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2.
J Christ Nurs ; 36(3): 148-156, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31180959

RESUMO

Largely underutilized in North America, the use of medications to treat alcohol dependence is frequently a successful method of reducing alcohol craving and promoting abstinence. Recovery from alcohol addiction can be a complicated process, requiring nutritional, social, psychological, spiritual, and physical aspects of healing and self-directed behavioral change. Nurses can intervene in alcohol use disorder via screening, referrals, support of medical and behavioral treatments, and spiritual care that emphasizes hope, forgiveness, and relief from shame and guilt.


Assuntos
Alcoolismo/reabilitação , Dissuasores de Álcool/uso terapêutico , Alcoolismo/tratamento farmacológico , Alcoolismo/enfermagem , Fissura , Humanos , Naltrexona/uso terapêutico , Enfermagem na Comunidade de Fé
3.
J Addict Nurs ; 30(1): 32-39, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30829998

RESUMO

BACKGROUND: Emergency departments (EDs) treat over 20,000 patients daily with alcohol use disorders (AUDs). However, nurses receive limited education about AUDs. Studies have shown that ED nurses have negative attitudes about patients with AUDs. Negativity can contribute to the symptoms of compassion fatigue (CF) and to dissatisfaction with work. PURPOSE: The aim of this study was to design, implement, and evaluate education about AUDs and CF for ED nurses. DESIGN: This study used a quasi-experimental pretest-posttest within-subjects design. SAMPLE: A convenience sample of 44 nurses was recruited at a large urban ED. METHODS: Nurses completed demographics, Professional Quality of Life: Compassion Satisfaction and Fatigue (ProQOL), and Short Alcohol and Alcohol Problems Perceptions Questionnaire. Then, the nurses participated in 5 hours of an online educational program and a 1-hour live class about AUDs and CF. The surveys were readministered. RESULTS: The difference in pretest and posttest Short Alcohol and Alcohol Problems Perceptions Questionnaire subscales of role security (expected value = 8.5, p < .006) and therapeutic commitment (expected value = 7.50, p = .018) was statistically significant. For ProQOL constructs, no statistical significance was found. The ProQOL subscales were compared with norms and were statistically significantly different. CONCLUSION: Nurses' attitudes about patients with AUDs improved after completing the curriculum. Studied nurses had higher levels of professional satisfaction at baseline.


Assuntos
Alcoolismo/enfermagem , Fadiga por Compaixão/enfermagem , Educação em Enfermagem/métodos , Serviço Hospitalar de Emergência , Recursos Humanos de Enfermagem no Hospital/educação , Transtornos de Estresse Pós-Traumáticos/enfermagem , Adulto , Idoso , Alcoolismo/complicações , Atitude , Esgotamento Profissional/psicologia , Currículo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Satisfação Pessoal , Estatísticas não Paramétricas , Transtornos de Estresse Pós-Traumáticos/complicações , Inquéritos e Questionários
4.
Adv Emerg Nurs J ; 41(1): 65-75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30702536

RESUMO

Alcoholism continues to be a persistent health problem in the United States, accounting for up to 62% of emergency department (ED) visits. This quality improvement (QI) project examined whether identifying the benefit for early use of Alcohol Use Disorders Identification Test (AUDIT C) and Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIW-ar) in the ED would avoid escalation of care and offset poor outcomes of alcohol withdrawal syndrome (AWS). A preimplementation chart review (N = 99) showed an average of 12%-15% of patients requiring escalation of care at the project site. The QI project utilized a single-group, pre-/posttest design. The setting was a Southwest Veterans Affair tertiary care referral center. Thirty-five ED staff members were surveyed for baseline knowledge and attended education sessions, led by an advanced practice nurse, on the use of AUDIT-C and CIWA-ar. Posteducation, patients admitted to the hospital were screened with AUDIT-C and treated with CIWA-ar. Postimplementation, charts were reviewed for admitted patients (N = 42) on the use of AUDIT-C, CIWA-ar, length of stay (LOS), and area patient treated. Although the test scores after didactic education were statistically significant (p ≤ 0.050), there was no significant difference in the use of AUDIT-C or CIWA-ar in the ED, nor a significant decrease in LOS for those patients with CIWA-ar ordered. However, the potential for clinical benefit could not be disavowed. Barriers to implementation included survey fatigue, inability to embed AUDIT-C in the electronic medical record, inconsistency in completing AUDIT-C, interrater reliability, and patient fear of stigmatization. Advanced practice nurses provide an integral role to augment early identification and treatment of AWS in the ED.


