Journal of addictions nursing最新文献

Background: Using quality improvement (QI) methods, we sought to improve the inpatient screening of opioid withdrawal symptoms using the Clinical Opioid Withdrawal Scale (COWS), an industry validated instrument that is not widely used in the inpatient setting. By educating nurses and providers on the clinical manifestations of opioid withdrawal and implementing an evidence-based Opioid Withdrawal Screening Pathway, we sought to improve outcomes for those at risk for opioid withdrawal during hospitalization.

Methods: The pre-post test design using Plan-Do-Study-Act cycles involved two implementation phases. Phase I consisted of a 2-week formal education program for nurses and providers, including topics such as opioid use disorder, opioid withdrawal symptoms, COWS, opioid withdrawal treatment options, and criteria for consultation with the Inpatient Pain Management Team. Phase II involved a 12-week implementation of the Opioid Withdrawal Screening Pathway using COWS assessments and QI chart audits of pathway compliance data.

Results: Screening of illicit drug use rates were low, yet significantly increased during the QI pilot. Education completion rates were high. Discharge against medical advice rates and average length of stay were significantly reduced. Transfers to a higher level of care did not involve illicit opioid use and were not significant for two units. The incidence of workplace violence events was equal between baseline and implementation data.

Conclusions: Through the implementation of an education program and screening pathway, the health care organization improved its screening rates of illicit opioid use and number of COWS assessments.

Background: E-cigarette use among youth in the United States has become a public health epidemic. Adults who regularly interact with youth-such as coaches, mentors, counselors, trainers, and caregivers-can significantly influence youth perceptions and behaviors related to e-cigarette use, either positively or negatively.

Purpose: The study purpose was to examine the effectiveness of a nurse-led educational presentation among youth-serving adults about e-cigarette products and their negative health effects through knowledge assessment.

Methods: A 30-minute educational session was delivered using adapted materials from the Stanford REACH Lab's You & Me, Together Vape-Free curriculum within their Tobacco Prevention Toolkit. Participants (N = 24) completed a 20-question knowledge assessment before and after the presentation.

Results: A paired t test revealed a statistically significant improvement in knowledge scores from preintervention (mean = 13.9, SD = 1.8) to postintervention (mean = 17.1, SD = 1), t(22) = 7.9, p < .001. Participants demonstrated an average increase of 3.21 correct responses (16.1%).

Conclusions: The nurse-led educational presentation significantly improved participants' understanding of e-cigarettes and their harmful effects. By equipping youth-serving adults with accurate information, this approach supports informed conversations that may prevent youth e-cigarette use. School nurses are well positioned to lead such efforts, with national organizations endorsing their role in tobacco prevention. Further research is needed to assess long-term knowledge retention and behavioral outcomes.

Background: Drug overdose deaths have been drastically rising in the past decade. Healthcare providers need to continuously innovate practices to provide historically underserved patients with access to harm reduction. The purpose of this study is to identify previously implemented take-home naloxone (THN) interventions to review outcomes and implementation strategies across different organizations in the United States. This review provides guidance to assist in developing, shaping, and evaluating benchmarks for other emergency departments (EDs).

Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this systematic review was conducted using PubMed, CINAHL Ultimate, and PsycInfo. This study used a two-concept search strategy with naloxone and ED subject headings to identify peer-reviewed articles with primary data from an ED-based THN intervention. The data were extracted using a tool developed by the author and comprised of three main categories: sample, components, and delivery.

Results: After screening for inclusion, a total of 10 articles were retained in the final sample. Studies varied by administration credibility based on the delivery of the overdose education and the degree of follow-up after discharge. While each study delivered naloxone, the programs across all sites packaged several different intervention components into the THN.

Conclusions: Study implementers should be aware of the cost, technological, and political feasibility of each component of the program. Specifically, funding has consistently been listed as a barrier to implementation. It is recommended that study teams become interdisciplinary and include voices from multiple departments within the healthcare system, as well as in partnership with local community organizations.

Background: Due to the diversity of self-help smoking cessation programs, the effects of those programs on smoking and the factors involved in their efficacy remain unclear, with contradictory results.

Purpose: The purpose of this review was to systematically analyze literature from 2000 to 2023 to evaluate the effectiveness of various self-help smoking cessation programs including a follow-up at 6 months postintervention and to identify if any specific type of material proved to be more effective than others.

Methods: Using the Preferred Reporting Items for Systematic Review and Meta-Analyses method, 17 studies were included in this review.

Results: Results suggest that programs actively involving users are the most effective ones. While technological self-help smoking cessation programs are prevalent, they do not inherently surpass traditional print-based methods in effectiveness. Technology alone does not necessarily enhance smoking cessation outcomes. The findings also highlight specific limitations associated with assessing the effectiveness of interventions: numerous studies primarily compare various intervention types, often lacking a suitable control condition, and frequently involve numerous confounding variables. Additionally, most interventions lack a clearly defined timeline, impeding a precise assessment of real-time effects. Finally, the results raise questions about the duration of protocols: 6 months may not always be adequate to observe the progression of an individual's nicotine addiction.

