Compton, Tiffany Rader, Rachel Harbison, Renee Twibell

Background: Alcohol use affects 14.5 million Americans and high prevalence of use and potential for withdrawal among hospitalized patients presents a challenge for health care professionals to anticipate and manage effectively. Due to the acuity and fast-paced nature of the hospital environment, nurses need assessment tools that can be readily completed and drive efficient protocol-based treatment. The purpose of this study was to examine psychometric properties of the alcohol withdrawal assessment tool (AWAT).

Aims: The aims were to examine AWAT (1) reliability, (2) validity, and (3) usability.

Methods: Patients (n = 55) and nurses (n = 47) were recruited from six hospitals within one health care system in the Midwest. Psychometric testing included inter-rater reliability and criterion-related validity testing, using the Clinical Institute Withdrawal Assessment of Alcohol Scale-Revised (CIWA-Ar) as a comparison. Usability was assessed with a 5-item Likert-type scale.

Results: Findings supported strong agreement (ICC: .931) between raters on the AWAT and a moderate correlation (Pearson r: .548) between scores on the AWAT and CIWA-Ar. Nurses agreed/strongly agreed that the AWAT took 2 min or less to complete (n = 42; 89%), was easy to use for assessment (n = 42; 89%) was easy to learn (n = 40; 85%), and they were confident using the AWAT (n = 39; 83%).

Conclusions: Study findings provide evidence of reliability, validity, and usability of the AWAT in the hospital setting. The AWAT has potential to improve assessment efficiency and nurses caring for inpatients with mental health disorders should consider implementing the tool into practice.

背景:有 1450 万美国人酗酒,住院病人中酗酒和潜在戒酒的高发率给医护人员预测和有效管理带来了挑战。由于医院环境的急迫性和快节奏,护士们需要能随时完成评估的工具,以推动基于方案的高效治疗。本研究旨在检查酒精戒断评估工具(AWAT)的心理测量特性:方法:从美国中西部一个医疗保健系统内的六家医院招募患者(55 人)和护士(47 人)。心理测试包括评分者之间的信度和标准相关的效度测试,使用临床研究所酒精戒断评估量表-修订版(CIWA-Ar)作为对比。可用性采用 5 项李克特量表进行评估:结果:研究结果表明,AWAT 的评分者之间具有很高的一致性(ICC:.931),AWAT 和 CIWA-Ar 的评分之间具有中等相关性(Pearson r:.548)。护士们同意/非常同意 AWAT 只需 2 分钟或更短时间即可完成(n = 42;89%),易于用于评估(n = 42;89%),易于学习(n = 40;85%),并且她们对使用 AWAT 充满信心(n = 39;83%):研究结果证明了 AWAT 在医院环境中的可靠性、有效性和可用性。AWAT具有提高评估效率的潜力,护理住院精神障碍患者的护士应考虑在实践中使用该工具。
{"title":"Alcohol Withdrawal Assessment Tool (AWAT) Reliability and Validity: Implications for Nurses Caring for Inpatients With Mental Health Disorders.","authors":"Carmen R Davis, Alyson Keen, Lauren Compton, Tiffany Rader, Rachel Harbison, Renee Twibell","doi":"10.1177/10783903231183910","DOIUrl":"10.1177/10783903231183910","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use affects 14.5 million Americans and high prevalence of use and potential for withdrawal among hospitalized patients presents a challenge for health care professionals to anticipate and manage effectively. Due to the acuity and fast-paced nature of the hospital environment, nurses need assessment tools that can be readily completed and drive efficient protocol-based treatment. The purpose of this study was to examine psychometric properties of the alcohol withdrawal assessment tool (AWAT).</p><p><strong>Aims: </strong>The aims were to examine AWAT (1) reliability, (2) validity, and (3) usability.</p><p><strong>Methods: </strong>Patients (<i>n</i> = 55) and nurses (<i>n</i> = 47) were recruited from six hospitals within one health care system in the Midwest. Psychometric testing included inter-rater reliability and criterion-related validity testing, using the Clinical Institute Withdrawal Assessment of Alcohol Scale-Revised (CIWA-Ar) as a comparison. Usability was assessed with a 5-item Likert-type scale.</p><p><strong>Results: </strong>Findings supported strong agreement (ICC: .931) between raters on the AWAT and a moderate correlation (Pearson <i>r</i>: .548) between scores on the AWAT and CIWA-Ar. Nurses agreed/strongly agreed that the AWAT took 2 min or less to complete (<i>n</i> = 42; 89%), was easy to use for assessment (<i>n</i> = 42; 89%) was easy to learn (<i>n</i> = 40; 85%), and they were confident using the AWAT (<i>n</i> = 39; 83%).</p><p><strong>Conclusions: </strong>Study findings provide evidence of reliability, validity, and usability of the AWAT in the hospital setting. The AWAT has potential to improve assessment efficiency and nurses caring for inpatients with mental health disorders should consider implementing the tool into practice.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"757-764"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9698335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Updates to American Psychiatric Nurses Association: Seclusion and Restraint Position Statement and Standards of Practice. 美国精神科护士协会更新:隔离与约束立场声明和实践标准》。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-07-01 Epub Date: 2023-06-29 DOI: 10.1177/10783903231184200
Evelyn Perkins, Ellen W Blair, Diane E Allen, Lincoln Akre Teal, Pamela E Marcus, Jennifer L Fordmeir

Objective: The purpose of this discussion paper is to summarize the 2022 updates to the American Psychiatric Nurses Association's (APNA) Seclusion and Restraint Position Statement and Seclusion and Restraint Standards of Practice.

