Perspectiva espiritualidad en integrantes de alcohólicos anónimos: estudio piloto / Perspective spirituality in members of alcoholics anonymous: pilot study

La espiritualidad es un concepto que se ha relacionado de manera positiva con la salud física y mental de las personas y se ha observado que juega un papel importante en el manejo y recuperación del abuso de sustancias como el alcohol. El objetivo principal de este estudio fue determinar la perspectiva espiritual de los integrantes de AA (Alcohólicos anónimos). El diseño fue cuantitativo, descriptivo de corte transversal. La población estuvo conformada por integrantes de AA de 3 municipios suburbanos de Nuevo León, México. Se realizó un muestreo no probabilístico, la muestra estuvo conformada por 35 adultos pertenecientes a los grupos de AA, se utilizó la Escala de Perspectiva Espiritual (SPS). Los resultados muestran que el promedio del índice de espiritualidad en los participantes fue de 66.33 (DE = 17.23), el promedio de prácticas espirituales fue de 59.64 (DE = 25.11) y el de creencias espirituales fue de 70.70 (DE = 16.60). Se concluye que los integrantes de AA tienen un nivel alto de espiritualidad total, en prácticas espirituales y en creencias espirituales (AU)

Spirituality is a concept that has been linked positively with physical and mental health of people and has been found to play an important role in the management and recovery of substance abuse like alcohol. The main objective of this study was to determine the spiritual perspective of the members of AA. The design was quantitative, descriptive cross-sectional. The population consisted of members of AA 3 suburban municipalities of Nuevo Leon, Mexico. A non-probability sampling was performed, the sample consisted of 35 adults from AA groups, Spiritual Perspective Scale (SPS) was used. The results show that the average rate of spirituality in the participants was 66.33 (SD = 17.23), the average spiritual practices was 59.64 (SD = 25.11) and spiritual belief was 70.70 (SD = 16.60). It is concluded that AA members have a high level of total spirituality, spiritual practices and spiritual beliefs (AU)

Nursing Care in Alcohol and Drug User Treatment Facilities.

Registered and advanced practice nurses are employed in substance user treatment facilities across the US and in most industrialized countries. Patterns of employment and job descriptions for nurses, however, are highly inconsistent and seriously flawed. Many regulatory system, legislative and government agency factors and to some degree, the nursing profession itself, sustain the flaws and limit the delivery of comprehensive care. Competencies linked to addictions nursing best practices are often underutilized because of narrow job descriptions. This results in limited health and nursing service delivery to vulnerable populations receiving treatment in these government funded programs. This article highlights the increasing demand for the delivery of integrated care to psychiatric and substance using populations. The author considers factors which stake holders can influence to change flawed employment patterns and limited access to comprehensive care for substance users.

A 'symptom-triggered' approach to alcohol withdrawal management.

In acute hospital settings, alcohol withdrawal often causes significant management problems and complicates a wide variety of concurrent conditions, placing a huge burden on the NHS. A significant number of critical incidents around patients who were undergoing detoxification in a general hospital setting led to the need for a project to implement and evaluate an evidence-based approach to the management of alcohol detoxification-a project that included a pre-intervention case note audit, the implementation of an evidence-based symptom-triggered detoxification protocol, and a post-intervention case note audit. This change in practice resulted in an average reduction of almost 60% in length of hospital stay and a 66% reduction in the amount of chlordiazepoxide used in detoxification, as well as highlighting that 10% of the sample group did not display any signs of withdrawal and did not require any medication. Even with these reductions, no patient post-intervention developed any severe signs of withdrawal phenomena, such as seizures or delirium tremens. The savings to the trust (The Pennine Acute Hospital Trust) are obvious,but the development of a consistent, quality service will lead to fewer long-term negative effects for patients that can be caused by detoxification. This work is a project evaluation of a locally implemented strategy, which, it was hypothesised,would improve care by providing an individualised treatment plan for the management of alcohol withdrawal symptoms.

