Brief intervention protocol by telephone delivered by nurses to patients with harmful alcohol use in primary health care: A feasibility trial.

AIM: The aim of this study is to examine the feasibility of a brief intervention protocol by telephone performed by nurses in primary health care facilities. METHODS: A nonrandomized single-arm feasibility study was performed. The proposed intervention of this study is the Brief Intervention carried out by the nurse delivered by telephone, synchronously with alcohol users. The brief intervention is a motivational approach based on the FRAMES model, with its components being: Feedback, Responsibility, Advice, Menu of options, Empathy and Self-efficacy. To assess the feasibility of the protocol, we evaluated the procedure for enrolling participants, the acceptability of the protocol to participants, the satisfaction of the participants, convenience and treatment continuity. The quantitative data analysis was carried out in the R software, using descriptive statistics, categorical variables were reported by frequencies and percentages. For continuous variables, medians, means, standard deviations and range values were computed. RESULTS: We followed the participants (n = 165) from baseline (T0) until 3 months (T1) and 6 months (T2) after the brief intervention. The partial effect suggests a reduction in alcohol consumption, and statistically significant differences were observed from baseline before the BI, with a decrease of 0.66 points in AUDIT scores at T1. Among the patients who completed the 3-month follow-up, 48 % reported a positive experience of receiving the brief intervention by the nurses, and 44 % reported a decrease in alcohol consumption. CONCLUSIONS: Brief intervention delivered by telephone was considered feasible and acceptable by primary health care patients, and they perceived improvement in their alcohol consumption after receiving the BI performed by nurses.

The effectiveness of mindfulness for the management of anxiety in the nursing staff: Systematic review and meta-analysis.

A systematic review with meta-analysis following Joanna Briggs Institute recommendations. It aimed to determine the effectiveness of mindfulness for the management of anxiety symptoms in the nursing staff and stress as a secondary outcome. The databases searched were MEDLINE, Embase, LILACS, CINAHL, Web of Science, Scopus and Psycinfo. Search was conducted in October 2022. Independent reviewers used standardized methods to research, track, and code the included studies. Data meta-analysis was performed using random effects models. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used as an approach to assess the quality and certainty of evidence in research studies. The review examined the effectiveness of mindfulness on nursing staff in 13 studies. The meta-analysis revealed a statistically significant decrease in anxiety and stress after treatment, with an average reduction of 0.36 in anxiety and 0.48 in stress. The results emphasizes the possibility of mindfulness being an effective intervention to the management of anxiety and stress in nursing staff. However, the studies analyzed presented limitations in the design and sampling in the development of the intervention, which impact the conclusive statements about the effectiveness of mindfulness and the generalization of the results. The implications to the nursing field involve adopting evidence-based research and practices to improve the well-being and quality of life of nursing professionals, as well as strengthening the evidence base surrounding mindfulness interventions in nursing practice. This may lead to changes in healthcare policies, care practices, and recognition of the importance of nurses' well-being for effective healthcare delivery.

Alcohol use patterns and associated variables among the Karipuna indigenous people in the extreme Northern Brazilian Amazon.

The objective of this study was to identify the prevalence and patterns of alcohol consumption and associated factors in the Karipuna indigenous people. A cross-sectional population-based study was conducted with 230 Karipunan respondents aged 15 or over from 12 villages in the state of Amapá, in the extreme northern Brazilian Amazon. The participants completed the Alcohol Use Disorders Identification Test (AUDIT). The prevalence of alcohol use among the Karipuna was 70%. Of these, 59.6% had low-risk use, 38.3% had hazardous or harmful alcohol use, and 2.2% met criteria for probable alcohol dependence. Overall, 40.5% of the respondents had hazardous or harmful alcohol use; 66.6% were men, and 33.4% were women. In the regression analysis, age, sex, religion, not having an occupation, being a student, low educational attainment, suicidal ideation and having sexual intercourse after alcohol consumption were associated with hazardous or harmful alcohol use. Sex and Catholic religion were risk factors for this alcohol use pattern among the Karipuna. The prevalence of problematic alcohol use among the Karipuna is higher than that observed among the general Brazilian population, and preventive screenings should be widely implemented. Efforts to address and minimize the consequences of harmful and hazardous alcohol use among Brazilian Amazonian indigenous populations could be developed.

Effectiveness of a Brief Group Intervention for Harmful Alcohol Use in Men at a Primary Health Care Facility in Brazil: A Randomized Clinical Trial.

