Journal of Addictions Nursing最新文献

Abstract: The purpose of this study was to explore the determinants of self-reported smoking cessation among out-of-school Korean adolescents who participated in a counselor-visiting smoking cessation program. This retrospective descriptive study analyzed data from the Korea Health Promotion Institute. Participants were enrolled between June 1, 2015, and December 31, 2017, at a regional smoking cessation center in a counselor-visiting smoking cessation program for out-of-school adolescents. Participants consisted of 807 adolescents (70.3% male) with a mean age of 16.9 ± 1.2 years. Multiple logistic regression analysis showed that female gender (OR = 1.54-1.92), cohort year 2016 (OR = 1.69-1.90), smoking more than half a pack a day (OR = 0.44-0.50), strong motivation to quit (OR = 1.44), and number of counseling in person (OR = 1.97-2.10) were statistically significant independent contributors to quitting, based on follow-up assessments at 4 weeks, 12 weeks, and 6 months. This study explored smoking cessation outcomes of a government-driven smoking cessation program that targeted out-of-school adolescents and identified several risk factors that affect a successful outcome. More research is necessary to evaluate the efficacy of such smoking cessation programs for marginalized or understudied populations.

Abstract: Trauma exposure is prevalent in the general population, but healthcare workers may be at greater risks for additional work-related trauma. Trauma is a known risk factor for substance use, particularly tobacco and risky alcohol use. Few studies have examined the relationship between trauma and substance use in healthcare workers. Among healthcare workers, the aims of our study were to examine (a) frequency of current tobacco use and risky alcohol use, (b) frequency and types of traumatic experiences, and (c) the associations between trauma experiences and current tobacco and risky alcohol use controlling for demographic factors. This study is a secondary analysis of cross-sectional survey data from healthcare workers (N = 850) in an academic medical center. Demographic and work-related variables, trauma experience, and substance use were examined. Multivariate logistic regression analysis examined associations between trauma exposure and tobacco and risky alcohol use controlling for demographic and work-related variables. Nearly 75% of respondents reported at least one lifetime traumatic experience, and one in 10 reported tobacco and risky alcohol use. When controlling for demographic and work-related variables, a dose-response relationship was observed such that the higher the number of traumatic experiences, there was a greater likelihood of reporting tobacco or risky alcohol use. Because healthcare providers have additional work-related trauma risk above the public, and greater trauma is associated with increased risk for substance use, it is important to screen for trauma and provide appropriate treatment resources to healthcare providers. Future research is needed to better delineate the relationship between specific traumas and risky substance use among healthcare providers.

Background: Family caregivers are an essential resource for individuals with opioid use disorder (OUD). Overburdened caregivers often experience detrimental effects to their emotional and physical well-being.

Method: A cross-sectional, nonexperimental, correlational study was used to identify correlates and predictors of burden and resilience in caregivers of care recipients with OUD. Pearson product-moment correlation and multiple regression analysis were used to explore the relationships between caregiver characteristics, care recipient characteristics, the caregiver-care-recipient dyad characteristics, and burden and resilience among caregivers of individuals with OUD and to determine the best predictive model. Participants ( N = 152) completed the study using an online electronic survey.

Results: The standardized regression coefficients indicated that supervision of care recipient behavioral problems (β = .29), dyadic interaction (β = .29), caregiver stress (β = .28), and care recipient opioid use (β = .12) were the strongest predictors of caregiver burden, whereas caregiver mental health (β = -.31) and physical health (β = .30) were the strongest predictors of caregiver resilience.

Conclusions: Caregiver and care recipient characteristics, and their dyadic interaction, directly influence the degree of burden and resilience reported by family caregivers. Caregivers experiencing increased stress who are tasked with supervising problematic care recipient behaviors are more likely to experience higher levels of burden. In contrast, caregivers with good physical and mental health and adequate resources showed higher levels of resilience.

Purpose: The opioid crisis has contributed to the mortality, morbidity, and rising healthcare costs in the United States. Buprenorphine (BUP) is an effective medication for opioid use disorder. The aims of this quality assurance evaluation of a BUP program were to (a) evaluate the clinic's performance in illicit opioid abstinence and (b) identify patient risk and resilience characteristics to improve patient success in recovery with BUP.