Method: Both documents were the work of the APNA 2022 Seclusion and Restraint Task Force that consisted of APNA nurses with expertise in the use of Seclusion and Restraint, who practice across a wide range of clinical settings.

Results: The 2022 Updates to the APNA Position Statement and Standards were guided by evidence-based information found in the review of seclusion and restraint literature and clinical expertise from the 2022 Seclusion and Restraint Task Force.

Conclusions: Updates were evidence-based and in line with APNA's core values and initiatives in diversity, equity, and inclusion.

目的:本讨论文件旨在总结美国精神科护士协会(APNA)《2022 年隔离与约束立场声明》和《2022 年隔离与约束实践标准》的更新内容:这两份文件都是APNA 2022年隔离与约束工作组的工作成果,该工作组由APNA在使用隔离与约束方面具有专长的护士组成,他们在广泛的临床环境中开展工作:结果:APNA立场声明和标准的2022年更新版以隔离与约束文献综述中发现的循证信息和2022年隔离与约束工作组的临床专业知识为指导:结论:更新内容以证据为基础,符合 APNA 的核心价值观以及多样性、公平性和包容性方面的倡议。
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引用次数: 0
Longitudinal Outcomes of Resilience, Quality of Life, and Community Integration in Treatment-Resistant Depression: A Two-Group Matched Controlled Trial. 耐治性抑郁症患者的恢复力、生活质量和社区整合的纵向结果:一项两组匹配的对照试验。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-07-01 Epub Date: 2023-10-30 DOI: 10.1177/10783903231204881
Chia-Yi Wu, Ming-Been Lee, Pham Thi Thu Huong, I-Ming Chen, Hsi-Chung Chen, Min-Hsien Hsieh

Background: Current evidence of nonpharmacological intervention for patients with treatment-resistant depression (TRD) is lacking. AIMS: To examine whether an 8-week nurse-led cognitive-behavioral based group intervention would enhance resilient coping and life quality among community-based patients with TRD.

Method: The participants were randomly sampled from a cohort of TRD recruited from two general teaching hospitals. The two groups were assessed with multiple outcome measures at baseline (T0); 8-week post-baseline (T1); and at 3, 6, and 9 months after T1 (T2-4). Psychoeducation was nested in the cognitive behavioral group intervention to facilitate discussion.

Results: Of the 23 participants (mean age 56 years, 69.6% female) in the experimental group, higher resilient coping and lower mental distress levels at T1 as well as later improved quality of life and community integration at T2-4 were observed compared to the controls across COVID-19 (T3). Overall, the scores of resilience and community integration were higher throughout the four follow-up points of observations for the experimental group.

Conclusion: The findings indicated that an 8-week nurse-led cognitive-behavioral based group intervention may enhance the TRD patients' resilient coping and mental distress levels while providing the potentials for community reintegration after mental health psychoeducation engagement. It is imperative for the nurses caring for patients with TRD to extend from clinical-based intervention to community-based self-care approach, with the importance of short-term stress management and healthy lifestyle development highlighted during the community reintegration trajectory.

背景:目前缺乏对难治性抑郁症(TRD)患者进行非药物干预的证据。目的:研究为期8周的护士主导的基于认知行为的小组干预是否能提高社区TRD患者的弹性应对能力和生活质量。方法:参与者从两家综合教学医院招募的TRD队列中随机抽取。两组在基线(T0)时采用多项结果测量进行评估;基线后8周(T1);以及T1后3、6和9个月(T2-4)。心理教育嵌套在认知行为组干预中,以便于讨论。结果:在实验组的23名参与者(平均年龄56岁,69.6%为女性)中,与新冠肺炎(T3)的对照组相比,观察到在T1时更高的应对能力和更低的精神痛苦水平,以及后来在T2-4时生活质量和社区融合的改善。总体而言,在实验组的四个后续观察点中,复原力和社区融合的得分更高。结论:研究结果表明,为期8周的护士主导的基于认知行为的小组干预可以提高TRD患者的弹性应对和精神痛苦水平,同时为参与心理健康心理教育后重返社区提供潜力。护理TRD患者的护士必须从基于临床的干预扩展到基于社区的自我护理方法,在重新融入社区的过程中强调短期压力管理和健康生活方式发展的重要性。
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Journal of the American Psychiatric Nurses Association
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