To evaluate the effectiveness of a brief group intervention (BGI) in reducing the use of alcohol and increasing the readiness to change in men with risky and harmful alcohol use. A randomized clinical trial with follow-ups at 30 and 90 days that was conducted in a primary health care (PHC) facility in the central region of São Paulo (Brazil). A total of 112 men were randomized to the experimental group (EG) (n = 55) or the control group (CG) (n = 57). To identify the pattern of alcohol use and the readiness to change, the Alcohol Use Disorders Identification Test (AUDIT) and the readiness to change (RTC) rule were used. The EG received a BGI session applied by nurses using the Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy (FRAMES) model. The CG was instructed to continue with the standard service of the unit after an initial interview. Intergroup analyses using the generalized equation estimation (GEE) method were performed. A significant difference in the pattern of use was observed between the EG and CG at follow-up evaluated (EG T1 (7.73 ± 5.14), CG T1 (12, 48 ± 5.62)) and EG T2 (6.65 ± 4.83), CG T2 (11.68 ± 6.65)). When compared the baseline (T0) measures (13.04) with the last time (T2) (6.65) at EG, it was identified a reduction of 6.39 in the AUDIT score. Differences between groups were found for readiness to change at follow-up ((EG T1 (8.50 ± 2.44) and CG T1 (5.67 ± 3.10) and (EG T2 (8.80 ± 1.73) and CG T2 (5.36 ± 3.33)), when contrasting with the baseline. The data suggest that the BGI was effective when compared to the control condition, as there was a reduction in risky and harmful use of alcohol for low-risk use, according to the alcohol use scores, and an increase in the stages of readiness to change.

Interpersonal Theory of Nursing for Anxiety Management in People with Substance Use Disorder (ITASUD): A Feasibility Study.

This study aim to evaluate the feasibility, based on six feasibility study criteria, of using a one-week intervention of interpersonal theory of nursing for anxiety management in people who are taking part in a substance use disorders (ITASUD). The study adopted a feasibility mixed methods approach. The ITASUD was implemented with 39 male users of cocaine/crack as their principal drug with high levels of anxiety. The outcome (anxiety) was assessed by the Beck anxiety inventory. To address the feasibility criteria, data were gathered during appointments. Additionally, qualitative open-ended interviews were conducted in the final appointment. The assessment of the six feasibility criteria indicated the following: (1) demand: there was high demand among eligible participants; (2) acceptability: the ITASUD had better acceptability until the 3rd appointment; (3) implementation: the ITASUD's complexity and design was acceptable for participants; (4) practicality: 61.54% of participants used strategies from the ITASUD to manage their anxiety; (5) adaptation: there was no contamination and cointervention; and (6) safety: the ITASUD was safe. The exploratory analysis showed a relation between the level of anxiety and ITASUD (p < 0.0001). The ITASUD appears to be feasible. The participants reported positive experiences with the implementation of the ITASUD. The findings support the design of a powered larger trial to evaluate the effectiveness of the ITASUD.

Reducing women's alcohol use: a brief intervention pilot study at a primary health care service in Brazil.

This study assesses the feasibility of a brief intervention among women with hazardous alcohol use at a primary health care service in Brazil. A two-arm randomized pilot study was carried out from July 2017 to January 2018 with 44 women aged 18 years or older with hazardous alcohol use. The intervention group completed a brief intervention in a single session lasting 20 to 30 minutes. The control group received five minutes of brief advice. Alcohol use was assessed by the Alcohol Use Disorders Identification Test (AUDIT), and the frequency and quantity of alcohol consumed in the previous month were assessed at baseline and the first and third months of follow-up in both groups. The AUDIT score was decreased in both groups at baseline (intervention group 12.89, control group 10.64), the 1st month (intervention group 12.78 p = .9; control group 7.9 p = .01) and the 3rd month (intervention group 10.11 p = .13; control group 7.09 p < .01). The intervention group continued using alcohol after the brief intervention, although the quantity of alcohol consumed was reduced compared with that at baseline (p < .01). Finally, the brief intervention delivered in a primary health care service in Brazil showed the potential to reduce women's pattern of alcohol consumption.

Psychopathological Symptoms in School Children: Analysis in a Sample from a State in the Brazilian Amazon.

