Journal of addictions nursing最新文献

Abstract: Substance use disorders (SUD) are associated with a two- to fourfold increase in rates of tobacco use. Clients with comorbid SUD and tobacco dependence are more likely to die of tobacco-related causes, and smoking cessation is associated with a reduced risk of returning to substance use. Therefore, smoking cessation care should be an integral part of SUD treatment. However, many organizations do not follow recommendations for integrating tobacco cessation practices into their SUD treatment models. A large residential SUD treatment program in the southeastern United States with a tobacco use rate over 70% implemented a quality improvement project to improve smoking cessation care in preparation for a statewide policy prohibiting tobacco products. The project involved enhanced smoking cessation screening and intervention using the 5As approach and implementing a multiweek smoking cessation course composed of combination nicotine replacement therapy (NRT), counseling, and peer support. The project was implemented in collaboration with state and local tobacco control boards and an academic-practice partnership. Tobacco use counseling rates improved from 31.8% preimplementation to 71.4% postimplementation. The smoking cessation classes had high rates of retention and were associated with nearly 43% of clients quitting tobacco use for at least 7 days during the implementation period and 14% remaining tobacco free 60 days after course completion. The enhanced screening, counseling, and smoking cessation course reduced smoking rates in anticipation of a statewide tobacco ban.

Introduction: In the United States, an estimated 19.7 million people have a substance use disorder (SUD). Treatment protocol is transition into recovery, necessitating physical well-being and social supports. Exercise is an effective treatment for addiction. One modality that posits success on ability to provide an effective workout and a sense community is CrossFit. This study explored experiences of individuals participating in CrossFit within an SUD recovery program.

Methods: This focused ethnography study took place at a recovery center. Inclusion criteria were 18 years of age and older with an SUD and current or former inpatient utilizing CrossFit offered through the center. Twelve participants (N = 12) were recruited. Data collection was through semistructured interviews. A thematic analysis was utilized to understand what CrossFit means to participants. Systematic coding organized data and potential themes were identified. Themes were reviewed and refined through mapping and generation of clear definitions and names.

Results: Seven participants were aged 26-35 years, and five were aged 36-45 years, with 5 women and 7 men. All identified as White and cisgender.Three themes emerged from the data: (a) mental health with physical benefits, (b) commonality and community, and (c) building a foundation for life.

Conclusions: Prior research has demonstrated exercise as an effective treatment for addiction. Ours is the only known study to focus on CrossFit. Future studies might obtain similar findings beyond CrossFit-branded programming. Additionally, longitudinal research related to CrossFit or high-intensity interval training might provide additional evidence in long-term recovery.

Background: About 65 million health care providers worldwide are exposed to trauma. Work-related trauma exposure is associated with risky alcohol use, which is correlated with health burdens and productivity impairments among health care providers. Hence, it is important to highlight the association between work-related trauma exposure factors and risky alcohol use among health care providers.

Objective: In this systematic review, we examined the relationship between work-related factors, trauma exposure, and risky alcohol use among health care providers.

Methods: We conducted a systematic search of PubMed, PsychINFO, and Google Scholar databases including studies published in English up to February 2024.

Results: Of 15 retrieved studies, researchers examined the association between work-related factors and risky alcohol use among health care providers in 10 studies. Increased burnout (work stress) was significantly associated with increased risky alcohol use among health care providers. However, there were differences between nurses/midwives and physicians in the relationship of risky alcohol use with work schedules (e.g., night shifts and hours worked). In the remaining five studies, trauma exposure increased risky alcohol use among health care providers.

Conclusions: Evidence suggests that work-related factors and trauma exposure are significantly associated with risky alcohol use among health care providers. However, the extent of the association varies among health care provider specialties. Thus, it is necessary in the future to evaluate the association between work- and trauma-related factors and risky alcohol use among each specialty of health care providers, especially nursing, which represents the largest number of employees in the health sector.