Assuntos
Alcoolismo/diagnóstico , Alcoolismo/enfermagem , Serviço Hospitalar de Emergência , Conhecimentos, Atitudes e Prática em Saúde , Melhoria de Qualidade , Síndrome de Abstinência a Substâncias/diagnóstico , Síndrome de Abstinência a Substâncias/enfermagem , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Diagnóstico de Enfermagem , Inquéritos e Questionários , Estados Unidos
5.
J Clin Nurs ; 28(3-4): 650-662, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30182502

RESUMO

AIMS AND OBJECTIVES: To determine whether a portable FibroScan® device can be an acceptable screening tool for chronic liver disease in a community alcohol support service, through recording uptake, determining apparent prevalence of undiagnosed fibrosis/cirrhosis in participants and report engagement following referral to specialist liver services of those individuals referred because of a FibroScan® reading ≥ 7.1 kilopascals (kPa). BACKGROUND: Alcohol-related liver disease, including cirrhosis, is a major cause of death in the UK. Liver disease is silent and usually presents late. Socially deprived patients with alcohol-related liver disease are a "hard to engage" population and at higher risk of death than less deprived. A FibroScan® device is a non-invasive tool for measuring liver stiffness. A result of ≥7.1 kPa can indicate possible chronic liver disease. DESIGN: Prospective observational study. METHOD: Individuals who self-identified as harmful drinkers were recruited. Consented individuals attended for a liver FibroScan® . Those with a reading ≥7.1 kPa were referred to a nurse-led liver clinic for further investigations, results of which determined referral to a liver specialist in secondary care. Participants referred were monitored for compliance over a 6-month period. RESULTS: Seventy-nine consented individuals participated, an uptake of 67% of those informed of the study. Of the 79 scans performed, three were unreliable leaving 76 participants. After scanning, 20/76 (26%) had a FibroScan® ≥7.1 kPa requiring referral on to the nurse-led clinic. All 20 (100%) engaged in further assessment. Of those, 12 required onward referral to specialist services. Subsequent compliance with specialist services in this sample (n = 12) was ≥90%. CONCLUSION: A nurse-led FibroScan® outreach clinic encourages socially deprived drinkers to engage with liver services. RELEVANCE TO CLINICAL PRACTICE: A 67% uptake suggests a nurse-led FibroScan® service in a community alcohol service is acceptable. High engagement gives potential for early intervention and improved health outcomes.


Assuntos
Alcoolismo/enfermagem , Cirrose Hepática/diagnóstico por imagem , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Alcoolismo/complicações , Serviços de Saúde Comunitária , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Cirrose Hepática/etiologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Estudos Prospectivos , Reino Unido
6.
J Clin Nurs ; 28(7-8): 1174-1182, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30428140

RESUMO

AIMS AND OBJECTIVES: To elucidate the lived experience of how patients with alcohol use disorders experience being cared for when admitted to acute medical units. BACKGROUND: Alcohol use is health damaging and is identified as one of the major avoidable risk factors, and alcohol use disorder is classified among the most harmful, debilitating disease categories. Patients suffering from alcohol use disorders are characterised by complex problems and health pictures spawned by chaotic lifestyles. However, the experience of the hospitalisation from patients' perspective is poorly documented. DESIGN: The present study has a qualitative research design and is anchored in phenomenological and hermeneutical methodology, as described in reflective lifeworld research. METHODS: The data set consists of 15 in-depth interviews with patients suffering from alcohol use disorders admitted to an acute medical unit. A purposive sampling strategy was used, and the interviews were conducted as open dialogues. The study was reported in accordance with the consolidated criteria for reporting qualitative research. RESULTS: Being cared for when hospitalised was experienced as a two-stage process that changed throughout the hospitalisation from an experience of scheduled care experienced as caring to an experience of scheduled care experienced as non-caring. Four constituents further described the variable experiences: being in a safe haven, sharing a tacit but mutual goal, being in a chaotic space and being on your own. CONCLUSIONS: The study showed that being met in an authentic presence by nurses was a powerful tool that helped ease the hospitalisation. Patients suffering from alcohol use disorders call for an intentional and distinctive attentiveness and authentic presence from the nurses throughout their hospitalisation. RELEVANCE TO CLINICAL PRACTICE: Our findings highlight that patients suffering from alcohol use disorders call for an intentional and distinct attentiveness from nurses throughout the hospitalisation, where a possible transfer of attention is noticed and responded to in the care provided.


