Alcohol Abstinence Self-Efficacy and Recovery Using Alcoholics Anonymous®: An Integrative Review of the Literature.

Alcohol use disorder (AUD) is a chronic health problem in the United States, with social, economic, and personal consequences. The purpose of the current integrative review was to examine recovery from AUD in adult Alcoholics Anonymous® (AA) members working the 12 steps. Databases were searched using a combination of search terms with inclusion criteria of human adult studies published in English between 2010 to 2020. Searching the references of retained records also identified other relevant studies for inclusion. Through the process of two searches and examination of retained records' reference lists, 20 articles were retained. AA outcomes frequently cited are abstinence, improved self-efficacy, improved psychosocial well-being, and improved social networks. These positive outcomes are linked to attendance and participation in AA. There is a deficiency of research specific to how AA works to achieve the ascribed outcomes. This identified gap in the state of the science lays the foundation for future research. [Journal of Psychosocial Nursing and Mental Health Services, 59(12), 33-39.].

Comparison of lecture and manipulative teaching methods on learning and application to practice.

IMPORTANCE: Manipulatives are hands-on or virtual displays that facilitate teaching and learning and are interactive and engaging to students during the learning activity. Manipulatives have been shown to be effective teaching tools for a wide range of students. OBJECTIVE: This study examined whether the use of manipulatives in nursing education improved Satisfaction, Learning/Knowledge Retention, Behavior/Transfer of Learning, and Intentions to Change Practice. Underpinning theoretical frameworks included Kirkpatrick's Four Levels of Evaluation Model and Theory of Planned Behavior. DESIGN, SETTING, AND PARTICIPANTS: A quasi-experimental design comparing lecture to manipulative training was used with a sample of nursing interns and students. The study manipulative was a hands-on tool that demonstrated physiologic changes that occur with fluid imbalances. Data were collected using three questionnaires (1) before training, which included demographics and questions on participants' level of comfort with fluid imbalances, (2) immediately following training, which evaluated Satisfaction, Learning, Behavior, and Intentions, and (3) 6-8 weeks after training, which evaluated Learning, Behavior, and Intentions. MEASURES: Independent sample t-test, Mann-Whitney U test, and repeated-measure analysis of variance were used to analyze the data. CONCLUSION: Findings revealed significant differences in Intentions to change practice (p = 0.014), indicating the manipulative had a greater potential effect on clinical practice compared to the lecture.

Manipulatives in nursing education: A concept analysis.

Use of manipulatives is an active learning strategy that relies on student interaction with objects to help them understand abstract concepts. Manipulatives are frequently used in elementary and middle schools but literature demonstrates that they are also effective tools for adult learners. The aim of this concept analysis is to evaluate the use of manipulatives in education and its applicability to nursing education. Walker and Avant's eight-step concept analysis process was used for this evaluation. Google Scholar, EPSCO, PubMed, and Cumulative Index to Nursing and Allied Health Literature databases were searched using the terms manipulative and manipulatives, college or higher education, and teaching strategies. Three defining attributes emerged from the analysis: manipulatives must be positively engaging to students, learners must interact with objects or virtual graphics, and objects or graphics must be used to facilitate learning. Based on these defining attributes an operational definition is proposed. The model case provides an example of the use of manipulatives in nursing education, whereas additional cases support the defining attributes and the operational definition. Empirical referents describe uses of manipulatives in nursing education, both in academic and clinical settings. The concept of manipulatives and their defining attributes can be used by nurse educators to plan, organize, and evaluate education programs.

Lessons from the Homeless: Civil and Uncivil Interactions with Nurses, Self-Care Behaviors, and Barriers to Care.

BACKGROUND: Civility, rooted in social justice, is a fundamental value of nursing. Homeless people are particularly at risk for experiencing uncivil behavior from nurses. PURPOSE: The purpose of this study was to explore homeless people's perceptions of their interactions with nurses. METHOD: In this descriptive, qualitative study, we interviewed 15 homeless adults who described their experiences with nurses. The interview guide, developed by the researchers, consisted of open-ended questions and probes. Transcriptions and field notes were analyzed through thematic analysis. RESULTS: Three major themes emerged: nurses should be civil, self-care behaviors, and barriers to good care. Subthemes included listening, compassion, attentiveness, and judgment as components of civility; where they go for care and who cares for them as self-care behaviors; and lack of money and homeless status as barriers to care. CONCLUSIONS AND IMPLICATIONS: Our findings indicate people who are homeless often perceive nurses to be uncivil and uncaring toward them; furthermore, our participants provide a unique description of healthcare interactions from the perspective of the homeless. These findings can be used as a basis for the development of education interventions for students and practicing nurses to assist them in learning to provide civil and compassionate care for the homeless.

