Alcohol Use, Misuse, and Abuse Among Nursing Students: A Photovoice Study.

BACKGROUND: Rates and frequencies of alcohol consumption remain unknown among nursing students, and risk and protective factors associated with alcohol misuse are poorly understood. Nursing curricula often lack content on substance use disorders among nurses, which is reported to begin prior to or during college. PURPOSE: The aims of the study were to examine nursing students' perceptions of the risk and protective factors associated with alcohol behaviors among themselves and their peers and to identify substance use policies and their influence. METHODS: We used the Photovoice method, which employs participatory action research. Participants were screened for alcohol misuse via AUDIT-C, and thoughts and perceptions were obtained regarding their alcohol consumption behaviors through self-expression and group advocacy. Data were collected from four focus groups that included nine undergraduate nursing students. RESULTS: Data reflected the following key issues: stress, environmental influences, societal acceptance, and availability of alcohol. Participants identified that the following problems place them at risk for alcohol misuse: lack of addiction/alcohol education; nursing program expectations increase stress/anxiety; unhealthy habits, social isolation, and individual influences; peer influence/the college experience; and ineffective and unenforced campus policies. Protective factors included university policies; life experiences; and nursing program policies, responsibilities, peer influences, and perceived reputation. CONCLUSION: This action research informed a dialogue with colleagues regarding nursing students' stressors and resulting professional ramifications. Recommendations for future work include investigation of expressed social isolation from university peers and its effects on their alcohol consumption behaviors and increase alcohol education with emphasis on adaptive coping strategies in a stressful professional role in Bachelor of Science in Nursing curricula.

Setting up an alcohol treatment centre.

In the emergency unit at University Hospital of Wales (UHW), Cardiff, a rise in the number of patients presenting with alcohol intoxication was reducing the amount of clinical space available to, and affecting the care of, other patients. In response, an alcohol treatment centre (ATC) staffed by emergency nurse practitioners, healthcare assistants and police officers was set up and piloted for three months in the city centre to ensure that people who were severely intoxicated could be managed safely without attending the emergency unit at UHW. This article describes the collaborative approach adopted to launch the three-month pilot project and discusses findings from a review of the ATC conducted when the pilot had ended. These findings indicate that severely intoxicated patients at low or moderate risk had been diverted from the emergency unit to the ATC and that clinical care in the unit, and police and ambulance services, had improved as a result.

Healthcare Professionals' Perceptions of Alcohol-Intoxicated Trauma Patients: Implications for Healthcare Delivery at South Rand Hospital Emergency Department

Objectives: The objectives of this study were to explore healthcare professionals' (HCPs) perceptions about patients who had been assaulted; who consult under the influence of alcohol; and to make them aware of their attitudes towards these patients; with a view to improving their care. Design: An explorative; descriptive study with 15 HCPs purposively selected across professional categories; qualifications; work experience; gender and age. These HCPs participated in four focus group interviews on intoxicated patients who had been assaulted. The interviews were audio-taped and supplemented with field and observational notes. Themes were identified using the cut-and-paste method and grouped into categories. Findings were subjected to mental triangulation; peer review and member check; and were compared with those in the literature. Settings and subjects: HCPs who treat assault patients within the emergency department (ED) of South Rand Hospital; Rosettenville; comprised the study population. They expressed their perceptions and inner feeling about patients under the influence of alcohol who had been assaulted. Interviews were carried out in the boardroom of the hospital. Outcome measures: HCPs' awareness of their attitudes towards assaulted patients under the influence of alcohol. Results: Frustration; anger; a desire to punish intoxicated patients and concern about wastage of hospital resources were some of the stressors experienced by HCPs. Exposure to health hazards and a poor security system were concerns that arose following intimidation; aggression and verbal abuse from alcohol-intoxicated patients who had been assaulted. Conclusion: HCPs experience negative emotions and develop negative attitudes in response to alcohol-intoxicated patients who have been assaulted

Struggling to survive: the experiences of women sexually assaulted while intoxicated.

Approximately half of all sexual assault cases involve substance abuse or misuse, yet no studies have focused specifically on women who were under the influence of a substance when assaulted. The aim of this study was to explore the experiences of women who were sexually assault while under the influence of a substance. A phenomenological approach was used to gather data using individual, in-depth interviews with women following a sexual assault while intoxicated. Interviews were conducted using open-ended and probing questions to explore participants' life experiences from childhood to the present. The study uncovered a continuous struggle to survive among the participants. Five themes including previous victimization, substance misuse, struggling with feelings, finding support, and struggling to break the cycle were found. This research revealed lives complicated by substance misuse and histories of victimization. Intoxication raises vulnerability and risk for sexual assault. Effective nursing interventions designed to address the women's history of victimization and substance misuse may benefit women sexually assaulted while intoxicated.

Intoxicação alcoólica em crianças e adolescentes: dados de um centro de assistência toxicológica / Alcoholic intoxication in children and adolescents: information from an intoxication control center

O abuso de álcool constitui um dos problemas sociais e de saúde de grande magnitude em nosso tempo. O estudo teve como objetivo caracterizar as ocorrências toxicológicas em crianças e adolescentes com idade até 18 anos, hospitalizados por intoxicação alcoólica e notificados em um Centro de Controle de Intoxicação nos anos de 2003 a 2007. O estudo foi retrospectivo, com análise quantitativa dos dados. Encontraram-se 338 notificações. O abuso de álcool ocorreu predominantemente no sexo masculino, sendo os finais de semana, o período noturno e o uso agudo de maior ocorrência. A intoxicação alcoólica relacionada às ocorrências violentas aumentou em 12 vezes as chances de internação, e observou-se relação significativa entre o uso crônico e o aumento da gravidade clínica. Sugere-se estudos para aprofundar a temática e a implementação de políticas e estratégias preventivas tendo a criança e o adolescente como foco principal.