Assuntos
Alcoolismo/enfermagem , Hospitalização , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Pesquisa Qualitativa
7.
Rev. pesqui. cuid. fundam. (Online) ; 11(2, n. esp): 502-509, jan. 2019. il, tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-970107

RESUMO

Introduction: Wernicke-Korsakoff Syndrome (WKS) is one of the most serious consequences of alcohol abuse. The cognitive impact of the pathology is derived from alcoholic neurotoxicity and thiamine deficiency, which can progress to stupor, coma and death. Objective: Performing a case study regarding an alcoholic patient bearing the WKS, and also designing a nursing care plan. Methods: It is a case study with a qualitative approach that assesses an alcoholic patient bearing the WKS. The study was performed at the Hospital Universitário Oswaldo Cruz (HUOC) in Recife, Brazil, over the period from February to March 2016. Results: We were able to identify 14 nursing diagnoses, as follows: chronic confusion/memory deficit/disturbed thought processes/ impaired verbal communication; impaired walking/risk of tumble down; self-care deficit; nutrition smaller than the needs/fatigue; excessive fluid volume/impaired tissue integrity; bleeding risk; impaired skin integrity; ineffective tissue perfusion. Conclusion: The nursing professionals have singular importance with regards to both the execution of health education actions as well as the alcoholics' treatment, thus preventing the complications of the disease


Introdução: A síndrome de Wernicke-Korsakoff (SWK) é uma das mais graves consequências do abuso de álcool. O impacto cognitivo da patologia é derivado da neurotoxicidade alcóolica e deficiência de tiamina, podendo progredir para estupor, coma e morte. Objetivo: Realizar um estudo de caso de paciente alcoolista portador de SWK e construir um plano de assistência de enfermagem. Métodos: Estudo de caso com abordagem qualitativa. O estudo foi realizado no Hospital Universitário Oswaldo Cruz (HUOC), em Recife, Brasil, fevereiro a março de 2016. Resultados: Identificamos 14 diagnósticos de enfermagem: confusão crônica/memória prejudicada/ processos do pensamento perturbados/comunicação verbal prejudicada; deambulação prejudicada/risco de quedas; déficit no autocuidado; nutrição desequilibrada menor que as necessidades/fadiga; volume excessivo de líquido/integridade tissular prejudicada; risco de sangramento; integridade da pele prejudicada; perfusão tissular ineficaz. Conclusão: A enfermagem tem especial importância na execução das ações de educação em saúde e tratamento de alcoolistas prevenindo as complicações da doença


Introducción: El síndrome de Wernicke-Korsakoff (WKS) es una de las más graves consecuencias del abuso del alcohol. El impacto de trastorno cognitivo se deriva de la neurotoxicidad alcohólica y la deficiencia de tiamina, que puede progresar a estupor, coma y muerte. Objetivo: Realizar un estudio de caso de un paciente con SWK alcohólica y construir un plan de atención de enfermería. Métodos: Un estudio de caso con enfoque cualitativo. El estudio se realizó en el Hospital Universitario Oswaldo Cruz (HUOC) en Recife, Brasil, entre febrero y marzo de 2016 Resultados: Se identificaron 14 diagnósticos de enfermería: confusión crónica/deterioro de la memoria/ procesos de pensamiento perturbados/alteración de la comunicación verbal; alteración de la deambulación/riesgo de caídas; déficit de autocuidado; la nutrición desequilibrada menos necesita/fatiga; volumen excesivo de líquido/ la integridad del tejido deteriorado; riesgo de sangrado; alteración de la integridad de la piel; la perfusión tisular ineficaz. Conclusión: La enfermería tiene especial importancia en la implementación de las iniciativas de educación en la salud y el tratamiento de alcohólicos prevención de las complicaciones de la enfermedad


Assuntos
Humanos , Masculino , Feminino , Adulto , Encefalopatia de Wernicke/enfermagem , Síndrome de Korsakoff/enfermagem , Alcoolismo/complicações , Alcoolismo/enfermagem , Alcoólicos , Encefalopatia de Wernicke/complicações , Encefalopatia de Wernicke/prevenção & controle , Educação em Saúde , Síndrome de Korsakoff/complicações , Síndrome de Korsakoff/prevenção & controle
8.
J Nurs Meas ; 26(2): 204-216, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30567940

RESUMO

BACKGROUND: Publications on translation are almost all about the translation and cultural adaptation of tools developed by English speakers for use in non-English speaking cultures and languages. The reverse process, where translation goes from a native language to English, is rare. PURPOSE: Translate to English, culturally adapt, and content validate the Attitudes Scale on Alcohol, Alcoholism, and Alcoholic Persons (EAFAA). METHODS: A methodological study with analysis including the conceptual, semantic, and item equivalencies. RESULTS: Satisfactory content validity coefficients (FVI = 0.97; CVI = 0.93) were obtained. CONCLUSIONS: The EAFAA was adequately translated into American English, and the content validity was confirmed by empirical tests yielding satisfactory validity coefficients. These results provide direction for further studies to examine the factor structure and the psychometric qualities of the EAFAA-English Version.


