Journal of Addictions Nursing最新文献

Abstract: Vulnerable populations such as those with substance use disorders (SUDs) are at a higher risk for early morbidities and mortalities yet are less likely to receive primary care and other necessary psychosocial services essential for comprehensive care of these clients. This need has been magnified by the COVID-19 pandemic. Evidence supports an increase in alcohol sales in 2020, and overdoses from illicit drugs have been reported to have more than doubled by May 2020 from the 2018 and 2019 baseline rates, and one reason for these increases is because of COVID-19. The healthcare system is overwhelmed with the cost of treating and addressing the impact of SUDs. Individuals with SUDs often meet providers who are not sufficiently prepared to address their complex issues that include co-occurring mental and physical health disorders. In addition to changes in practice, nursing education must change their curricular approach to meet the challenges in health services across the life span, and nursing education should include lessons being learned during the COVID-19 pandemic. Nurses must be prepared to recognize and screen individuals for SUDs at the undergraduate level as well as assess and treat individuals with SUDs at the advanced practice level in all areas of healthcare services. SUDs should not continue to be siloed and separated into the psychiatric-mental health nursing course within the nursing curriculum but should be addressed in multiple specialties across the curricula and include health responses in regard to the impact that the COVID-19 pandemic is having on SUDs.

Abstract: Adolescent substance use disorder contributes to negative psychosocial and physical health outcomes. Parents best support their child's treatment and recovery when they are equipped with knowledge and skills; however, barriers hinder parental engagement. Social-media-based groups present an opportunity for parents who may not otherwise seek support. Qualitative data were collected via focus groups to examine the opinions of adolescents, parents, and treatment providers on the potential utility and possible concerns of a Facebook-based parent support group; input constituted the development phase for an online group (PURPOSE). Fifty-eight participants, recruited through adolescent treatment programs, took part in six focus groups: two parent ( n = 18), two adolescent ( n = 21), and two provider ( n = 19) groups. Groups were audio recorded and transcribed, and themes were extracted. Three main themes emerged: (a) traditional support groups and treatment services, (b) PURPOSE intervention content and delivery, and (c) issues related to PURPOSE implementation. Traditional treatment/support groups can be helpful, but participation in them is limited. Emotional support offered by peers is valuable, but parents also need and seek out psychoeducation, parenting skills, and self-care support. PURPOSE could offer easy access to skills and real-time peer support.

Objective: The aim of this study is to determine internet gaming disorder (IGD) prevalence in primary grade students and the associated factors and parents' opinions about their children's gaming habits.

Materials and methods: This cross-sectional study was conducted between April 1, 2019, and June 1, 2019. In this study, 805 children's and parents' forms were analyzed. Participation rate was 94.5%. Data were collected using "Digital Gaming-Children's Form," "Digital Gaming-Parents' Form," and the "Internet Gaming Disorder Scale-Short Form (IGDS9-SF)." Data were analyzed using descriptive statistics and significance tests.

Results: The mean age of the students was 11.24 ± 1.243 years; 42.7% were male. The children's mean IGDS9-SF score was 16.83 ± 6.53. There were only 91 students with a score equal to or above the cutoff point of 36. The mean IGDS9-SF scores varied according to gender, grade level, family environment, and employment status of the father. Analysis of the students' gaming characteristics and mean IGDS9-SF scores showed that their mean IGDS9-SF scores varied depending on computer/phone/tablet gaming status, type of game played, type of connection, mode of connection, frequency of conflicts with parents, and whether families received help to regulate gaming behavior.

Conclusion: It is essential for a family to have information about games and talk to their children about the games they play to provide appropriate supervision. Providing families and children with counseling about digital games, IGD symptoms, and considerations by nurses during home visits can play an important role in preventing IGD.

Background: There is a lack of substance use disorder (SUD) providers in the micropolitan Midwestern state. Individuals who live in rural areas with SUD may have a gap in treatment for their addiction.