Abstract: The stigma associated with substance use disorder (SUD) harms the lives of people who use drugs (PWUD). Perceptions and projections such as PWUD are unclean, dangerous, noncompliant, or at fault for their addiction are unfounded and can harm the person's quality of life, impacting all social determinants of health. Stigmatic behaviors displayed in the healthcare setting directly influence the ability of the person with SUD to engage fully in their care as feelings of trust are replaced by shame. Experiential learning is an effective methodology for learning, development, and change. An opportunity to view a documentary composed of various forms of art and focused on the experiences of PWUD, followed by an expert panel discussion, was offered to community members in Western Massachusetts. The Perceived Stigma of Substance Abuse Scale was administered preintervention and postintervention with additional open-ended questions following participation. Using a Wilcoxon signed-rank test, there was a significant decrease (p > .0445) in the overall Perceived Stigma of Substance Abuse Scale scores from baseline to postintervention. A comparison and thematic analysis were performed, and findings of reported changes in perception, including the recognition of stigma, cognitive and behavioral changes, the impact of the film, and community benefits, were identified. The study findings offer the potential to facilitate positive changes in perception and behaviors that may influence the projection of stigma against people with SUD.

Aim: The aims of this study were to explore the correlation of sleep quality and Internet addiction (IA) with the health status of hospital nurses and to investigate whether sleep quality is a mediator in the influence of IA on the health of the nurses.

Background: Excessive Internet use is a public health concern. However, few researchers have investigated the interrelationship of the IA, sleep quality, and health status of hospital nurses.

Design: This study used a descriptive and cross-sectional design.

Methods: The study was conducted using survey data from a medical center in Taiwan. The Chen Internet Addiction Scale, Chinese version of the Pittsburgh Sleep Quality Index, and Chinese Health Questionnaire-12 were provided to the participants. Independent t tests, chi-square test, and structural equation model were performed for analysis.

Results: A total of 628 participants were recruited. The participants with IA exhibited significantly worse health status and poorer sleep quality compared with the participants without IA. Participants with poor sleep quality exhibited significantly worse health status and higher IA than those with normal sleep quality. The influence of IA on health status was indirect, with sleep quality as a mediator.

Conclusions: Hospital nurses with IA or poor sleep quality exhibited poor health status. Sleep quality mediated the influence of IA on the health status of the nurses. Hospital administrators should identify nurses at a high risk of IA, provide support strategies, and schedule work shifts more reasonably to improve their sleep quality. The hospital nurses' health and patients' safety could be further protected.

Background: Injectable opioid agonist treatment (iOAT) programs are increasing as a method of harm reduction for opioid use disorder. Although there have been numerous studies of client experience in iOAT programs, there have been few studies on the experiences on healthcare professionals working in these programs.

Aim: In this study, we aimed to understand the experiences and perspectives of healthcare professionals in iOAT programs. This study is among the first to explore the experiences of healthcare professionals in an operational iOAT program, with the aim of making workforce recommendations to enhance the sustainability of iOAT programs.

Methods: We conducted a secondary analysis using a thematic analysis approach with qualitative interview transcripts.

Results: Sixteen participants were interviewed, and we analyzed the transcripts, identifying three major themes: healthcare professionals' experiences in the iOAT program, approaches to work, and navigating practice issues. Working in iOAT was rewarding for participants because of the changes the program created in clients' lives. Participants reported that building trusting relationships with iOAT clients was key to the client's success. Healthcare professionals' approaches to their work varied, where they adopted either client-centered care or rules-based approaches. Healthcare professionals' experiences were shaped by program structure, the need to adapt their work, and building relationships with other healthcare services. Managing limited resources was a challenge for participants.

Conclusion: Supportive work environments can foster relationships between healthcare professionals and clients, for success in iOAT programs. Healthcare professionals require adequate support and staffing to provide high-quality care.