Perceptions of New Nurses Concerning Incivility in the Workplace.

BACKGROUND: Although an atmosphere of civility in which nurses respect and value each other is crucial to health care, incivility continues to be widespread. METHOD: New graduate nurses completed an online questionnaire in which they described incivility and discussed its impact on new nurses and patients. RESULTS: Findings were categorized according to the impact of incivility on new nurses and patients. Embedded in these categories are rich descriptions of incivility in health care. CONCLUSIONS: The participants witnessed uncivil interactions that negatively impacted them emotionally, professionally, and physically. They also discussed the harmful effects of incivility on patients, whose care may be impeded or their faith in caregivers eroded in hostile, uncivil care environments. Nurses in professional development play a crucial role in promoting a culture of civility through raising awareness, supporting nurses new to the profession, and helping health care workers to better cope with incivility.

The Impact of Disordered Gambling Among Older Adults.

The current study is a secondary analysis that describes the mental, social, and economic health impacts of disordered gambling in older adults recovering from pathological gambling. The study sought to answer the following research questions: (a) What are the problem behaviors in the mental, social, and economic health dimensions?; and (b) What is the association between mental, social, and economic health impact dimensions and the South Oaks Gambling Screen score? The study population comprised a convenience sample of 40 older adults recovering from pathological gambling in the Midwestern United States. Participants were originally recruited from Gamblers Anonymous(®) meetings and gambling treatment centers. Significant findings for the current study population were: gambling causing depression, being fired from a job due to gambling, and still paying off gambling debt. Nurses should evaluate effects of disordered gambling, assess for disordered gambling, and include a financial assessment in routine care of this patient population.

Behind Bars: Experiences Conducting Behavioral Addictions Research in a County Jail.

Individuals who are incarcerated experience disparities in mental health, warranting study by nurse researchers. However, nurse researchers' unfamiliarity with the jail environment may pose a barrier to conducting research with this vulnerable population. The current article presents an account of the planning and implementation needed to study perceived health and gambling behavior in county jail inmates. The challenges and rewards of research that aim to better understand the mental health issues affecting this population are also identified. Developing relationships with jail personnel and understanding the incarcerated population and their surroundings are key to conducting research in this environment.

Gambling and perceived health among adult jail inmates.

Gambling problems have been associated with lower perceived health in community samples, but little research has examined this relationship in an incarcerated population. The purpose of this study was to determine the perceived health and gambling problems of adult inmates (18-49 years old) in a county jail. We surveyed 184 male and female inmates aged 18-49 years. Nearly 35% of inmates scored as problem or pathological gamblers, and inmates scored significantly lower on all Short Form-36 Version 2 perceived health scales than the U.S. population norm. There were no significant differences on perceived health scores between recreational and problem/pathological gamblers. The high prevalence of gambling problems and poor perceived health necessitates research to provide screenings and test effectiveness of gambling and health interventions in this population.

Perceived health and gambling behavior of inmates: a review of the literature.

PURPOSE: An integrative review was conducted to determine perceived health and gambling behavior in incarcerated adults (ages 18-49), measures of perceived health and gambling behavior, and relationships between perceived health and gambling behavior. CONCLUSIONS: Adult inmates report poorer perceived health and increased levels of gambling problems than those who are not incarcerated. No research investigating the relationships between perceived health and gambling among adult inmates was found. PRACTICE IMPLICATIONS: Knowledge of relationships between perceived health and gambling can assist healthcare providers in understanding potential healthcare needs of the inmates and begin treatment while they are still incarcerated. Nurses in settings such as free and private clinics, homeless shelters, churches, and emergency departments need to screen for problem gambling in this population. This will facilitate appropriate referrals and continued treatment as these inmates transition back into society.

An intervention to promote civility among nursing students.

AIM: The purpose of this exploratory, mixed-methods study was to test an intervention to build social capital and civility among nursing students. BACKGROUND: Incivility impacts nurses and nursing students, and can negatively influence patient care and the quality of nursing education. The Institute of Medicine and the Joint Commission recommended implementation of strategies to manage incivility and build social capital. METHOD: Twenty-five student nurses completed the Ways of Coping Questionnaire and participated in interviews; 10 participated in the intervention, a journal club focused on civility in nursing. This study provided insight into student nurses' perceptions of civility. RESULTS: Participation in the intervention changed students' attitudes and behavior regarding civility. Specifically, students refused to participate in uncivil behavior, helped peers, were supportive, and tried to prevent or avoid incivility. CONCLUSION: Expansion of this study to further test the impact of civility-focused journal clubs is recommended.