Conclusions: This study considers the factors involved in the effectiveness of self-help smoking cessation programs, provides insight into the existing limitations of current research and suggests potential avenues for future studies.

Background: Auricular acupressure has been used to treat addiction, but there are few studies on gambling addiction and the mechanism of auricular acupressure.

Materials and methods: This study examined the effects of auricular acupressure on depressive symptoms, gambling withdrawal symptoms, and platelet serotonin s in individuals with gambling disorders. This was a quasi-experimental study. Data were collected between September 2021 and April 2024 at a gambling treatment center in South Korea. A total of 34 people with gambling disorders were assigned to one of the two groups: auricular acupressure and education. The experimental group received auricular acupressure for 6 weeks, and the control group received educational materials.

Results: Depressive symptoms significantly decreased in the experimental group ( t = 2.30, p = .029). Effect size d was 0.79 (95% confidence interval: 0.07-1.47). Auricular acupressure significantly reduced gambling withdrawal symptoms over 6 weeks compared to education for withdrawal symptoms ( F = 5.74, p = .001). The effect size d was 0.77 (95% confidence interval: 0.05-1.44). Serotonin levels also significantly changed (F = 4.48, p = .043).

Conclusions: Auricular acupressure effectively alleviates gambling withdrawal symptoms in individuals with gambling disorders and may also reduce depressive symptoms. Finding regarding serotonin could be used to explain the mechanism of auricular acupressure on symptoms.

Background: Syringe services programs (SSPs) are evidence-based harm reduction programs for persons who inject drugs that offer sterile injection equipment and linkages to care including substance use disorder (SUD), medical, and mental health care. Integrating an SSP into a primary care setting may increase engagement and reduce stigma.

Objectives: We sought to describe the purpose, preimplementation, and implementation steps of a primary care-based SSP. We report on the facilitators and barriers in implementation, along with early clinical outcomes.

Methods: We identified the need to establish an SSP within a primary care setting and its purpose through stakeholder input. We formed a project facilitation group to execute early implementation and examine facilitators and barriers throughout development.

Results: Barriers to implementation included legal implications of the SSP and facility restrictions on harm reduction supplies. Utilizing specific facilitators, such as collaboration with stakeholders, facility leadership, and community and national resources, aided in overcoming such barriers. Additional facilitators included creating a nurse- and pharmacist-driven workflow to allow patient walk-ins, triage appropriately, and increase accessibility. The primary care SSP had 18 persons who inject drugs from July 2022 to March 2023. In addition to receiving comprehensive harm reduction services, patients utilized primary care visits, wound care, referrals to specialty care, and SUD medication management within the same visit.

Conclusions: Through the implementation of a primary care-based SSP, patients accessed harm reduction resources and SUD, medical, and mental health care services. Our SSP provides a model for other primary care SSPs to be developed in the future.

Objective: This study aimed to examine the role alcohol use and gender played in the association between cognitive function and depressive symptoms among older adults.

Methods: Using the China Health and Retirement Longitudinal Study baseline survey, cognitive function was measured by figure drawing, telephone interview of cognitive status-10, and word recall tests. Depression was measured by Center for Epidemiologic Studies Depression Scale short form. Multiple regression models were conducted separately to examine their associations for males and females among alcohol use groups while controlling for covariates.

Results: Significant negative associations were found between domains of cognitive functioning and depressive symptoms across different alcohol user groups (Bs range: -6.21 to -0.14, p s all <.05). Moreover, the effects were stronger in females compared with males.

Conclusions: Different cognitive components should be prioritized based on older adults' alcohol use when helping them reduce depressive symptoms. Older women warrant additional attention due to their cognitive decline being more pronounced deterioration in depressive symptoms compared with older men.

People who undergo bariatric surgery have a higher risk of alcohol use disorder. This can be explained by a mix of biological and psychosocial factors, with various theories for this suggested. After bariatric surgery, long-term follow-up by healthcare is recommended, focusing mainly on diet. Patient views on the association between alcohol use disorder and bariatric surgery are sparsely studied, as are patient perceptions of care needs. This study aimed to explore perceptions of patients with addiction problems on the associations between bariatric surgery and addiction. A further aim was to explore patients' perceptions on what kind of support would be useful to handle alcohol-related problems in connection with bariatric surgery. Data were collected through semi-structured interviews with 10 individuals seeking treatment at an addiction clinic after bariatric surgery and inductively analyzed using applied thematic analysis. We identified four themes reflecting addiction problems and associations with bariatric surgery and one theme related to unmet care needs. The participants reported heightened vulnerability before surgery in terms of alcohol use and mental well-being. Alcohol problems could develop or worsen after bariatric surgery and were perceived to be associated with both biological and psychosocial aspects. Surgery follow-up did not occur or was not person-centered. Patients wanted supportive talks that encompassed difficulties, for example, alcohol use, related to their bariatric surgery. The results indicate that a holistic approach to alcohol-related problems after bariatric surgery and person-centered care could be beneficial to support patient recovery.