Factors Associated with Nurses' Motivation to Provide Care for Patients with Alcohol Use and Alcohol Use-Related Problems.

BACKGROUND: There is a high human and economic cost associated with alcohol use and alcohol use-related problems. Nurses have a pivotal role in addressing the needs of this patient population. Purpose: The study aimed to examine the correlation between nurses' demographics/background characteristics, personal attitudes, professional attitudes, and their motivation to provide care to patients with alcohol use and alcohol use-related problems. METHODS: A descriptive, cross-sectional correlational design was utilized. Nurses were recruited from four Southwestern Pennsylvania hospitals. The study variables were examined using questionnaires that explored nurses' demographic/background characteristics, their personal and professional attitudes, and motivation to care for patients with alcohol use and alcohol use-related problems. RESULTS: The sample included 234 nurses. Demographic/background characteristics were identified as associated with nurse's alcohol use-related motivation, including gender, primary work setting and specialization. Previous personal experience with alcohol use-related problems (nurses themselves or co-workers), familiarity, perceived dangerousness, fear, social distance, personal responsibility beliefs and disease model were also associated with nurses' alcohol use-related motivation to care for these patients. In addition, all professional attitudes were associated with nurses' motivation toward caring for patients with alcohol use and alcohol use-related problems. CONCLUSIONS: The study revealed that certain demographic/background characteristics and personal and professional attitudes were associated with nurses' motivation to provide care to this patient population. This study provides the foundation for future studies aimed at exploring predictors of nurse's motivation to care for patients with alcohol use and alcohol use-related problems.

Preoperative Delirium Nursing Model Initiatives to Determine the Incidence of Postoperative Delirium Among Elderly Orthopaedic Patients.

Delirium is a common neurocognitive disorder prevalent in hospitalized older adults. The development of delirium is associated with adverse health outcomes, including functional decline and mortality. This study aimed to investigate the incidence and risk factors of postoperative delirium in older adults (≥60 years) who underwent orthopaedic surgery. Elderly orthopaedic patients were recruited from a large urban hospital over 12 months. Patients were preoperatively screened for delirium and followed up at least once daily postoperatively until discharge. Of the 124 patients in the sample, 21 (16.9%) had postoperative delirium. There were no significant differences in any of the baseline characteristics between the delirious and nondelirious patients. Patients using antidepressants were more likely to develop postoperative delirium compared with those not using antidepressants (odds ratio: 2.72, p = .05). Postoperative delirium was common in this sample of older adults who underwent orthopaedic surgery. Aiming prevention strategies toward patients using antidepressants may help reduce the incidence of delirium in this population.

Personal and professional attitudes associated with nurses' motivation to work with patients with opioid use and opioid use-related problems.

Background: Opioid use and opioid use-related problems contribute significantly to increased morbidity rates and premature deaths as well as an increased economic burden. Nurses have key roles in providing care to this patient population; however, they often report low motivation toward working with these patients. Examining personal and professional attitudes associated with nurses' motivation to work with this population can present a valuable opportunity to enhance their willingness to intervene at an earlier stage when patients do not have a diagnosable opioid use disorder. Methods: A descriptive, correlational design was used. Nurses were recruited from four hospital settings in Southwestern Pennsylvania. Data on nurses' demographic/background characteristics, personal attitudes, professional attitudes, and motivation related to working with patients with opioid use and opioid use-related problems were collected via a paper/pencil survey and analyzed using linear regression. Results: A sample of 234 nurses were included in the final analyses. Personal attitudes associated with nurses' motivation included personal experience with a family member related to alcohol and/or other drugs, and stigma perceptions (familiarity, perceived dangerousness, fear, social distance and personal responsibility beliefs). Professional attitudes associated with nurses' motivation included working experience with substance use (SU), SU education as continuing education or other educational resources, role security, therapeutic commitment, role responsibility, and self-efficacy. Conclusions: This study's findings provide valuable information regarding the bivariate relationships between nurses' personal attitudes, professional attitudes, and motivation to work with patients with opioid use and opioid use-related problems. The study provides a base for future studies aimed at developing interventions to enhance nurses' motivation to work with this patient population particularly related to preventing the progression of opioid use to a diagnosable disorder.