Background: Substance use among healthcare professionals is not uncommon. The challenges of seeking treatment, maintaining employment, and being in recovery are compounded by the demanding profession.

Methods: This qualitative descriptive study used interviews with substance use treatment providers in Colorado. Data were collected on providers' perspectives on barriers and facilitators to treatment, recovery, and returning to work for nurses and physicians. Inductive content analysis was utilized to identify themes across interviews.

Results: Fear is a barrier that delays treatment initiation. Healthcare professionals with substance use fear losing their job or license, or being judged by colleagues. There is a lack of awareness about available treatment options for health professionals with nonmedical substance use. Nurses and physicians often wrestle with their desire to be in control of situations while struggling with substance use.Additional systems-level barriers exist surrounding substance use treatment for healthcare professionals. These include inadequate insurance coverage for treatment, lack of confidentiality for healthcare professionals in treatment, lack of qualified treatment providers, and variability in how physician and nurse substance use and return to work are managed. Few facilitators are present to combat these challenges and facilitate success. Extensive monitoring during treatment and recovery was identified as a key facilitator, in addition to having supportive employers and colleagues.

Conclusions: The results of this study can be used to inform professional licensing boards, substance use treatment programs, healthcare employers, and policy makers to address barriers to treatment and to facilitate healthcare professionals returning to work after substance use treatment.

Abstract: Opioid use disorders (OUDs) are a public health crisis. Individuals with OUD often have coexisting symptoms: smoking, chronic pain, and anxiety. These coexisting symptoms increase the prevalence and severity of OUD. To inform OUD management, a new holistic theoretical framework (Complexity of Opioid Use Disorder Model [COUDM]) is proposed by combining two theories: Theory of Unpleasant Symptoms and Self-Determination Theory (SDT). TOUS and SDT comprehensively represent the complexity of the OUD experience, including influencing factors, interconnected conditions, and the motivation of individuals based on psychological needs that impact overall outcomes. Individuals receiving OUD treatment informed by SDT are more engaged and experience lower occurrences of drug relapse when they are intrinsically and autonomously motivated. COUDM encompasses the multidimensional aspects of OUD. To acquire a healthier and better future for OUD patients, novel frameworks to guide new approaches are needed. COUDM is a new theoretical framework, incorporating biopsychosocial factors and symptom clusters associated with OUD to improve treatment strategies.

Background: Vicarious trauma (VT) can have major negative consequences for those working with patients who have experienced trauma. The topic has been investigated for over three decades, and yet, the role of VT among nurses working in addiction services remains underresearched.

Aim: The aims of this study were to identify what is known and to report on the gaps in the literature on VT among nurses working in addiction services.

Methods: Using a systematic approach, Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and articles published between 1990 and 2019, a review of the international literature was conducted using databases CINAHL, Medline, PsycINFO, Embase, Web of Science, and Global Index Medicus (WHO). Keywords and relevant controlled vocabulary terms related to VT and nurses were included. A narrative synthesis of key findings from the selected articles was prepared.

Results: The initial search yielded 721 articles, and after removing duplicates, 588 articles were screened, identifying 33 potentially relevant full-text articles, but 20 were excluded based on specific criteria, leaving 13 articles eligible for review. Common themes within the literature were as follows: (a) VT has negative implications, (b) there is no reliable tool to measure VT within the nursing profession, (c) common risk factors, (d) common coping mechanisms, (e) importance of organizational leadership's role, (f) negative and positive consequences, and (g) paucity of studies.

Conclusions: The results of this review indicate a compelling requirement for increasing awareness and establishing a dependable method of measuring VT among those members of the nursing profession working in addiction services. Enhancing educational initiatives and facilitating the exchange of effective coping strategies are crucial in preventing burnout and the erosion of expertise among addiction nursing professionals. Both educational and practice-based leadership play integral roles in advancing these findings, not only for the well-being of nurses but also for the individuals experiencing trauma who are under their care.