The role of community nursing in providing integrated care for older people with alcohol misuse.

Alcohol misuse in older people is a growing problem for health and social care providers, but remains largely hidden from public view and therefore largely overlooked by commissioners. Many older people with alcohol misuse have a 'dual diagnosis' (alcohol misuse accompanying other mental disorders) rather than alcohol misuse alone, which requires specialist nursing expertise. Over the past 10 years, assessment of and interventions for the detection of alcohol misuse in older people have been developed within one London borough. This article details the background, strategy and outcomes of this service, which provides integrated care in a multi-disciplinary community mental health team covering an inner-city area with a high prevalence of alcohol misuse and dual diagnosis in older people.

[Support in addictology: hydrotherapy]. / Accompagnement en addictologie: une pratique de l'hydrothérapie.

Hydrotherapy is a corporal mediation treatment used with patients with addictions by the Mayenne centre for addiction support therapy and prevention. A demonstration of the benefit of hydrotherapy for these patients through a patient's case.

Female-to-male transmasculine adult health: a mixed-methods community-based needs assessment.

BACKGROUND: There is a dearth of health research about transgender people. OBJECTIVES: This mixed-methods study sought to formatively investigate the health and perceived health needs of female-to-male transmasculine adults. DESIGN: A cross-sectional quantitative needs assessment (n = 73) and qualitative open-ended input (n = 19) were conducted in June 2011. A latent class analysis modeled six binary health indicators (depression, alcohol use, current smoking, asthma, physical inactivity, overweight status) to identify clusters of presenting health issues. RESULTS: Four clusters of health indicators emerged: (a) depression; (b) syndemic (all indicators); (c) alcohol use, overweight status; and (d) smoking, physical inactivity, overweight status. Transphobic discrimination in health care and avoiding care were each associated with membership in the syndemic class. Qualitative themes included personal health care needs, community needs, and resilience and protective factors. CONCLUSIONS: Findings fill an important gap about the health of transmasculine communities, including the need for public health efforts that holistically address concomitant health concerns.

A sociodrama: an innovative program engaging college students to learn and self-reflect about alcohol use.

TOPIC: A sociodrama addressing college drinking. PURPOSE: This article reports on the development, production, and evaluation of an innovative sociodrama addressing college drinking mental health professionals caring for students who drink at levels that cause negative consequences can use techniques addressed in the sociodrama to help students self-reflect on their alcohol use. The goal is to help students make healthy choices to decrease the negative consequences as a result of drinking. A script for the sociodrama was developed and five students acted out the sociodrama. A facilitator engaged the audience of college students, at scripted pauses, during the production to reflect on the scenes presented. The purpose of the sociodrama is to foster a discussion, to aid in student understanding concerning college drinking, to have students consider and commit to use harm reduction techniques, to access resources, and to correct misperceptions about drinking. The sociodrama format can help address communication challenges, problem solving, and self-awareness. METHODS: Pre- and post-surveys were administered to test commitment to use harm reduction techniques, assess the perception of a student's own drinking pattern to the perception of their fellow student colleague drinking, assess the student use of resources, and assess the effectiveness of the sociodrama as a means of learning. This research was Institutional Review Board approved. FINDINGS: Over 41% of students reported not consuming alcohol the last time they partied or socialized yet reported only 3.8% of their students colleagues did not consume alcohol. Most students (94%) reported that drinking five or more drinks would place them at risk as opposed to estimating that the same amount would put fewer students at risk (75%). Students significantly increased their commitment to use harm reduction techniques. CONCLUSION: A sociodrama is an effective method of involving students in discussions about college drinking and engaging them in conversation and self-reflection.

Comprehensive versus holistic care. Case studies of chronic disease.

