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1.
J Am Psychiatr Nurses Assoc ; : 1078390320905669, 2020 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-32052669

RESUMEN

BACKGROUND: Substance misuse remains a public health crisis and contributor to morbidity and mortality. The nursing workforce is not immune to the impacts of substance misuse as rates are thought to mirror those of the general population. Additionally, as substance misuse often begins in adolescence or early adulthood, prevalence of misuse among practicing nurses highlights the fact that students are also at risk. OBJECTIVES: The purpose of this study was to examine rates and patterns of substance use and adverse childhood experience (ACE) exposure among nursing students while also examining associations between substance use and ACE exposure. METHOD: This study utilizes a cross-sectional and descriptive design through the provision of email surveys to nursing students. Email surveys consisting of the Alcohol Use Disorders Identification Test, the Drug Abuse Screening Tool 10-item survey, the ACE Questionnaire, and a demographic inquiry were distributed via Qualtrics survey software. RESULTS: A total of 662 individuals participated in the survey, the majority of whom self-identified as female, were undergraduate students, and were between 18 and 21 years. Moderate- to high-risk alcohol use was identified in 20% of students, while moderate- to high-risk drug use was identified in 3.6% of students. More than half of students endorsed exposure to at least one ACE. Significant associations were found between the Drug Abuse Screening Tool 10-item survey and the ACE Questionnaire. CONCLUSIONS: The results of this study have significant implications for nursing educators and must inform groundwork for the development of policies and interventions that are evidence based, nonpunitive, and trauma informed.

2.
J Child Adolesc Psychiatr Nurs ; 32(4): 179-186, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31523884

RESUMEN

TOPIC: In 2017, there were a total of 70 million forcibly displaced individuals or refugees, worldwide. Unfortunately, over 50% of refugees are under the age of 18 years. Refugee youth are at-risk for a variety of mental health conditions. PURPOSE: The purpose of this report is to provide psychiatric-mental health nurse practitioners (PMHNPs) with an understanding of unique cultural implications in refugee youth, risk factors towards the development of psychiatric illness, and means to identify those at-risk for sequelae or those meeting diagnostic criteria. Also presented are foundational treatment and management implications to ensure the provision of culturally sensitive and efficacious care to this unique population. SOURCES USED: Utilizing PubMed, CINAHL, and PsycINFO, a literature review was conducted to identify relevant publications pertaining to mental health issues in refugee youth spanning from 2013 to present. Reference lists of identified articles were also searched. CONCLUSIONS: A variety of risk and protective factors are discussed, spanning from premigration, during flight, and postsettling periods. PMHNPs must be proficient in screening and diagnosis of mental health conditions in refugee youth and implementation of pharmacological and psychotherapeutic interventions. PMHNPs must also be well versed in community-based resources that can be utilized to promote optimal outcomes.

3.
J Am Psychiatr Nurses Assoc ; : 1078390319858658, 2019 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-31253067

RESUMEN

BACKGROUND: Substance use among adolescents remains a major public health concern, which is correlated with mortality. AIMS: The purpose of this study was to (1) examine risk factors predisposing adolescents to substance use and (2) identify patterns of simultaneous drug exploration among adolescents. METHOD: Data (N = 15,624; collected in 2015) were drawn from the Centers for Disease Control and Prevention, National Youth Risk Behavior Survey, which is a national school-based survey of 9th- to 12th-grade students to monitor health risk behaviors. Substance use was assessed using self-reported questionnaires, and latent class analysis and logistic regression were used for data analysis. RESULTS: Five latent patterns of substance use were identified: (1) abstinent (64%); (2) 1st-step social experimenter (25%) (i.e., used alcohol, e-cigarettes, and/or marijuana); (3) 2nd-step social experimenter (6%) (i.e., used alcohol, cigarettes, e-cigarettes, marijuana, synthetic marijuana, and/or prescription pills); (4) pill experimenter (4%), (i.e., used prescription pills); (5) full experimenter (2%) (i.e., likely to use all assessed substances). Gender, race, grade, and depressive mood were strong predictors of membership in a particular substance use class. CONCLUSION: Adolescents presenting for care may possess symptoms associated with various substances beyond those being managed. Mental health nurses can leverage these results in reducing adolescent substance use through primary and secondary prevention. A longitudinal study of not only substance use patterns but also the progression to substance use disorders among adolescents is warranted.

4.
Can J Nurs Res ; : 844562119840172, 2019 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-30947519

RESUMEN

BACKGROUND: Interprofessional education strategies are becoming more prevalent as nursing schools integrate interprofessional practice activities into their curricula. PURPOSE: This paper presents the results of a federally funded project to deliver online interprofessional education to nursing students on screening for alcohol and substance use in rural areas, in which their perceptions about interprofessional education were measured. METHODS: A quasi-experimental within-subjects repeated measures design was utilized. Students in the bachelor or associate degree program were recruited from two rural nursing schools. A demographic questionnaire, Alcohol and Alcohol Problems Questionnaire, Drug and Drug Problems Questionnaire, and Interprofessional Education Perception Scale were utilized. General linear modeling was used to determine changes in these measurements over time. Data collection was performed at pretraining, posttraining, and following an online interprofessional dialogue. RESULTS: The study consisted of 89 nursing students. The participants were 87% female (n = 77/89) and 91% white (n = 81/89); their mean age was 24.9 years (standard deviation = 10.36). Analysis of evaluation questionnaires demonstrated increased levels of confidence in working with patients who consume alcohol or other drugs and on certain aspects of interprofessional education. CONCLUSION: Online interprofessional preservice education holds the potential to positively increase nursing students' confidence in working with patients and to increase their interprofessional practice.