Hearing Loss and Communication Among Hospitalized Older Adults: Prevalence and Recognition.

The current quality improvement study aimed to determine hearing loss (HL) prevalence in older adult patients in a large urban hospital, and the success of current processes to identify its presence during routine admission procedures. Predictors of HL were also evaluated, with the goal of identifying risk factors that might help staff anticipate patient communication challenges. A sample of 162 newly admitted patients, age 70 and older, participated in a hearing/communication assessment that included audiometry and an informal self-report measure about hearing difficulty. Chart review was conducted to assess whether patients with confirmed hearing/communication deficits had been identified as such during the admission or nursing assessments. Results revealed a high prevalence of HL (72.8%) and relatively low sensitivity of routine admission procedures in identifying this communication deficit (14.4% to 43.2%). Age and male gender were found to be predictors of HL. The invisibility of HL poses a challenge to nurses in recognizing when older adult patients are at risk for communication breakdowns. Communication breakdowns associated with HL can potentially impact patients' adherence to treatment plans. [Journal of Gerontological Nursing, 46(6), 34-42.].

Hearing and Health Outcomes: Recognizing and Addressing Hearing Loss in Hospitalized Older Adults.

As age increases, the prevalence of hearing loss significantly increases, reaching up to 89% of those 80 years and older. Hearing loss in older patients is often unrecognized and its consequences are often underappreciated. Hearing loss can interfere with the ability to exchange important health information and to participate in health care decision-making. Hearing loss during hospitalization increases the risk of misdiagnosis. There is a lack of empirical data regarding prevalence and recognition of hearing loss in hospitalized older adults. In this article, we describe a variety of negative outcomes that may result when older inpatients are functioning with unrecognized hearing loss.

Associations between psychologic symptoms and life satisfaction in women with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with many physical and physiological changes and can affect women's psychological functioning and satisfaction with life. Previous research has focused mainly on cardiovascular risk factors, with few studies investigating the psychological effects of the condition. The aims of this study were (1) to determine if clinically depressive symptoms and psychological traits (anger, anxiety, hostility/cynicism) and decreased satisfaction with life are associated with PCOS; (2) to investigate within PCOS cases, factors associated with depressive symptoms, specifically body mass index (BMI), smoking status, education, marital status, and parity. DESIGN: The subjects examined in this study were selected from those in a previous case-control study, with observational follow-up over a 12-year period, 1995 to 2006. METHODS: A total of 161 cases and 161 controls were matched on age, race, and neighborhood and participated in the baseline psychological assessment arm of our original study. They were part of the original Cardiovascular Health and Risk Measurement Study conducted in 1992-1994 to investigate coronary heart disease risk factors in women with PCOS. Psychological characteristics of the women were assessed using the Beck Depression Inventory I (BDI I), the Spielberger Trait Anger and Anxiety Scales, the Cook-Medley Scale, and the Diener Satisfaction with Life Scale. RESULTS: Women with PCOS had a higher prevalence of mild or moderate depressive symptom levels (BDI scores >9): 31% vs. 17% in controls (p=0.016; OR 1.9, CI 1.55-2.16). The difference between cases and controls for the continuous BDI score was also statistically significant (p=0.002). The odds of having PCOS increased with each unit of BDI score by 1.06. Within cases, results of the logistic regression analysis showed that BMI, education, and parity were significant predictors of mild or moderate depressive symptoms (p<0.05). The odds of a BDI score >9 increased by 6% for each unit increase of BMI and by 44% for parity (per live birth), and decreased by 20% for each year of education. The associations between PCOS and anger, hostility, hostility/cynicism, and satisfaction with life were not significant. CONCLUSIONS: Depressive symptoms are a significant psychological concern in PCOS. Among women with PCOS, those who are heavier and have more children and less education are at greatest risk for mild to moderate depressive symptoms. Women should be screened at regular intervals in order to detect risk factors for depression and to treat depressive symptomatology.