Assuntos
Alcoolismo/psicologia , Psicometria , Alcoolismo/enfermagem , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções
9.
Rev. bras. med. trab ; 16(3): 297-304, out.2018.
Artigo em Inglês, Português | LILACS | ID: biblio-966067

RESUMO

Introdução: Os fatores psicossociais se constituem, por um lado, em interações entre o conteúdo do trabalho e as condições ambientais e organizacionais e, por outro, nas competências e necessidades dos trabalhadores. Quando se trata da assistência ao usuário dependente químico ou com adoecimento mental, o serviço é maximizado pela necessidade de cuidado constante. Objetivo: Analisar a concepção do trabalhador de enfermagem que atua na assistência aos usuários de álcool e outras drogas acerca dos fatores psicossociais que interferem na sua saúde mental. Método: Trata-se de um estudo exploratório, descritivo, de abordagem qualitativa, no qual participaram 22 profissionais da saúde integrantes da equipe de enfermagem. Os dados foram obtidos por meio de entrevista, processados no software IRAMUTEQ e analisados pela Classificação Hierárquica Descendente (CHD). Resultados: Em geral, os participantes percebem os fatores psicossociais que influenciam seu trabalho e, sendo estes desagradáveis, representam riscos para a saúde e sobrecarga mental. As mulheres reportaram maiores exigências laborais e mais sintomas de estresse. Em relação à saúde física e à psicológica, a percepção dos fatores psicossociais aumenta ao longo dos anos na organização, e a maioria referiu a existência, principalmente, de estresse ocupacional decorrente de carga e ritmo de trabalho. Conclusão: A exposição ocupacional a fatores psicossociais desfavoráveis no trabalho esteve presente no relato da maioria dos trabalhadores da enfermagem. Contudo, a correta avaliação desses fatores nas situações de trabalho apresenta dificuldades conceituais e, provavelmente, nem sempre há o seu reconhecimento


Background: Psychosocial factors represent interactions between the content of work and environmental and organizational conditions, and reflect on the competencies and needs of workers. In the case of substance-dependent or mentally ill patients, the workload is maximized due to the need to provide constant care. Objective: To analyze the perception of nursing professionals who provide care to users of alcohol and other drugs in regard to the psychosocial factors which interfere with their mental health. Method: Exploratory and descriptive study with qualitative approach conducted with 22 nursing professionals. Data were collected in interviews, processed with software IRAMUTEQ, and analyzed based on the descending hierarchical classification technique. Results: In general the participants were aware of the psychosocial factors which interfere with their work, and being unpleasant, they represent a risk to health and mental overload. The women reported more job demands and stress symptoms. The perceived influence of psychosocial factors on physical and mental health increased with the time in the job. Most participants complained of occupational stress derived from the workload and pace of work. Conclusion: Most participants reported occupational exposure to unfavorable psychosocial factors at work. However, accurate analysis of such factors is hindered by conceptual aspects, in addition to the fact they are not always recognized


Assuntos
Saúde Mental , Saúde do Trabalhador , Alcoolismo/enfermagem , Usuários de Drogas , Equipe de Enfermagem , Epidemiologia Descritiva , Coleta de Dados
10.
J Contin Educ Nurs ; 49(10): 467-473, 2018 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-30257030

RESUMO

Alcohol is the third leading cause of death and a preventable risk factor contributing to more than 200 diseases and conditions. Unquestionably, health care practitioners should routinely screen and give patients brief feedback on alcohol consumption related to health outcomes; however, they rarely ask patients about alcohol use. Alcohol screening and brief intervention (SBI), a public health model of prevention and identification of at-risk alcohol use, has not been widely disseminated. The nursing profession, the largest and most trusted sector of the health care workforce, is perfectly poised to close this gap. This article describes the development of a two-university, grant-funded collaborative online educational program with unique and time-conscious simulation and testing components to increase the knowledge and skills of nurses. The goal of the program is to promote alcohol SBI as a standard of practice in all settings. J Contin Educ Nurs. 2018;49(10):467-473.