Binge drinking and disordered eating in college students.

PURPOSE: To explore the co-occurrence of binge drinking and disordered eating behaviors in college-aged students. DATA SOURCES: Data were collected from 211 college-aged students (mean age 20.7 years) at a private university in the northeastern United States using a web-based survey. Gender-specific binge drinking rates (five drinks per occasion for men and four drinks per occasion for women) were ascertained. Disordered eating behaviors included measures of binge eating as well as unhealthy weight loss behaviors (skipping meals, fasting, diet pills, laxatives, and self-induced vomiting). CONCLUSIONS: Binge drinking rates were high (63% of female, 83% of male students). Binge eating was reported by 48% of students and was correlated with healthy and unhealthy weight loss behaviors. Female students were more likely to endorse the use of skipping meals, fasting, use of diet pills, laxatives, and self-induced vomiting. IMPLICATIONS FOR PRACTICE: Binge drinking and disordered eating behaviors are practiced by both male and female students and are common occurrences on college campuses. Nurse practitioners need to be aware of these behaviors, their co-occurrence, and the need to assess and intervene with students who are at risk for the negative health outcomes associated with the use of these behaviors.

Aggressive events in adolescent dating violence.

This purpose of this paper is to present a typology of common aggressive events that occur in the context of adolescent dating violence. The typology is based on 42 transcripts of interviews with young adults, ages 18 to 21, who described dating violence they had experienced when adolescents (ages 13-18). One-hundred and eighty-four text units that contained a description of an event involving aggression or violence between the participant and a dating partner were extracted from the transcripts. Cross-case analysis was used to create categories of events that shared similar characteristics. The analysis yielded eight types of aggressive events: (a) tumultuous, (b) explosive, (c) scuffling, (d) violating, (e) threatening, (f) controlling, (g) disparaging, and (h) rejecting, ignoring, or disrespecting. The typology can provide a foundation for further research on adolescent dating violence from a situational perspective and can be used as a tool to promote discussion of dating violence with victimized or at-risk youth.

Men who experienced violence or trauma as children or adolescents and who used violence in their intimate relationships.

Understanding the lived experience of men who have committed violent acts against their intimate partners may provide insight into nursing interventions that may prevent or cease violence against women. Nurses have opportunities to intervene with men who use violence in their intimate relationships who present with a history of maltreatment or trauma as a child or young adult or who have a history of having been exposed to cultures that promoted violence. The purpose of this study was to gain insight into the lived, everyday experiences of men who have used violence in their intimate relationships, including the men's values, purposes, and choices they had in life. To answer the research question, "What is the lived experience of men who have used violence in their intimate relationships and who have used alcohol or other drugs?" a descriptive, phenomenological research design was undertaken. Unstructured individual interviews with seven men resulted in the emergence of 16 themes, three of which are described in this paper: being part of a family culture that promoted violence; being part of a non-family culture that promoted violence; and early experiences of maltreatment or trauma. The participants described how their experiences with maltreatment or trauma as children and young adults impacted their mental health as adults and their use of violence in their adult intimate relationships. The participants' experiences provided insight into how nurses can intervene to prevent or stop violence against women and provided implications for future research.

Drinking games and college students. Part 2: Nursing implications.

In Part 1 of this article, published in the February 2010 issue, the problem of drinking game participation by U.S. college students was described. College students may play these games for reasons of peer acceptance and social interaction. Unfortunately, approximately two thirds of U.S. college students participate in this risky binge drinking behavior, from which serious consequences and harms can result. In this article, implications for community and mental health nurses are discussed. Nurses in a variety of settings have unique opportunities to educate, counsel, treat, and refer these students regarding the risks and protections of this behavior.

Preventing unsafe alcohol consumption on the 21st birthday: roles for nurses.

Because of its legal significance, the 21st birthday is considered a milestone event. Research reveals that turning 21 is an occasion that is often marked by the ingestion of excessive, perhaps even lethal, amounts of alcohol. Peer pressure and lack of knowledge about the potentially life-threatening effects of alcohol overconsumption can make this birthday a perilous event. Birthday rituals have developed that encourage reckless consumption. Literature addressing the prevalence of excessive drinking among college students is abundant. However, the authors found minimal literature addressing the potential contribution of nurses toward the reduction of unsafe alcohol consumption among young adults celebrating their 21st birthday. This article provides a brief review of the physiological effects of alcohol and practical suggestions for promoting safety among young adults celebrating this milestone birthday.

Use of a breathalyzer in a local bar: A community education project.

In completing a faculty-assigned service-learning project, a group of nursing students sought to educate their peers and the public about the effects of alcohol consumption. Breathalyzer readings were obtained from 150 bar patrons and correlated with the number of drinks consumed and number of hours spent drinking. The results were used to educate bar patrons about the difference between how intoxicated they felt and their actual blood alcohol levels. The students also distributed information about substance abuse assistance and safe transportation home. This screening technique served as an application of secondary prevention principles for the nursing students. The project was considered innovative in that no similar study was found in the literature. Selected Healthy People 2010 goals were also addressed in this project.