Objective: The objective of this quality improvement project was to increase the engagement, participation, and awareness of rural primary care providers in treatment of individuals with SUD.

Methods: This is a quality improvement project that utilized a skip-logic standardized survey to evaluate participants who attended Project ECHO (Extension for Community Healthcare Outcomes) Addiction educational sessions.

Results: Findings included 176 participants over 14 sessions, while reaching primary care providers in 62 clinics over a 7-month period. However, it was found that only half of those participants completed the survey. A variety of topics surrounding SUD were offered. In addition, each session included a case study with feedback provided by the team. Seventy participants (79%) rated "strongly agree" and "agree" to "I will make changes to my practice." Participants provided feedback as to how they would change their practice after an educational session; responses included adapting how naltrexone is prescribed based on the recommendations made during the presentation, update treatment guidelines, screen for adverse childhood experiences, utilize motivational interviewing, feeling more confident in providing medication-assisted treatment for patients, and finally, better able to manage pain in those with SUD.

Conclusion: Project ECHO Addiction is an evidence-based translational quality improvement project that reaches rural primary care providers to help increase awareness, engagement, and networking in treatment of patients with SUD, which in turn improves patient outcomes as they receive treatment in a timely fashion.

Background: Smoking is a serious public health challenge across the world. Fasting in Ramadan requires people to stay away from smoking as well as activities such as eating, drinking, and sexual intercourse. We examined the effect of fasting on cigarette smoking and nicotine addiction during the Ramadan.

Methodology: This study was designed as a descriptive cross-sectional survey. A questionnaire was prepared to determine sociodemographic data and smoking habits of a sample population. The questionnaire was delivered through face-to-face interviews at several family medicine clinics in Turkey, with smokers who fast in Ramadan.

Results: There were 354 persons, of which 278 were male (78.5%), 76 were female (21.5%), and the mean age was 32.92 ± 11.84 years. A significant decrease in cigarette consumption during the Ramadan was reported by 285 (80.5%) smokers ( p < .001). The number of smokers who had difficulty resisting the urge to smoke was less in Ramadan than non-Ramadan periods ( p < .001). Religious sentiments were reported as the most important reason for coping with nicotine abstinence (53.7%). Significantly in 14.7% of the cases, participants stopped smoking during the whole period of Ramadan.

Conclusions: Religious beliefs and willpower were found to be effective in helping people reduce or temporary stop smoking. Fasting may play a significant role in changing smoking behavior. Smoking cessation along with counseling supported by the state, health authorities, and clergy can be useful in the fight against smoking in Ramadan.

Background: Nurses' substance use disorder (SUD) endangers patient safety and decreases nurses' work ability and health. To better understand the methods, treatments, and benefits of the programs used to monitor nurses with SUD and promote their recovery, a systematic review of international research is needed.

Aim: The aim was to gather, evaluate, and summarize empirical research on programs for managing nurses with SUD.

Design: An integrative review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis instructions.

Method: Systematic searches were conducted in the CINAHL, PsycInfo, PubMed, Scopus, and Web of Science databases between 2006 and 2020, complemented with manual searches. Articles were selected based on inclusion, exclusion, and method-specific evaluation criteria. The data were analyzed narratively.

Results: The review identified 12 studies of which nine focused on recovery and monitoring programs for nurses with SUD or other impairment and three concerned training programs for nurse supervisors or worksite monitors. The programs were described in terms of their target groups, goals, and theoretical basis. The programs' methods and benefits were described together with challenges in their implementation.

Conclusion: There has been little research on programs for nurses with SUD, the programs that exist are heterogenous, and the evidence available in this field is weak. Further research and developmental work are needed on preventive and early detection programs as well as rehabilitative programs and programs supporting reentry to workplaces. In addition, programs should not be restricted to nurses and their supervisors; colleagues and work communities should also be involved.

