A Hostile Environment: An Exploratory Study of Prelicensure Nursing Student Exposure to Patient Aggression.

BACKGROUND: The literature regarding the increased risk of violence toward registered nurses and health care workers is plentiful; yet, data on prelicensure nursing student exposure to violent patient behaviors are limited and did not exist for the university's nursing program. PURPOSE: The purpose of this exploratory study was to examine nursing student exposure to patient aggression or violent behavior in a prelicensure nursing program in the Midwestern United States. METHODS: The research design was an exploratory study using surveys completed by nursing students in their junior and senior years. RESULTS: Almost 74% of male students and 85% of female students experienced some form of verbal aggression from their patients, with a statistically significant difference between male and female nursing students on their exposure to sexual harassment. Students also experienced extreme emotions and feelings. CONCLUSIONS: The survey results reveal nursing students are exposed to patient aggression or violent behavior, do not feel prepared to manage these situations, and desire faculty mentoring.

Health care administration and drug policy.

The American healthcare system faces a potential reorganization of the way in which services are provided and financed. We argue that healthcare administrators need to be increasingly aware of the ways in which our nation's illicit drug policy, commonly referred to as the 'War on Drugs', affects the provision of health services. A large and growing portion of the US population uses one or more of the currently illegal drugs and some of these persons suffer from an addiction or other substance use disorder. This is clearly demonstrated by the current opioid epidemic which is not yet being adequately controlled. Providing specialty treatment for drug abuse disorders will be increasingly important for healthcare administrators thanks to recent mental health parity legislation. At the same time, drug users and abusers will be increasingly encountered while providing care not specifically tied to drug use or abuse. The character of our current national drug policy has an important impact on how drug abuse disorders are treated and how the health delivery system responds to drug users who are increasingly often encountered in primary care, emergency care, specialty care, and long-term care settings.

Health Workers' Knowledge and Perceptions on Dementia in Skilled Nursing Homes: A Pilot Implementation of Teepa Snow's Positive Approach to Care Certification Course.

INTRODUCTION: A knowledge gap on caring for people with dementia exists among health workers employed in skilled nursing facilities. This article reports on knowledge gained and perceptions changed among 24 skilled nursing facility health workers who completed Teepa Snow's innovative Positive Approach to Care Certification course as a regional initiative. METHODS: This pilot study used a quasi-experiment with a one-group pretest-posttest design to assess the dementia knowledge and perceptions of health workers who participated in the course. Paired responses (n = 22) for the 54-item dementia knowledge and training/coaching perceptions survey were compared using the McNemar test, Paired t test, and Wilcoxon signed-rank test to analyze the improvement in knowledge and perceptions of dementia. RESULTS: Significant knowledge gain was found among health workers after completing the program (t(21) = -7.46, P < .001). Statistical differences (P < .05) were present in eight knowledge items (ie, working memory, mental health, temporal lobe, "sapphire", "space and awareness", personal space, binocular vision, and hippocampus) and four perception areas (ie, approaching, understanding, calming, and instructing) about dementia. Significant changes were also found in four areas of health workers' perceptions about dementia (P < .05). DISCUSSION: The certification course can improve knowledge and facilitate perceptual change on dementia. Implementing this program as a novel regional initiative has robust potential in ensuring continuing workforce development in health care settings challenged with ever-changing people living with dementia needs and high staff turnover.

A Comparative Study of Factors Associated with Relapse in Alcohol Dependence and Opioid Dependence.

BACKGROUND: Alcohol and opiates are among the most addictive substances posing significant public health problems due to the biopsychosocial impact that they have on individuals. Research shows that majority of abstinent alcohol and/or opioid dependence subjects relapse within 1 year. It has also been estimated that 26-36 million people worldwide abuse opiates, with exceptionally high-relapse rates. The purpose of this study was to compare the sociodemographic factors and correlates relapse in alcohol dependence and opioid dependence. METHODOLOGY: This research uses a cross-sectional comparative study design with a sample size of 60 drawn from a population of clinically diagnosed patients of alcohol dependence (n = 30) or opioid dependence (n = 30) and seeking treatment for relapse. In addition to collecting sociodemographic data, other factors such as craving, affect, self-efficacy, and expressed emotions were measured using standardized instruments including brief substance craving scale, Bradburn affect balance scale, drug avoidance and self-efficacy scale and family emotional involvement, and conflict scale. The data were statistically analyzed. RESULTS: Disparity in sociodemographic factors was seen in both the groups with opioid group being more likely to be single, unemployed, belonging to lower socioeconomic status, and having a criminal record (P = 0.025). Among factors associated with relapse, the opioid group scored significantly higher on craving, perceived criticism (P = 0.0001), and lower on self-efficacy (P = 0.016). Most common reason cited for relapse in both the groups was desire for positive mood. CONCLUSION: This study highlights the role of social determinants in drug dependence and relapse. Relapse was found to be a complex multifactorial phenomenon. Despite differences in presentation, somewhat similar relapse mechanisms were seen in both groups.

Overweight status in Indian children: prevalence and psychosocial correlates.

OBJECTIVE: To examine the association between overweight status and psycho-social risk factors in Indian children. METHODS: Data from India's nationally-representative Global School-based Student Health Survey were analyzed using SPSS for all participating students (n=8130, 58% males). RESULTS: The likelihood of being overweight was significantly higher for children with fewer friends (OR=1.16, 95%CI=1.13-1.18) or friends who were not kind or helpful, children with symptoms of depression (OR=1.20, 95%CI=1.03-1.39) and anxiety (OR=1.09, 95%CI=1.07-1.15), children with little parental involvement (OR=1.06, 95%CI=1.02-1.10), and children who felt lonely or missed school days without permission. CONCLUSIONS: Psychosocial distress in overweight Indian children warrants comprehensive interventions for screening and treatment of pediatric obesity.