Assuntos
Alcoolismo/diagnóstico , Alcoolismo/enfermagem , Currículo , Diagnóstico Precoce , Educação Continuada em Enfermagem/organização & administração , Enfermeiras Administradoras/educação , Recursos Humanos de Enfermagem no Hospital/educação , Adulto , Instrução por Computador , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudantes de Enfermagem , Estados Unidos
11.
Rev. pesqui. cuid. fundam. (Online) ; 10(3): 683-689, jul.-set. 2018. ilus, tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-906334

RESUMO

Objetivo: Realizar um estudo de caso de um jovem portador de tuberculose pulmonar (TP) e construir um plano de assistência de enfermagem, visando a melhoria da qualidade de vida do paciente. Métodos: Estudo de caso com abordagem qualitativa de um paciente portador de TP, hipertensão arterial pulmonar, desnutrição e alcoolismo, no Hospital Universitário Oswaldo Cruz (HUOC) em Recife-PE, no período de março a junho de 2016. A coleta de dados foi realizada mediante anamnese, exame físico, análise do prontuário, pesquisa literária e histórica de enfermagem. Resultados: Identificamos 13 diagnósticos de enfermagem: padrão respiratório ineficaz, nutrição/fadiga, manutenção ineficaz da saúde e do lar, distúrbios da identidade/autoestima, risco de solidão/suicídio e angustia espiritual. Conclusão: A enfermagem tem especial importância nas ações de controle da TP realizando a supervisão do tratamento, evitando o abandono e a tuberculose resistente, garantindo a adesão e um tratamento bem-sucedido


Objetivo: Realizar un estudio de caso de un paciente joven con tuberculosis pulmonar (TP) y construir un plan de atención de enfermería con el fin de mejorar la calidad de vida del paciente. Métodos: Un estudio de caso con enfoque cualitativo de un paciente con enfermedad de Parkinson, la hipertensión arterial pulmonar, la desnutrición y el alcoholismo, el Hospital Universitario Oswaldo Cruz (HUOC) en Recife, de marzo a junio de 2016. La recolección de datos fue realizado por la historia clínica, examen físico, análisis de la historia clínica, la investigación literaria y la historia de enfermería. Resultados: Se identificaron 13 diagnósticos de enfermería: Modelo ineficaz la respiración, la nutrición/fatiga, mantenimiento ineficaz de la salud y el hogar, trastornos de identidad/autoestima, la soledad de riesgo/suicidio y la angustia espiritual. Conclusión: La enfermería tiene especial importancia en las acciones de control TP mediante la supervisión del tratamiento, evitar el abandono y la tuberculosis resistente, asegurando la adherencia y un tratamiento exitoso


Objective: Performing a case study of a young patient having pulmonary tuberculosis disease (TB) and design a nursing care plan aiming to improve the patient life quality. Methods: Case study with a qualitative approach of a patient having TB, pulmonary arterial hypertension, malnutrition state and also alcoholism. The study was done at the Oswaldo Cruz University Hospital (HUOC) in Recife, Brazil, from March to June 2016. Data collection was performed through anamnesis, physical examination, medical records analysis, literary research and nursing history. Results: We were able to identify 13 nursing diagnoses, as follows: ineffective respiratory pattern, nutrition/fatigue, ineffective maintenance of health and home, identity/self-esteem disorders, solitude/ suicide risk and spiritual distress. Conclusion: The nursing professionals have especial importance regarding the actions of TB control, supervising the treatment, avoiding abandonment and resistant tuberculosis, as well as, guaranteeing adherence and a successful treatment


Assuntos
Humanos , Masculino , Adulto , Cuidados de Enfermagem , Cooperação e Adesão ao Tratamento , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/enfermagem , Alcoolismo/enfermagem , Hipertensão Pulmonar Primária Familiar/enfermagem , Desnutrição/enfermagem
12.
J Addict Nurs ; 29(2): 90-95, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29864057

RESUMO

BACKGROUND: Alcohol misuse is prevalent among college students and negatively affects their health, relationships, and academics. Alcohol misuse screening for this age group is advised but often overlooked. OBJECTIVE: The aim of this study was to implement an evidence-based alcohol screening tool, the Alcohol Use Disorders Identification Test-Consumption, at a southern university health clinic. METHODS: This quality improvement project used a preintervention/postintervention, mixed-methods design. A survey containing the Alcohol Use Disorders Identification Test-Consumption screening tool is used to identify students with alcohol misuse who are then offered education and follow-up. Students who were found to misuse alcohol were retested 1 month later. Qualitative comments were also gathered about the success of the project. RESULTS: Alcohol misuse at this location is high and usually missed during the student health encounter. Screening and identification of alcohol misuse were increased. The follow-up survey showed a reduced number of students misusing alcohol. CONCLUSION: Alcohol screening and treatment in a university health setting may result in decreased alcohol-related problems. The potential to improve student outcomes at other colleges and universities should be considered.