OBJECTIVE: This study sought to identify and analyze the psychopathological symptoms of schoolchildren from a state in the Brazilian Amazon region. METHODS: This is a convergent parallel mixed study conducted with school-age children (6 to 12 years) from Amapá, located in the Brazilian Amazon region. For data collection, the Psychopathological Symptom Identification Scale was used with schoolchildren in addition to individual interviews. RESULTS: Most children had few psychopathological symptoms, and 12.65% required referral to a specialist. The symptoms were positively and significantly related to age and negatively and significantly related to the frequency of physical exercise. Participants who had relatives with mental disorders and who used psychoactive substances had significantly more symptoms. Some symptoms related to anxiety, mood, social behavior, attention and eating patterns had an average of answers that was higher than expected (1.5), which, in the children's discourses, were likely related to family situations such as poverty, violence, illness, abandonment, and social pressure due to aesthetic standards. CONCLUSION: Psychopathological symptoms such as anxiety, mood, social behaviors, and eating patterns were the most frequent among the students investigated, suggesting a relationship between these symptoms and the greater social vulnerability to which these children are exposed. PRACTICE IMPLICATIONS: This study supports the promotion of a social practice based on the use of observational power for the transformation of reality, with pediatric nurses, primary care providers and health and education systems as important agents of social change through actions designed to promote mental health in schools, families and society.

Suicidal ideation in gender and sexual minority students in the largest Brazilian University.

OBJECTIVE: Identifying the presence of suicidal ideation and associated factors among university students from a public university in Brazil. METHODS: A cross-sectional study was performed with 72 university students between 18 and 29 years old. Were used a sociodemographic data questionnaire and the Beck's Suicidal Ideation Scale. RESULTS: The suicidal ideation was significantly in the participants, as well as the association of gender, gender identity, sexual orientation and housing with it. CONCLUSIONS: The suicidal ideation in this population is important, and there is a need to explore the factors related, such as gender, sexual orientation, gender identity and housing.

Psychiatric Nurses' Attitudes Towards Violent Behaviour: A Brazilian Study.

This study examines nurses' attitudes towards violent behaviour and the management of aggressiveness. A convenience sample of 185 nurses working in psychiatric urgent care and emergency services in Brazil responded to the MAVAS-BR. The results show that nurses' attitudes are more reflective of the external and situational models of violent behaviour and the use of control methods to manage aggressiveness. The mapping of this phenomenon using the same tools in a different context from those traditionally studied while observing similar results suggests a pattern of attitudes towards violent behaviour and the management of aggressiveness among nurses around the world.

[Patterns of alcohol use and related issues: analysis of nurses' knowledge]. / Padrões de uso do álcool e questões associadas: uma análise do conhecimento de enfermeiros.

Descriptive study that aimed to identify and compare the nurses' knowledge addressed to patterns of alcohol use and related issues. The study included 185 nurses of which 84 had attended a training course on the subject. Data were collected through a questionnaire of knowledge showing that while the trained group obtained the highest average on correct answers, there was a lack of knowledge in both groups, especially with regard to the identification of complications from alcohol use. Important definitions to nursing practice in the area of addictions are presented, suggesting that future training may consider the various dimensions involved in caring for people with problems related to alcohol.

Effectiveness of Clinical Practicum Experience in Drug Addiction Treatment Facilities in Nursing Students' Attitudes Toward Alcohol, Alcohol Use Disorders, and Alcoholics: Systematic Review and Meta-Analysis.

ABSTRACT: The aim of this study was to identify, analyze, and synthesize the best evidence on the effectiveness of clinical practicum experience in drug addiction treatment facilities on nursing students' attitudes toward alcohol, alcohol use disorder (AUD), and persons with AUD. This systematic review followed the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and used the System for the Unified Management of the Assessment and Review of Information to assess methodological quality and extract data for meta-analysis. A comprehensive literature search of the EBSCO databases, Embase, PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde, PsycINFO, Scopus, Web of Science, Mednar, Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior, and ProQuest Dissertations & Theses catalog was conducted. The System for the Unified Management of the Assessment and Review of Information tool was used for the extraction and critical evaluation of the selected articles followed by a meta-analysis. After removing duplicates, 2,831 publications were identified, and eight met the inclusion criteria. More positive attitudes were observed after performing practicum experience in specialized services (-1.27, 95% confidence interval [-2.85, -0.30]), and an increase in the motivation and satisfaction among the students to care for patients with AUD was also noted. In conclusion, the review suggests that clinical practicum experience in a drug addiction treatment facility has the potential to change the attitudes of nursing students toward AUD and persons with AUD.

Prevalence of psychological and mental health symptoms among nursing professionals during the COVID-19 pandemic in the Americas: Systematic review and meta-analysis.