Perceptions of academic integrity among nursing students.

PURPOSE: Academic dishonesty is growing among nursing students. Reasons for this growth can be categorized into student, faculty, and system factors. Nursing faculty designed a study to explore this problem. CONCLUSIONS: We identified three themes: characteristics of students with academic integrity, patient safety, and professional outcomes. Exploring student perceptions of academic integrity can help faculty design measures to prevent dishonesty in these three areas. PRACTICE IMPLICATIONS: We recommend fostering culture change through strategies that target students, faculty, and systems. These strategies include peer mentoring, role modeling integrity, enhancing awareness of what constitutes cheating, and developing policies that promote honesty.

Gambling behaviors and perceived health among incarcerated older adults.

The proliferation of lotteries and casinos has led to increased participation in gambling. Older adults who have opportunities to gamble may be vulnerable to gambling problems, and incarcerated older adults may be the most vulnerable. Furthermore, research has linked decreased health to gambling problems. This study compared perceived health and gambling problems among 43 incarcerated older adults from two county jails in the midwestern United States. Results from the South Oaks Gambling Screen indicated 48.83% of the sample scored in the problem or pathological range. Short Form-36 results were compared with U.S. norms for ages 55 to 64 and showed significantly lower perceived health scores on Role-Physical, Bodily Pain, Mental Health, Social Functioning, and Role-Emotional subscales. The problem and pathological gamblers showed significantly lower social functioning than the recreational gamblers. Assessment of health conditions and gambling behaviors is important for quantifying current and anticipated burdens of these conditions on correctional health care systems and the community.

Journal clubs: a strategy to teach civility to nursing students.

Incivility affects nurses and nursing students and can negatively influence patient care and the quality of nursing education. The Institute of Medicine, The Joint Commission, and the American Association of Colleges of Nursing recommended implementation of strategies to manage incivility and build social capital. The purpose of this mixed methods study was to explore the influence of a journal club as an educational intervention to build civility and academic integrity among nursing students. Seventy-nine nursing students completed the Nurses' Intervention for Civility Education Questionnaire and the Ways of Coping Questionnaire before and after the Civility Journal Club intervention. Students involved in the Civility Journal Club were more aware of civility and incivility, more likely to be helpful to their peers, and better equipped to cope with episodes of incivility.

Does your older adult client have a gambling problem?

Pathological gambling is becoming an increasing problem in today's culture, particularly because opportunities and inducements to gamble abound. This article describes symptoms, consequences, and comorbidities experienced by pathological gamblers. Gambling pathology is often invisible because pathological gamblers seldom disclose gambling problems to their primary care provider. Thus, nurses will benefit from knowledge of the physical and emotional signs of the disorder. A two-question assessment tool, the Lie/Bet Questionnaire, is useful in helping nurses identify pathological gamblers. Interventions and treatment options, including group therapy and environmental modification, are also discussed. As always, education concerning problems and consequences of pathological gambling is a first step. Because research has indicated that visits to casinos by older adults have doubled since 1975, the authors use an example of an older adult to clarify the issues. Although the article's content is applicable to clients across the life span, it has particular significance for older adults.

Antidepressant treatment of depression in rural nursing home residents.

Under-diagnosis and under-treatment of depression are major problems in nursing home residents. The purpose of this study was to determine antidepressant use among nursing home residents who were diagnosed with depression using three different methods: (1) the Geriatric Depression Scale, (2) Minimum Data Set, and (3) primary care provider assessments. As one would expect, the odds of being treated with an antidepressant were about eight times higher for those diagnosed as depressed by the primary care provider compared to the Geriatric Depression Scale or the Minimum Data Set. Men were less likely to be diagnosed and treated with antidepressants by their primary care provider than women. Depression detected by nurses through the Minimum Data Set was treated at a lower rate with antidepressants, which generates issues related to interprofessional communication, nursing staff communication, and the need for geropsychiatric role models in nursing homes.

Comorbid psychiatric disorders among older adult recovering pathological gamblers.

The proliferation of state lotteries and casinos has led to an increased participation in gambling and its associated problems. Older retired adults have more opportunities to gamble and available funds than other demographic groups. For these reasons, older adults may constitute a special risk group for pathological gambling. Because substance misuse, mood, anxiety, and personality disorders are common in problem and pathological gamblers, we sought to examine rates of comorbid psychiatric disorders in 40 older adults with lifetime pathological gambling using structured assessments of known reliability. The results indicate a high level of psychiatric comorbidity in this population including depression, alcohol dependence, panic, and generalized anxiety disorders, as well as obsessive compulsive and avoidant personality disorders. Implications of these findings for psychiatric nurses are discussed.

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.