Assuntos
Consumo de Álcool na Faculdade , Alcoolismo/diagnóstico , Enfermagem Baseada em Evidências , Diagnóstico de Enfermagem , Inquéritos e Questionários , Adolescente , Adulto , Alcoolismo/enfermagem , Feminino , Humanos , Louisiana , Masculino , Sensibilidade e Especificidade , Universidades , Adulto Jovem
14.
JAMA Intern Med ; 178(5): 613-621, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29582088

RESUMO

Importance: Experts recommend that alcohol use disorders (AUDs) be managed in primary care, but effective approaches are unclear. Objective: To test whether 12 months of alcohol care management, compared with usual care, improved drinking outcomes among patients with or at high risk for AUDs. Design, Setting, and Participants: This randomized clinical trial was conducted at 3 Veterans Affairs (VA) primary care clinics. Between October 11, 2011, and September 30, 2014, the study enrolled 304 outpatients who reported heavy drinking (≥4 drinks per day for women and ≥5 drinks per day for men). Interventions: Nurse care managers offered outreach and engagement, repeated brief counseling using motivational interviewing and shared decision making about treatment options, and nurse practitioner-prescribed AUD medications (if desired), supported by an interdisciplinary team (CHOICE intervention). The comparison was usual primary care. Main Outcomes and Measures: Primary outcomes, assessed by blinded telephone interviewers at 12 months, were percentage of heavy drinking days in the prior 28 days measured by timeline follow-back interviews and a binary good drinking outcome, defined as abstinence or drinking below recommended limits in the prior 28 days (according to timeline follow-back interviews) and no alcohol-related symptoms in the past 3 months as measured by the Short Inventory of Problems. Results: Of 304 participants, 275 (90%) were male, 206 (68%) were white, and the mean (SD) age was 51.4 (13.8) years. At baseline, both the CHOICE intervention (n = 150) and usual care (n = 154) groups reported heavy drinking on 61% of days (95% CI, 56%-66%). During the 12-month intervention, 137 of 150 patients in the intervention group (91%) had at least 1 nurse visit, and 77 of 150 (51%) had at least 6 nurse visits. A greater proportion of patients in the intervention group than in the usual care group received alcohol-related care: 42% (95% CI, 35%-49%; 63 of 150 patients) vs 26% (95% CI, 19%-35%; 40 of 154 patients). Alcohol-related care included more AUD medication use: 32% (95% CI, 26%-39%; 48 of 150 patients in the intervention group) vs 8% (95% CI, 5%-13%; 13 of 154 patients in the usual care group). No significant differences in primary outcomes were observed at 12 months between patients in both groups. The percentages of heavy drinking days were 39% (95% CI, 32%-47%) and 35% (95% CI, 28%-42%), and the percentages of patients with a good drinking outcome were 15% (95% CI, 9%-22%; 18 of 124 patients) and 20% (95 % CI, 14%-28%; 27 of 134 patients), in the intervention and usual care groups, respectively (P = .32-.44). Findings at 3 months were similar. Conclusions and Relevance: The CHOICE intervention did not decrease heavy drinking or related problems despite increased engagement in alcohol-related care. Trial Registration: clinicaltrials.gov Identifier: NCT01400581.


Assuntos
Alcoolismo/enfermagem , Instituições de Assistência Ambulatorial , Assistência Centrada no Paciente/organização & administração , Atenção Primária à Saúde , Veteranos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
15.
Br J Nurs ; 27(4): 190-196, 2018 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-29457938

RESUMO

BACKGROUND: despite a 450% increase in UK alcohol-related liver disease mortality over the past 30 years, little evidence-based guidance exists regarding preventing recidivism post-liver transplant for alcohol-related liver disease. METHOD: a systematic literature review was conducted to identify demographic variables predictive of alcohol relapse and effective psychosocial interventions for alcohol-related liver disease patients post-liver transplant. RESULTS: variables most significantly predictive of alcohol relapse post-transplant were-less than 12 months pre-liver transplant abstinence; patients with children; poor pre-liver transplant psychosomatic evaluation; non-compliance with post-liver transplant treatment plan; and patients with active insurance policies. Structured management was the most effective psychosocial intervention in preventing alcohol relapse. CONCLUSION: findings should be interpreted cautiously, due to limited and poor-quality evidence. Rigorously designed further research of the psychosocial interventions targeting predictive demographic variables is recommended.