To assess the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent. A systematic review and meta-analysis of observational studies that estimated the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic was performed through bibliographic database searches. A three-level meta-analysis model was used with the inverse variance method, tau was estimated via restricted maximum likelihood and logistic transformation, and heterogeneity was presented as tau2 and I2. Of the 7467 studies obtained, 62 were included in the meta-analysis, which involved 52 270 nursing professionals. The overall prevalence for at least one mental health symptom was 56.3% (50.4%, 62.1%; I2 = 98.6%, p < 0.001). Eight mental health symptoms were found; among them, the most prevalent were burnout (52.1%, 37.1%, 88.8%; I2 = 98.5%, p < 0.001) and fear (52.1%, 30.1%, 73.3%; I2 = 98.1%, p < 0.001). The prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent was high, and strategies should be developed and implemented by managers and government agencies to promote the well-being, physical and mental health of nursing professionals. Studies like this one are necessary to highlight the need for efforts in the implementation of promotion and prevention actions to be developed by health organisations, managers and leaders with a view to improving the quality of life of nursing workers.

[The translation and cultural adaptation of the Management of Aggression and Violence Attitude Scale - MAVAS - for nurses in Brazil]. / Tradução e adaptação cultural da Management of Aggression And Violence Attitude Scale - MAVAS - em enfermeiros brasileiros.

This study translated and culturally adapted the Management of Aggression and Violence Attitude Scale - MAVAS - for use in Brazil (BR). The methodology followed the international guidelines for the cultural adaptation of psychometric scales: conceptual equivalence, semantic equivalence, items equivalence, and operational equivalence. A group of judges performed a content validity analysis that resulted in a 23-item scale divided into four factors with satisfactory content validity coefficients (CVCs) for the following parameters: clarity of language (CL; 0.88), practical relevance (PR; 0.91), and theoretical relevance (TR; 0.92). The data were collected in Londrina, state of Paraná, BR in 2011. The MAVAS was translated and culturally adapted for use in BR, and the MAVAS-BR exhibited satisfactory content validity. Future studies concerning the MAVAS-BR are suggested, including the evaluation of psychometric qualities, such as its construct validity and reliability.

[Knowledge and attitudes of nurses towards alcohol and related problems: the impact of an educational intervention]. / Atitudes e conhecimentos de enfermeiros frente ao álcool e problemas associados: impacto de uma intervenção educativa.

An exploratory study of quasi-experimental approach that aimed to verify the impact of an educational intervention on attitudes and knowledge of nurses towards alcohol use and associated problems. The sample included 185 nurses, divided into two groups: 84 submitted to a training course and formed the experimental group. Data were collected through a knowledge survey and an attitude scale. The attitudes of the participants of both groups were positive. There were no significant differences between groups in relation to knowledge. The strongest predictors of positive attitudes were possessed preparation to act with chemical dependents (OR = 2.18), "have received increased workload during graduation on the theme, 'alcohol and other drugs'" (OR = 1.70), and "completed graduate school" (OR = 2.59). The educational intervention had a positive impact on the attitudes of nurses towards alcoholics, work and interpersonal relationships with such clientele.

[Caring for people with psychoactive substance dependence: nursing student perceptions]. / Cuidar de dependentes de substâncias psicoativas: percepçães dos estudantes de enfermagem.

This was a qualitative exploratory study aiming to better understand the perceptions of student nurses regarding care of the chemically dependent. Semistructured interviews were conducted between 2007 and 2009 with 17 nursing students from a public university in the city of São Paulo who were training in specialized services for abusers of alcohol and drugs. The content analysis technique was used, and the discourse evaluation revealed that care for the chemically dependent was considered interesting but difficult and exhausting. A positive outcome noted by the students was that the discussion of theory and experience enabled them to change their perceptions of the issue from a moral model base to a more technical, scientific and ethical one. It was concluded that this teaching strategy can contribute to changing the perceptions of nurses toward these patients.

Is the Clinical Practicum in Addiction Treatment Facilities an Effective Educational Intervention to Improve Nursing Students' Attitudes Toward Alcohol Use Disorders?

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.

Attitudes Scale on Alcohol, Alcoholism, and Persons With Alcohol Use Disorders.