Methods: A retrospective chart review of open (n = 35) and closed (n = 21) cases and a cross-sectional survey in open cases were completed. Adults (aged ≥18 years) who completed 6 months of BUP treatment at a psychiatric clinic were included. Clinical performance was measured with percentages of opioid-negative urine and completed monthly urine drug tests (UDTs) for the first 6 months. Open cases were surveyed regarding risk and resilience characteristics (frequency of opioid cravings and triggers, therapy participation, and coping skills). Descriptive statistics, t test, and chi-square test were used to analyze data.

Results: Average opioid-negative urine was significantly higher in open cases than closed cases (88.57% vs. 74.82%; t = 2.885, p = .004). There was no significant association between open cases (61.4%) and closed cases (73.8%) in completed monthly UDT. Opening and closing of cases stabilized with mandatory monthly UDT. Most individuals reported therapy participation, minimal opioid cravings, and use of distraction to cope with chronic-pain-induced cravings.

Conclusions/implications: This clinic met benchmarks leading to improved substance recovery. Recommendations include regular evaluations of UDT, cravings, and chronic pain; therapy participation; and continuous quality assurance activities.

Abstract: The American Society for Pain Management Nursing and the International Nurses Society on Addictions hold the position that persons with co-occurring pain and substance use disorder have the right to be treated with dignity and respect and receive evidence-based, high-quality assessment and management for both conditions using an integrated, holistic, multidimensional approach. Nonopioid and nonpharmacological approaches to pain management are recommended. Opioids should not be withheld from anyone if necessary to treat pain, and a team-based approach, including pain and addiction specialists, should be utilized when possible. Pain management should include interventions aimed at minimizing the risk for relapse or escalation of problematic substance use and actively involve the person and their support persons in the plan of care. Institutions should establish policies and procedures that support this position statement.

Background: The Attitudes Scale on Alcohol, Alcoholism, and Persons with alcohol use disorders ("Escala de Atitudes Frente ao Álcool, ao Alcoolismo e ao Persons with alcohol use disorders" [EAFAA]) is an instrument designed to measure attitudes toward alcohol, alcoholism, and persons with alcohol use disorders. It has been validated in Portuguese and Spanish.

Objective: The purpose of this study was to examine the psychometric properties and factor structure of the American English version of the EAFAA (EAFAA-AEV).

Methods: One hundred eighty-seven participants (nurses = 101 and nursing students = 86) completed the EAFAA-AEV.

Results: Confirmatory factor analysis resulted in a four-factor solution, supporting the original factor structure of the EAFAA. The scale has shown good internal consistency and reliability for the four factors. The total scale had a Cronbach's alpha of .85 and a McDonald's omega of .87.

Conclusion: The EAFAA-AEV has similarly strong psychometric properties as the original version, suggesting that it is a reliable tool to identify attitudes toward alcohol and related issues among American-English-speaking nurses and nursing students.

Background: Dignity is a complex concept necessary for the adequate treatment of patients in the healthcare setting. Autonomy, self-sufficiency, respect, and equality are concepts used to define dignity. Dignity has not been studied in people who inject drugs (PWID).

Objective: This study aimed to determine how PWID maintain or have their dignity threatened during hospitalization in an acute care unit.

Design: The qualitative descriptive study was a deductive thematic analysis of secondary data on PWID experiences with received nursing care. In-depth, semistructured interviews were conducted and transcribed verbatim with a constant comparison method for thematic analysis using NVivo. A priori codes of dignity concepts from the literature and dignity scales were used as a guide to examine the nine qualitative transcripts.

Findings: The three most common threats to dignity during hospitalization were lack of equality compared with other patients, not feeling valued as an individual, and not feeling respected by the healthcare workers providing care. The three most common protectors of dignity were feeling respected by healthcare workers, having autonomy in treatment choices, and feeling valued as an individual.

Conclusions: Protecting dignity significantly affects whether PWID are willing to seek healthcare in the hospital setting. Preserving dignity in PWID during their hospitalizations can encourage this population to seek care earlier. Nurses must be experienced in caring for PWID and provide nonjudgmental care for this population.

Abstract: Telemedicine has been effective at bridging the gap between patients, providers, and health systems. As part of a large, academic medical center in Baltimore, MD, it has been found that using digital tools, particularly when access to care is otherwise limited, is beneficial to supporting recovery. However, there are barriers to telemedicine surrounding patient privacy and increased tendency of patients to avoid treatment. Maintaining personalized, evidence-based clinical care while limiting the spread of CoVID-19 has required swift adaptation from healthcare providers. The intent of this article is to discuss provider perspectives of benefits and barriers to telemedicine for substance use disorder treatment during the CoVID-19 pandemic.