Journal of the American Psychiatric Nurses Association最新文献

INTRODUCTION: Treatment for eating disorders (EDs) after hospitalization requires structured environments such as residential care programs where treatment options such as meal support therapy can help manage the physical and psychological effects of their illness. The residential center for this project follows a multidisciplinary approach that uses cognitive behavior therapy (CBT) as a treatment modality for ED. Structured meal support is an essential part of implementing the center's CBT program. AIM: The project aimed to determine if one-on-one mealtime support training for staff can help increase oral nutrition intake in adolescents with EDs. METHODS: Meal consumption data for five residents of the ED center was used for this project. First, 2 weeks of meal consumption data were collected (210 meals). Then residential center staff were trained on using meal support strategies adapted from the Auckland Eating Disorder Manual. After training the staff and having them implement the strategies with ED clients for a week, another 2 weeks of meal consumption data were collected (210 meals). The preimplementation and postimplementation data were compared to determine if the intervention had an impact on the overall meal intake by residents of the ED center. RESULTS: Before implementing the project, patients completed 122 meals in 2 weeks, representing 58.1% of their meals and after the intervention, patients completed 141 meals representing 67.14% of their meals. CONCLUSION: Project findings show that the use of mealtime support strategies while providing one-on-one support for patients with EDs led to an increase in the overall oral intake.

BackgroundNursing presence is a core relational phenomenon in nursing. It is the process of devoting attention to being with and connecting with another, requisite to providing quality, holistic, person-centered care. Presence has been incorporated in the newly revised scope and standards of nursing, as an intervention. There is a paucity of research on the experience of nurses practicing in mental health settings who employ presence to provide unique, relational care.AimsThe aim of this research is to understand the lived experience of nurses providing nursing care and engaging with presence in the mental health setting.MethodsThe tenets of hermeneutic phenomenology proposed by Heidegger and Gadamer were used to guide this inquiry. Twelve nurses practicing mental health were interviewed on Zoom using a semistructured interview guide and the interview time ranged from 45 min to 1 hr. Data were analyzed using the interpretative phenomenological analysis (IPA) process outlined by Smith et al.ResultsFour themes are identified: A powerful intervention which fuels healing, Building the bridge, Transcending barriers, and Preserving the well.ConclusionsNursing presence is implicated as essential to improving the quality of holistic health care, positively impacting patients and nurses. These findings may influence nursing leaders, educators, and administrators to incorporate nursing presence in nursing curricula, develop policies respecting presence, and alter the culture of the health care environment.

Objective: In 2023, over 20 million individuals in the United States experienced a mental health condition and a co-occurring substance use disorder. As many as 42% of individuals with a mental health condition report past-year illicit drug use, and as many as 6% report past-year opioid use. Given the high rates of psychiatric comorbidity and mortality associated with opioid use disorder, it is imperative that psychiatric mental health nurses not only view opioid use disorder as a brain-based, chronic remitting-relapsing disease but also leverage non-stigmatizing clinical approaches to improve patient outcomes. Harm reduction is a practical and transformative approach that seeks to empower people who use drugs with the choice to live healthy, self-directed, and purpose-filled lives. This article provides an overview of theoretical harm reduction approaches and tangible harm reduction interventions to inform psychiatric mental health nursing practice.

Methods: Relevant literature was reviewed related to harm reduction and its role in psychiatric mental health nursing practice.

Results: Harm reduction as an ethos is discussed, in addition to practical harm reduction strategies such as opioid antagonists for overdose reversal, fentanyl test strips, syringe service programs, and supervised consumption sites. The importance of patient engagement is highlighted as necessary in improving health outcomes among those who use substances.

Conclusions: Given the conclusive evidence that a harm reduction approach and associated interventions are lifesaving, it is the ethical duty of psychiatric mental health nurses to implement and advocate for harm reduction across the healthcare continuum.

BackgroundEarthquakes cause significant psychological and physical trauma in children, especially when leading to amputations, as they disrupt physical, emotional, and social well-being.AimThis study was conducted phenomenologically to explore the experiences of children amputated in the Kahramanmaraş earthquake and their parents/caregivers.MethodThis study was conducted as a phenomenological study with children who were amputated in the Kahramanmaraş earthquake and their parents/caregivers between August and October 2023. The sample of the study consisted of seven children and their parents/caregivers who met the inclusion criteria and volunteered to participate in the study through purposive sampling method. Data were collected through in-depth interviews using an introductory information form and a semistructured interview form developed by the researcher.ResultsIt was found that 57.2% of the children who participated in our study were male and their mean age was 11.25 ± 4.02 years. It was found that all the children's houses were destroyed in the earthquake, they were trapped under the debris, and they experienced losses in their family members and relatives. As a result of data analysis, nine themes were identified as apocalypse, pain, fear, and hopelessness for children and apocalypse, helplessness, pain, anger, and hopelessness for parents/caregivers.Conclusions:This study found that earthquake-affected amputee children perceived the earthquake as an apocalypse, experienced prolonged pain during hospitalization, continued to fear the earthquake, and felt hopeless about the future. The children's parents/caregivers also reported that they perceived the earthquake as an apocalypse, that they felt helpless and hopeless for themselves and the children, and that the children had angry/irritable behavior with pain after the disaster.

Background: Nurses enrolled in certified registered nurse anesthetist programs are taught to be experts in complex pharmaceutical agents, often under high stakes conditions. Such conditions may create maladaptive coping mechanisms, such as substance use. However, exploration of student registered nurse anesthetists' (SRNAs) perceptions of substance use and drug diversion have only been minimally described in the literature.

Aims: The study aims were to (a) investigate SRNAs' ratings of the American Association of Nurse Anesthesiology's (AANA) recommended strategies to reduce drug diversion and (b) analyze qualitative responses to open-ended items related to the use of substances.

Methods: Approximately 400 students responded to an online survey in March 2021. The survey was randomly sent to 3,000 SNRAs who were members of the AANA (return rate of 13%). Descriptive statistics and paired t-tests were calculated to determine differences between strategies viewed as effective and strategies that have been implemented. A descriptive content analysis was conducted to derive themes from four open-ended questions.

Results: For all 11 AANA strategies, the means for effectiveness were significantly higher than means for strategies that were implemented, indicating that strategies were seen as effective, but were not being implemented. The highest scored perceived effectiveness strategy was "Creating a safe environment for prompt reporting." Themes captured a high-pressured, high-stakes educational environment, characterized by rigidity and incivility.

Conclusions: Policies to support a safe environment to encourage students to self-report substance use, an awareness of alternative-to-discipline programs, and reintegration into educational programs should be formulated and implemented by educational institutions.

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.