Journal of addictions nursing最新文献

Introduction: Buprenorphine, an effective medication for opioid use disorder (MOUD), reduces opioid-related harms including overdose, but a significant gap exists between MOUD need and treatment, especially for marginalized populations. Historically, low MOUD treatment capacity is rising, driven by advanced practice registered nurses (APRNs). A graduate nursing course was designed to increase equitable buprenorphine treatment delivery by APRNs. We report on baseline findings of a curriculum evaluation study with a pretest-posttest design.

Design: Computerized surveys assessed trainee satisfaction with the course, trainee knowledge for providing MOUD, and trainee satisfaction in working with people who use drugs.

Methods: Quantitative survey results utilizing Likert scales are presented.

Results: Baseline precourse surveys revealed less than half (44%) of APRN students agreed/strongly agreed that they had a working knowledge of drugs and drug-related problems and 37% agreed/strongly agreed that they knew enough about the causes of drug problems to carry out their roles when working with people who use drugs. Approximately two thirds of APRN students agreed/strongly agreed that they want to work with people who use drugs (63%), that it is satisfying to work with people who use drugs (66%), and that it is rewarding to work with people who use drugs (63%). Nearly all students reported high satisfaction with the course.

Conclusion: APRN students reported high satisfaction with a novel course grounded in health equity that has potential to reduce health disparities and accelerate the closure of the MOUD treatment gap, particularly for racial/ethnic minorities, rural populations, and transition-age youth.

Abstract: Opioid use disorder (OUD) continues to impact communities worldwide. British Columbia specifically declared a public health emergency in April 2016. It is known that patients with OUD often experience barriers in access to care, including limited knowledge and training among providers, as well as persisting stigma in the medical community. The Doctor of Nursing Practice quality improvement project sought to provide barrier-targeted OUD education while using multiple effective teaching methods, such as test-enhanced learning, to family nurse practitioners (FNPs) working among private primary care clinics to assess the impact on knowledge and attitudes. In review of an experience survey, zero participants had received prior education on OUD (N = 7). The Drug and Drug Problems Perceptions Questionnaire was used to assess attitudes. In review of the data, attitudes before receiving education (Mdn = 74) improved after receiving barrier-targeted education (Mdn = 66), W = 0, p < .05. Knowledge was tested at three time points. After a review of unique identifiers, four participant tests were successfully linked. It was found that knowledge after receiving education (M = 7.75, Mdn = 7.5) improved in comparison with baseline knowledge (M = 6, Mdn = 6) and further improved after a 1-month time frame (M = 8.5, Mdn = 8.5). Although the project was limited by sample size, providing education to FNPs who have not received prior education on OUD, and using modalities such as test-enhanced learning, showed a favorable impact on knowledge and attitudes. In light of the opioid epidemic, nursing leaders must continue to actively engage practicing FNPs and students with OUD education. FNPs are well positioned to be champions in this area and may mobilize teams to overcome barriers among private primary care clinics and increase access to care.

Abstract: The paucity of education and training on alcohol use disorders (AUDs) in nursing curricula is the main predictor of negative attitudes and results in limited knowledge access and delivery of health care for persons experiencing these problems. Although experts advocate increasing the time devoted to alcohol-related content in a crowded curriculum, didactic strategies for teaching about addiction in prequalifying nursing education have been discussed. This study aimed to verify the effectiveness of an educational experience that integrated clinical practicum experience in addiction treatment facilities for nursing students' attitudes. A quasi-experimental one-group study with pre-and-post 3-month follow-ups was carried out with 108 nursing students who answered the Attitudes Scale toward Alcohol, Alcohol Use Disorder, and Patients with Alcohol Use Disorders. The effect of the clinical practicum was apparent, with statistically significant changes to more positive global attitude scores in all measures. Previous educational intervention for AUDs during nursing education was a predictor of positive attitudes (OR = 7.21, p < .04). Students' self-perceived skills and professional preparation to deliver and direct care for patients with AUDs improved after the intervention, suggesting that clinical practice influenced students' skills for AUD identification across nursing practice. Previous contact with this population with lack of training in substance use disorder seems to favor negative attitude development. Clinical practicum experience in addiction treatment facilities improved nursing students' attitudes toward AUDs and patients with AUDs, and its effects were sustained 3 months later.

Abstract: This study aimed to describe sleep disturbances and identify associated factors in adolescent smokers in South Korea. This study adopted a cross-sectional design and recruited 520 students aged 12-17 years from 35 schools to participate in a smoking cessation program. To compare demographic, smoking-related, psychological, and problem behavior characteristics between adolescent smokers with sleep disturbances and without sleep disturbances, chi-square tests and independent t tests were used. Logistic regression analysis was performed to identify the factors associated with sleep disturbances in adolescent smokers. Approximately 45.8% of adolescent smokers reported sleep disturbances. Sleep disturbances were more frequent among girls than among boys and more frequent among high school students than among middle school students. Other factors included cigarette use within 1 month, nicotine dependence, smoking cessation self-efficacy, depression, Internet addiction, and suicidal ideation. Gender (girls), school level (high school), depression, Internet addiction, and daily cigarette use (11 or more cigarettes) were significantly associated with sleep disturbances in adolescent smokers. To improve the sleep quality of adolescent smokers, health professionals should focus on sleep disturbances and associated factors and develop appropriate intervention programs.