BACKGROUND: The Attitudes Scale on Alcohol, Alcoholism, and Persons with alcohol use disorders ("Escala de Atitudes Frente ao Álcool, ao Alcoolismo e ao Persons with alcohol use disorders" [EAFAA]) is an instrument designed to measure attitudes toward alcohol, alcoholism, and persons with alcohol use disorders. It has been validated in Portuguese and Spanish. OBJECTIVE: The purpose of this study was to examine the psychometric properties and factor structure of the American English version of the EAFAA (EAFAA-AEV). METHODS: One hundred eighty-seven participants (nurses = 101 and nursing students = 86) completed the EAFAA-AEV. RESULTS: Confirmatory factor analysis resulted in a four-factor solution, supporting the original factor structure of the EAFAA. The scale has shown good internal consistency and reliability for the four factors. The total scale had a Cronbach's alpha of .85 and a McDonald's omega of .87. CONCLUSION: The EAFAA-AEV has similarly strong psychometric properties as the original version, suggesting that it is a reliable tool to identify attitudes toward alcohol and related issues among American-English-speaking nurses and nursing students.

An anxiety management intervention for people with substance use disorders (ITASUD): An intervention mapping approach based on Peplau's theory.

Background: The comorbidity of anxiety and drug use disorders complicates treatment prognosis, and one of the greatest challenges is to address the environmental and behavioral factors involved. The aim of this study was to describe the uses of intervention mapping in the design of a theory and evidence-based complex intervention to develop skills around the management of anxiety for cocaine users in outpatient addiction treatment. Methods: The six steps of the intervention mapping approach, which are needs assessment, creation of matrices of performance objectives, selection of methods and practical strategies, program development, adoption and implementation, and evaluation were applied to develop the Interpersonal Theory of nursing to Anxiety management in people with Substance Use Disorders (ITASUD) intervention. The theory used for the conceptual model was interpersonal relations theory. All theory-based methods and practical applications were developed at the individual level, acting in behavioral, interpersonal, organizational and community environments. Results: The intervention mapping provided a broad overview of the problem and outcome expectations. The ITASUD intervention consists of five consecutive sessions of 110-min targeting individual determinants of anxiety (knowledge, triggers, relief behaviors, self-efficacy and relations), delivered by a trained nurse using Peplau's concepts of interpersonal relations. Intervention Mapping is a multi-step process that incorporates theory, evidence, and stakeholder perspectives to ensure that implementation strategies effectively address key determinants of change. Conclusions: The intervention mapping approach increases the effectiveness of the intervention since the matrices provide a broad view of all factors that affect the problem and facilitate replication through transparency of the determinants, methods, and applications used. ITASUD addresses all factors that play an important role in substance use disorders based on a theoretical basis, which provides the translation of evidence from research into effective practice, policy, and public health improvements.

[Translation and cultural adaptation of the Global Appraisal of Individual Needs - Initial]. / Tradução e adaptação cultural do global appraisal of individual needs - initial.

The objective of this study was to perform the translation and cultural adaptation of the Global Appraisal of Individual Needs - Initial instrument, and calculate its content validity index. This is a methodological study designed for the cultural adaptation of the instrument. The instrument was translated into Portuguese in two versions that originated the synthesis of the translations, which were then submitted to the evaluation of four judges, experts in the field of alcohol and other drugs. After the suggested changes were made, the instrument was back-translated and resubmitted to the judges and authors of the original instrument, resulting in the final version of the instrument, Avaliação Global das Necessidades Individuais - Inicial. The content validity index of the instrument was 0.91, considered valid according to the literature. The instrument Avaliação Global das Necessidades Individuais - Inicial was culturally adapted to the Portuguese language spoken in Brazil; however, it was not submitted to tests with the target population, which suggests further studies should be performed to test its reliability and validity.

Alcohol Use and Anxiety in Primary Health Care Patients During the COVID-19 Pandemic: a Phone-Based Study.

In March 2020, physical distancing and quarantine measures were implemented in Brazil, which may have affected the physical and mental health of the population. This cross-sectional study used a convenience sample and telephone-based interviews to identify anxiety symptoms and alcohol use patterns among 1,264 Brazilian primary health care (PHC) patients during the COVID-19 pandemic. The State-Trait Anxiety Inventory-State 6 and Alcohol Use Disorders Identification Test (AUDIT-C) questionnaires were used to assess anxiety symptoms and alcohol use patterns, respectively. According to the AUDIT-C results, the prevalence of harmful drinking was 38.5%. Those who reported that their alcohol consumption decreased during the pandemic had high scores on the AUDIT-C, indicating a moderate/severe risk of drinking. Moderate or severe anxiety was observed in 60.1% of participants. These results highlight the needs to assess the pandemic's consequences on the mental health of the population and to encourage the implementation of preventive approaches in PHC settings to address anxiety and harmful alcohol consumption.