Persons with chronic disease often experience an involvement of multiple body systems. A comprehensive care approach to patient care is often used with the belief that a health care team will ensure that a patient's needs will be covered. Instead, this approach is reductionist in practice and leads to fragmentation of care, and the difficult patients often slip through the cracks of the health care system. However, a holistic theory-based approach puts a patient's perceived needs first and offers care not only for the body but also for the human spirit. Two case studies of patients with chronic disease are reviewed, both of whom began in a comprehensive care model and ended up with holistic care. Suggestions for assisting in the movement of a comprehensive care model toward a holistic model are offered for the practicing nurse.

The views of nurses to the conduct of a randomised controlled trial of problem drinkers in an accident and emergency department.

The Trent Regional Health Authority funded a study in 1995 to train nurses in an accident and emergency (A&E) department to screen all adult attendees for alcohol problems with a view to identifying a sample of problem drinkers to participate in a randomised controlled trial (RCT). In the RCT identified drinkers were to be assigned either to health education plus brief counselling intervention or, as controls, to health education alone. Despite 16654 attendance's at A&E during the recruitment phase of the study only 20% of attendees were screened of whom a further 19% were identified as problem drinkers by the CAGE screening questionnaire. Less than half of the problem drinkers were, however, provided with feedback by the nurses, leaving a small group of 264 eligible for entry to the RCT. The great majority of this subgroup refused an initial appointment at the specialist clinic and so the trial was abandoned. A number of in-depth interviews were undertaken with the nurses in an attempt to understand ways in which the overall conduct of the study might have been improved. This paper outlines in some detail some of the reasons for the lack of success with the study which include; general environmental factors that undoubtedly led to stress and poor morale amongst the nursing team, the differences in perception between managers and clinical nurses concerning the value of research and the inadequacy of the initial training programme. The paper concludes that there are problems in the NHS which do not provide a helpful backcloth to the successful conduct of health services research.

Biodynamic massage.

This paper introduces biodynamic massage, locates it in the field of massage, and body psychotherapy, describes some of its historical development and basic theoretical assumptions. A case study illustrates its usage in an National Health Service facility.

Exploring music intervention with restrained patients.

Roy's Adaptation Model is used in a case study approach to begin examining the potential of music intervention in hospitalized, restrained patients. Restraints were removed during the time in which the patient listened to a musical tape through a headset. Mr. D, presented in this case study, was one of the 30 medical-surgical patients who participated. His observable positive behaviors increased from 10 during the preintervention period to 12 during the musical intervention. Mr. D displayed no negative behaviors during the entire study period.

Assessment and monitoring of alcohol-related problems.

Employers are increasingly requesting employees to submit to screening for alcohol-related problems (ARPs). Holistic assessment, leading to problem identification and treatment, can lead to a reduction in the number of accidents occurring in the workplace. This article argues against the practice of assessment based solely on blood levels of liver enzymes and mean corpuscular volume of erythrocytes and introduces a new diagnostic test which, if used with a full and systematic assessment, may lead to more accuracy in diagnostic interpretation.

An exploration of women's perceptions of the major factors that contributed to their alcohol abuse.

The purpose of this research was to explore the interviewees' perceptions of the major factors that contributed to their alcohol abuse. The research was carried out by interviewing seven women who were identified by community mental health professionals. The research was qualitative and exploratory. The semi-structured tape-recorded interview technique was used as an enquiry tool. The tapes were then transcribed and coded, and the findings were scrutinized and scanned for emerging themes and concepts using an interactive and cyclical process of data-reduction techniques, data display and verification of findings. The findings suggest that the majority of the interviewees could identify and isolate specific life events and past-life crises that contributed to an increase in their alcohol intake. Results also indicate that there is a need to consider the efficacy of the current models of primary, secondary and tertiary care as well as relapse-prevention programmes of care in order to facilitate women to have every opportunity to make informed and rational health choices about their drinking behaviours, and to maintain abstinence, for the promotion of positive mental health and for enhancing the quality of their lives.