Assuntos
Alcoolismo/epidemiologia , Hepatopatias Alcoólicas/cirurgia , Cooperação do Paciente , Alcoolismo/enfermagem , Alcoolismo/prevenção & controle , Demografia , Humanos , Transplante de Fígado , Período Pós-Operatório , Recidiva , Medicina Estatal , Reino Unido/epidemiologia
16.
Health Soc Care Community ; 26(1): 27-34, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28585296

RESUMO

In France, few studies have examined home care when it comes to ageing support and even fewer have considered alcohol misuse in this context. The studies also show that being old and having alcohol use disorders are two unfavourable conditions for receiving help, whereas for the Alzheimer's disease, there is a clear need for optimal care. In this article, we study professional home caregiver's perceptions of their job along with their difficulties and satisfactions in supporting older people with Alzheimer's disease or alcohol misuse. Out of the 23 professionals approached, 17 took part in a research interview from October 2013 to January 2014. All interviews were recorded, fully transcribed and lexically analysed with Alceste® software. Among the five classes that were identified from 63% of the initial data, the main themes that emerged illustrate the nature of the associated pathologies, the perceptions and satisfactions related to the profession, their adaptive skills, the difficulties related to the life context of the older person, and the wine consumption of the latter. The lexical discourse analysis shows that the professional home caregivers are involved in looking after not only people with Alzheimer's disease but also those with alcohol misuse. However, despite the difficulties and satisfactions encountered, adaptation to the older people seems to be their priority and one of the many skills that they have acquired during their professionalisation. Most of the older people who are helped are women and the difficulties mentioned by their caregivers usually arise at the time of their death. Lastly, when caring for alcohol misusers, they describe negative attitudes in their support. Although research in this area is rare while home care for the older person, whatever the pathology, is increasing, professionals need to be supported by the associations or companies that employ them and should be trained to help them provide the appropriate care.


Assuntos
Alcoolismo/enfermagem , Doença de Alzheimer/enfermagem , Esgotamento Profissional/psicologia , Cuidadores/psicologia , Serviços de Assistência Domiciliar/estatística & dados numéricos , Satisfação no Emprego , Adulto , Idoso , Alcoolismo/psicologia , Doença de Alzheimer/psicologia , Cuidadores/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Satisfação Pessoal
17.
Rev Saude Publica ; 53: 04, 2018 Dec 20.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30652777

RESUMO

OBJECTIVE: To verify the effectiveness of brief group intervention, performed by nurses, in reducing the hazardous or harmful alcohol use in users of a primary health care service. METHODS: Clinical and randomized trial with follow-up of three months. The sample had 180 individuals with a pattern of hazardous or harmful alcohol use, recruited in a Basic Health Unit in the city of São Paulo. A sociodemographic questionnaire and the Alcohol Use Disorders Identification Test (Audit) were applied. The experimental group underwent the Brief Group Intervention, which had four group sessions, with weekly meetings. The control group received an information leaflet about issues related to alcohol consumption. Both groups participated in the follow-up of three months. The linear mixed model was used for data analysis, in which a 5% significance level was adopted. RESULTS: Forty-four individuals under hazardous or harmful alcohol use completed all phases of the research. The experimental group had a statistically significant reduction (p < 0.01) of about 10 points in Audit score after the brief group intervention [before BGI = 15.89 (SD = 6.62) - hazardous use; after BGI = 6.40 (SD = 5.05) - low hazardous use] maintaining the low hazardous use in follow-up [6.69 (SD = 6.38) - low hazardous use]. The control group had a statistically significant reduction (p ≤ 0.01) of about three points in Audit score [before BGI = 13.11 (SD = 4.54) - hazardous use; after BGI = 9.83 (SD = 5.54) - hazardous use] and in follow-up presented the mean score of 13.00 (SD = 5.70), indicative of hazardous use. Differences between the two groups (experimental group versus control group) in reduction of consumption were statistically significant (p ≤ 0.01). CONCLUSIONS: Our evidence showed that the brief group intervention performed by the nurse in the primary health care context was effective to reduce alcohol consumption in individuals with patterns of hazardous or harmful use.


Assuntos
Alcoolismo/prevenção & controle , Enfermagem de Atenção Primária/métodos , Atenção Primária à Saúde/métodos , Psicoterapia de Grupo/métodos , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/enfermagem , Alcoolismo/psicologia , Análise de Variância , Feminino , Humanos , Masculino , Enfermeiras Especialistas , Reprodutibilidade dos Testes , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
18.
Rev. pesqui. cuid. fundam. (Online) ; 9(3): 745-752, jul.-set. 2017. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-982956

RESUMO

Objective: To identify and to characterize the bibliographic production of nurses on alcohol and other drugs published in the Annals of the Brazilian Nursing Congress. Method: It is an exploratory, descriptive study through literature in the period of 2009 to 2013. We analyzed the five annals summaries of Brazilian Nursing Congress. The data were analyzed and grouped into categories according to the premises of Bardin. Results: The sample is composed of 88 abstracts that were directly related to the subject of the research, which were grouped into five categories of analysis. Conclusion: The production of alcohol and other drugs is still underrepresented. However, there was a slight increase in the number of abstracts related to the previous survey, and there was little variation among the themes explored by nurses in their research. It was pointed contemporary areas of nursing additions that need more attention.