5.
J Addict Nurs ; 29(3): 163-166, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30180001

RESUMEN

PURPOSE: The United States is in the midst of an unprecedented public health crisis, with annual morbidity and mortality data related to opioid use consistently increasing and appearing more worrisome. To mitigate such consequences, it is critical that those with opioid use disorders are provided with and have access to evidence-based treatment modalities. METHODS: The project utilized a course scaffolding approach to integrate a comprehensive substance use framework into an advanced practice nursing curriculum, with an emphasis on medication-assisted treatment as part of an advanced pharmacology course required for licensure. RESULTS: Students' knowledge assessment increased significantly, from an average of 2.82 to 3.78 out of 5 items, t(217) = -10.31, p < .01. CONCLUSIONS: Educators and academic administrators must be steadfast in their resolve to include substance use, and specifically opioid use, education into all areas and levels of nursing study.


Asunto(s)
Curriculum , Educación de Postgrado en Enfermería/organización & administración , Tratamiento de Sustitución de Opiáceos/métodos , Trastornos Relacionados con Opioides/tratamiento farmacológico , Buprenorfina/administración & dosificación , Enfermería Basada en la Evidencia , Humanos , Metadona/administración & dosificación , Naltrexona/administración & dosificación , Antagonistas de Narcóticos/administración & dosificación , Investigación en Educación de Enfermería , Trastornos Relacionados con Opioides/epidemiología , Estados Unidos/epidemiología
6.
J Am Assoc Nurse Pract ; 30(9): 493-498, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30095668

RESUMEN

BACKGROUND AND PURPOSE: Primary care providers who encounter children are often the first line of contact for individuals with gender dysphoria, which occurs when sex assigned at birth is incongruent with one's true, expressed sexual identity. Because those with untreated gender dysphoria are at risk of a variety of negative outcomes, including mood symptomatology, suicidality, substance use disorders, and other psychosocial risk factors, it is critical that health care providers are adept in the provision of holistic, patient-centered care. The purpose of this report is to provide an updated review of the current evidence from the literature pertaining to the identification, treatment, and coordination of care among children with gender dysphoria within the primary care setting or medical home. METHODS: Using PubMed and CINAHL, a literature review spanning from 2012 to the present was conducted using the following key words: gender dysphoria, transgender health, LGBT health, and hormone therapy. Reference lists of identified articles were also explored for relevance. CONCLUSIONS: Treatment may include a social transition, hormone antagonist therapy, or the administration of cross-sex hormone therapy, with a medical home needed to facilitate coordination of care. Best practice guidelines vary across pediatric and developmental groups and include both reversible and nonreversible modalities. Screening for negative psychosocial sequelae must be completed to include mood symptomatology, suicidality, substance use disorders, and risky sexual behavior, so that appropriate screening, identification, and treatment interventions can be implemented. IMPLICATIONS FOR PRACTICE: The primary care medical home must act as a foundation for the identification of gender dysphoria and/or associated comorbidities and must treat, when able, or refer, when indicated. In addition, because of structural barriers and stigmatization, public policy often fails the transgender community and can exacerbate the aforementioned psychosocial comorbidities faced by the transgender youth community. Health care providers, particularly nurse practitioners, are in a unique position to expand on the face-to-face care provided to the community and engage in advocacy efforts to dismantle structural barriers impeding transgender individuals and communities while also providing primary health care, anticipatory guidance, and care coordination.


Asunto(s)
Disforia de Género/psicología , Atención Primaria de Salud/métodos , Adolescente , Niño , Continuidad de la Atención al Paciente , Femenino , Disforia de Género/complicaciones , Disforia de Género/terapia , Identidad de Género , Hormonas/farmacología , Hormonas/uso terapéutico , Humanos , Masculino , Atención Primaria de Salud/tendencias , Conducta Sexual/psicología , Personas Transgénero/psicología
9.
Issues Ment Health Nurs ; 39(2): 151-158, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29370546

RESUMEN

Nurses are in an ideal position to talk to their patients of reproductive age about alcohol use and encourage the prevention of alcohol-exposed pregnancies. Effective conversations can be efficiently included in the clinical encounter to identify alcohol misuse and offer appropriate follow-up. This report presents results of an environmental scan of resources relevant to nursing professionals and nurses' role in addressing alcohol misuse. Gaps in nursing education and practice guidelines with regard to defining the nursing role in preventing alcohol-exposed pregnancies were revealed. Findings identified a need to promote adoption among nurses of evidence-based preventive practices to prevent alcohol misuse.


Asunto(s)
Trastornos Relacionados con Alcohol/prevención & control , Trastornos del Espectro Alcohólico Fetal/prevención & control , Rol de la Enfermera , Actitud del Personal de Salud , Humanos
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