Background: Opioid use disorder (OUD) is a public health crisis, yet most acute care nurses are not educated to deliver evidence-based OUD care. Hospitalization provides a unique opportunity to initiate and coordinate OUD care in people presenting for other medical-surgical reasons. The aim of this quality improvement project was to determine the impact of an educational program on self-reported competencies of medical-surgical nurses caring for people with OUD at a large academic medical center in the Midwestern United States.

Method: Data were collected from two time points using a quality survey examining self-reported nurse competencies related to (a) assessment, (b) intervention, (c) treatment recommendation, (d) resource use, (e) beliefs, and (f) attitudes toward caring for people with OUD.

Results: Nurses surveyed before education (T1G1, N = 123) and, after education, those who received the intervention (T2G2, N = 17) and those who did not (T2G3, N = 65) were included. Resource use subscores increased over time (T1G1: x = 3.83, T2G3: x = 4.07, p = .006). Results from the two measurement points found no difference in mean total scores (T1G1: x = 3.53, T2G3: x = 3.63, p = .09). Comparison of mean total scores of nurses who directly received the educational program with those who did not during the second time point showed no improvement (T2G2: x = 3.52, T2G3: x = 3.63, p = .30).

Conclusions: Education alone was insufficient in improving self-reported competencies of medical-surgical nurses caring for people with OUD. Findings can be used to inform efforts to increase nurse knowledge and understanding of OUD and to decrease negative attitudes, stigma, and discriminatory behaviors perpetuating care.

Abstract: Substance use disorders (SUDs) are often misunderstood as a reflection of an individual's lack of motivation or willpower or as a moral failing. SUDs are complex and require a biopsychosocial lens to understand the phenomenon, particularly treatment failure, which is described as a deficit in patients' willpower/self-regulation or dedication to managing their condition.Recent evidence has implicated inflammatory cytokines such as interleukin 6 (IL-6) in the action of substance use by impairing executive functioning, which is an essential aspect of self-regulatory control. Emerging research indicates that inflammation may also shape social behavior, including social withdrawal and approach, thus having potential implications on health-seeking and health-sustaining behaviors often interpreted as a dedication to managing health conditions.The aim of this two-part biobehavioral synthesis is to (a) examine the scientific evidence of the role of IL-6 in self-regulatory failure, (b) explore IL-6 as a common inflammatory mechanism across SUDs, and (c) investigate the role of IL-6 in social withdrawal and approach to gain an understanding of how this determinant may impact treatment failure.Overall, the evidence supports a new paradigm of treatment failure that stresses the influence of IL-6 on self-regulatory failure by way of dual cognitive processing and the role of IL-6 in shaping social behavior central to health-seeking and health-sustaining behaviors. This discovery will help to minimize stigma and blame. Understanding the role of IL-6 in treatment failure may elucidate novel targets for intervention, improve treatment outcomes, and break the social disconnection cycle often seen in SUDs.

Aim: The aim of this study was to identify whether the harmful use of alcohol is associated with an increased probability of presex drinking in Mexican young women.

Method: This was a study with a predictive design. Multiple logistic regressions were performed in a random sample of 304 young college women (between the ages of 18 and 24 years) from Guanajuato and Tamaulipas, Mexico. Participants completed a sociodemographic data survey and the Alcohol Use Disorders Identification Test questionnaire.

Results: Women with a pattern of harmful use of alcohol were more likely to report drinking before sex (adjusted odds ratio = 4.679, 95% confidence interval [1.619, 13.520], McFadden's pseudo R2 = 25.5%). Further analyses revealed that presex drinking by partners was an even stronger predictor of alcohol use before sexual intercourse in women (adjusted odds ratio = 12.749, 95% confidence interval [4.714, 34.483], McFadden's pseudo R2 = 34.7%).

Conclusions: The findings demand additional nursing studies to corroborate-and to better understand-the relationship between harmful use of alcohol in Mexican women, their partners' drinking behavior, and unhealthy behaviors like drinking before sexual intercourse.