Objetivo: Identificar e caracterizar a produção bibliográfica de enfermeiros sobre álcool e outras drogas, publicada nos Anais do Congresso Brasileiro de Enfermagem. Método: Estudo exploratório, descritivo, realizado por meio de levantamento bibliográfico no período compreendido entre 2009 a 2013. Foram analisados os cinco Anais de resumos do Congresso Brasileiro de Enfermagem. Os dados foram analisados e agrupados em categorias segundo os pressupostos de Bardin. Resultados: A amostra se constituiu de 88 resumos que estavam diretamente relacionados ao tema da pesquisa, os quais foram agrupados em cinco categorias de análise. Conclusão: A produção sobre álcool e outras drogas continua pouco representada. Entretanto, observou-se um discreto aumento do número de resumos quando relacionados a levantamento prévio, e houve pouca variação entre os temas explorados pelos enfermeiros em suas pesquisas. Apontam-se áreas contemporâneas da enfermagem em adições que necessitam de maior atenção.


Objetivo: Identificar y caracterizar la producción bibliográfica de enfermeros sobre alcohol y otras drogas, publicada en los anales del Congreso Brasileño de Enfermería. Método: Estudio exploratorio, descriptivo, realizado por medio de levantamiento bibliográfico en el período comprendido entre 2009 a 2013. Se analizaron los cinco anales de resúmenes del Congreso Brasileño de Enfermería. Los datos fueron analizados y agrupados en categorías según los presupuestos de Bardin. Resultados: La muestra se constituyó de 88 resúmenes que estaban directamente relacionados al tema de la investigación, los cuales fueron agrupados en cinco categorías de análisis. Conclusión: La producción sobre alcohol y otras drogas sigue siendo poco representada. Sin embargo, se observó un discreto aumento del número de resúmenes cuando se relacionaron con el levantamiento previo, y hubo poca variación entre los temas explotados por los enfermeros en sus investigaciones. Se señalan áreas contemporáneas de la enfermería en adiciones que necesitan de mayor atención.


Assuntos
Humanos , Transtornos Relacionados ao Uso de Álcool/enfermagem , Alcoolismo/enfermagem , Literatura de Revisão como Assunto , Drogas Ilícitas/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/enfermagem , Brasil
19.
Soins Psychiatr ; 38(311): 12-15, 2017.
Artigo em Francês | MEDLINE | ID: mdl-28683879

RESUMO

There is a plethora of applications designed to improve mental healthcare available on the digital market. All the caregivers involved in the field of psychiatric disorders must keep abreast of these advances in order to develop them to benefit patients as early as possible. However, their real efficacy remains unproven and their potential limits are obvious, such as the issue of accessibility for the frailest patients, data protection as well as the quality of the messages conveyed.


Assuntos
Atitude do Pessoal de Saúde , Transtornos Mentais/enfermagem , Transtornos Mentais/psicologia , Terapia Assistida por Computador , Alcoolismo/enfermagem , Alcoolismo/psicologia , Alcoolismo/reabilitação , Difusão de Inovações , Registros Eletrônicos de Saúde , França , Acesso aos Serviços de Saúde , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Telemedicina , Resultado do Tratamento , Interface Usuário-Computador
20.
Soins Psychiatr ; 38(311): 34-36, 2017.
Artigo em Francês | MEDLINE | ID: mdl-28683884

RESUMO

As part of the individualised management of patients with an addiction, a relapse prevention strategy for people dependent on alcohol or with bulimia has been developed by Sainte-Anne general hospital. Nursing support based on the use of a connected bike with virtual riding software recreates an environment which is considerably enriched on a social, motor and cognitive level.


Assuntos
Alcoolismo/enfermagem , Alcoolismo/reabilitação , Ciclismo/psicologia , Bulimia Nervosa/enfermagem , Bulimia Nervosa/reabilitação , Psicoterapia de Grupo/métodos , Transtornos Relacionados ao Uso de Substâncias/enfermagem , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Terapia Assistida por Computador/métodos , Interface Usuário-Computador , Alcoolismo/psicologia , Bulimia Nervosa/psicologia , Feminino , Humanos , Imaginação , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Medicina de Precisão/métodos , Prevenção Secundária/métodos , Autoimagem , Software , Transtornos Relacionados ao Uso de Substâncias/psicologia
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