Journal of the American Psychiatric Nurses Association最新文献

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.

Introduction: The lack of mental health supports and resources for psychiatric nurses during the COVID-19 pandemic contributed to stress, burnout, and reduced mental wellness. Simultaneously, the pandemic's safety mitigation measures made significant changes to the inpatient psychiatric population environment making it difficult to maintain a therapeutic milieu and increased mental health challenges among staff and patients.

Aims: This study aimed to identify external and internal resilience factors, mental health support, and resources provided by organizations, and additional mental health support and resources inpatient psychiatric nurses felt would have been beneficial during the pandemic.

Methods: An anonymous web-based survey was administered via American Psychiatric Nurses Association Member Bridge. Notably, 68 respondents represented 23 states across the United States.

Results: Interpersonal peer relationships, self-awareness, self-care, mindfulness, and purpose were identified resilience factors. Free counseling, decompression rooms, pastoral support, self-care discounts, and support groups were top support and resource options. Policies, time-off, personal protective equipment (PPE) availability, counseling and self-care, and appreciation were major themes reflecting what participants thought would have been beneficial. Coping strategies, organizational support, resilience, altruism, and family and peer support were instrumental in psychiatric nurses' survival during the pandemic.

Conclusion: Identifying factors of resilience is key to supporting and protecting the mental health of psychiatric nurses. Organizations can better support their nurses when they understand what mental health support and resource options are perceived as most beneficial by inpatient nurses.

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.

Background: It's estimated that over 50% of patients prescribed antipsychotic medication are nonadherent to the prescribed treatment. Medication nonadherence impedes the patient's safety, leads to relapse, and the need for rehospitalization. Thus bolstering the importance of routine nursing follow-up interventions to improve adherence rates in patients with SMI.

Aims: The purpose of this research is to address the significant impact that medication nonadherence has on patients with SMI and the positive impact that telephonic medication adherence programs have on improving patient outcomes through enhanced medication adherence.

Methods: The literature was examined from the past 5 years (2016-2021) on the use of telephonic follow-up interventions to improve medication adherence in patients with psychiatric disorders and other chronic diseases at risk for mental illness. Databases (PubMed, CINAHL, ProQuest, and the Cochrane Library) were used. The inclusion criteria focused on psychiatric disorders, telephone calls to improve medication adherence, and the use of questionnaires to determine adherence.

Results: The implementation of telephonic follow-up after discharge has proven to be an effective strategy to promote medication adherence in patients with mental illness and to provide additional support (emotional, side effect management, appointment reminders, and activity involvement) to improve the patient's well-being.

Conclusions: Telephonic follow-up is an effective strategy to improve medication adherence in patients with SMI and other chronic diseases as a short-term intervention (less than 24 months). Further research is needed on the benefits of telephonic follow-up as a long-term intervention (beyond 24 months).

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.

Objectives: Individuals with substance use disorders (SUDs) are increasingly admitted in emergency departments (EDs) nationwide. However, ED providers often have limited knowledge about and lack confidence in treating SUDs. This limited knowledge often results in poor treatment outcomes among patients with SUD in the ED setting. The aims of this pilot study were to (a) assess the desirability, applicability, and acceptability of a computer-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) education scenario and (b) examine changes in SUD knowledge scores among ED providers before and after engaging in the computer-based SBIRT education scenario.

Methods: A tailored computer-based education scenario was developed based on the SBIRT framework for ED providers in an academic medical center. Participants (N = 15) evaluated the desirability, applicability, and acceptability of the education tool. Also, a single-group pre-/post-design was used to examine changes in participants' SUD knowledge and proficiency scores.

Results: Participants rated the computer-based SBIRT education scenario as desirable, applicable, and acceptable based on 4.0/5.0 or greater evaluation scores for each component. Overall knowledge scores increased from 3.5 to 3.8, albeit non-significantly. Proficiency score percentages increased by 25%.

Conclusion: Computer-based SBIRT education scenario training may be acceptable by ED providers and may improve proficiency in addressing SUD for patients. Future studies should evaluate this training method with a larger sample size.

Introduction: Research studies have highlighted disparities in diagnosing schizophrenia between Black and White patients, with Black individuals being diagnosed at rates three to five times higher than their White counterparts. Moreover, studies have postulated that a lack of cultural awareness and biases leads to providers' misinterpretation and misdiagnosis of these patients.

Aims: This quality-improvement project aimed (a) to enhance cultural competemility, the synergistic process between cultural humility and cultural competence in health care providers (HCPs) serving Black patients, promoting cultural sensitivity among providers serving all patients; (b) to introduce the Brief Psychiatric Rating Scale (BPRS-24) as a standardized tool for evaluating suspected schizophrenia spectrum disorders and psychotic disorders across all patients; and (c) to reduce the disparities in schizophrenia spectrum disorders and psychosis diagnostic rates across all patients, with a focus on enhancing accuracy for Black patients.

Method: HCPs completed the Inventory for Assessing the Process of Cultural Competemility Among Healthcare Professionals (IAPCC-HCP) before and after training based on Campinha-Bacote's model of cultural competemility (CCM). In addition, they received training in the use of the BPRS-24. After training, HCPs incorporated the BPRS-24 into clinical practice for assessing patients initially diagnosed with schizophrenia spectrum disorders or psychosis.

Results: After introducing the BPRS-24 in clinical practice, it was used in 87.5% of assessments, with improved cultural skills and knowledge among HCPs.

Conclusion: Using the BPRS-24 and cultural competemility training, misdiagnosis was identified in 48.4% of the sample, regardless of race.