A Comparison Between the Involuntary and Voluntary Treatment of Patients With Alcohol Use Disorder in a Residential Rehabilitation Treatment Program.

OBJECTIVE: The purpose of the study was to determine if there was a significant difference between veterans who received treatment voluntarily versus involuntarily in regard to length of sobriety. METHOD: A sample of 120 veterans being treated for alcohol use disorder in a residential rehabilitation treatment program was used for this study. Veterans who were admitted under recommendation by court order (n = 60) were matched with veterans who were admitted without recommendation of court order (n = 60). Success of the program was determined by the number of days of sobriety postdischarge. RESULTS: The study revealed that there was no significant difference between types of motivation for residential treatment (i.e., voluntary vs. involuntary treatment) and length of sobriety for veterans with alcohol use disorder posttreatment. CONCLUSIONS: Findings revealed that there was no significant relationship when comparing types of motivation for treatment in a residential treatment program for veterans in regard to length of sobriety posttreatment. Therefore, a veteran's motivation for treatment may not necessarily be an accurate indicator of treatment outcomes (i.e., length of sobriety posttreatment) for residential treatment settings.

Improving Nursing Confidence and Consistency in Assessment of Opioid Withdrawal: Efficacy of Simulation and Debriefing.

The purpose of the current study was to determine if the amount of confidence in completing the Clinical Opiate Withdrawal Scale (COWS) varied among participants and whether consistency in scoring outcomes to patients occurred with COWS assessment among groups assigned to simulation and debriefing conditions. Sixty nursing staff were randomized into three groups: (a) scenario; (b) scenario and simulation; and (c) scenario, simulation, and debriefing. Staff were administered a questionnaire to assess their confidence before (i.e., pretreatment) and after (i.e., posttreatment) the simulation exercise and at 30-day follow up. The COWS assessment tool was completed by nursing staff during treatment and follow-up sessions. Significant improvements in confidence were found in all three treatment conditions. Highest consistency in scoring outcomes of the COWS to patients was found with the scenario, simulation, and debriefing condition. All participants reported having increased confidence completing the COWS. The amount of confidence among groups was not significant. Although nursing confidence did not differ among groups, increased scoring outcome reliability was found in groups using simulation and debriefing. [Journal of Psychosocial Nursing and Mental Health Services, 56(10), 27-35.].

Psychometric properties of the Beck Depression Inventory-II for OEF/OIF veterans in a polytrauma sample.

OBJECTIVE: The Beck Depression Inventory-II (BDI-II) is widely used as a screening instrument for depressive symptomatology in clinical settings. The factor structure has been researched in a variety of settings with results ranging from a single factor to a five-factor structure. The purpose of this study was to examine several identified factor structures when applied to a mixed polytrauma sample. METHOD: A sample of 310 veterans was used for this study. All subjects were administered the BDI-II screening measure as part of an evaluation in an outpatient polytrauma clinic. Confirmatory factor analysis was used to determine the best model. RESULTS: Confirmatory factor analysis revealed that a three-factor model provided a best fit. A model previously identified for individuals in residential treatment for substance abuse provided a best fit for this sample. CONCLUSIONS: The BDI-II may provide additional information for clinicians when examining the three-factor model with veterans in polytrauma settings.