Deborah S. Finnell

Measures assessing spirituality as more than religiosity: a methodological review of nursing and health-related literature

AIMS This paper is a report of a methodological review conducted to analyse, evaluate and synthesize the rigour of measures found in nursing and health-related literature used to assess and evaluate patient spirituality as more than religiosity. BACKGROUND Holistic healthcare practitioners recognize important distinctions exist about what constitutes spiritual care needs and preferences and what constitutes religious care needs and preferences in patient care practice. DATA SOURCES Databases searched, limited to the years 1982 and 2009, included AMED, Alt Health Watch, CINAHL Plus with Full Text, EBSCO Host, EBSCO Host Religion and Philosophy, ERIC, Google Scholar, HAPI, HUBNET, IngentaConnect, Mental Measurements Yearbook Online, Ovid MEDLINE, Social Work Abstracts and Hill and Hoods Measures of Religiosity text. REVIEW METHODS A methodological review was carried out. Measures assessing spirituality as more than religiosity were critically reviewed including quality appraisal, relevant data extraction and a narrative synthesis of findings. RESULTS Ten measures fitting inclusion criteria were included in the review. Despite agreement among nursing and health-related disciplines that spirituality and religiosity are distinct and diverse concepts, the concept of spirituality was often used interchangeably with the concept religion to assess and evaluate patient spirituality. The term spiritual or spirituality was used in a preponderance of items to assess or evaluate spirituality. CONCLUSIONS Measures differentiating spirituality from religiosity are grossly lacking in nursing and health-related literature.

Use of the Transtheoretical Model for Individuals with Co-Occurring Disorders

Because of the interactive nature between their mental disorder and their substance-use disorder, individuals with co-occurring disorders may experience factors that complicate behavioral change, such as considering abstinence from alcohol and drugs. This study examined the relationships between the stages-of-change and the processes of change, constructs of the Transtheoretical Model by Prochaska and DiClemente. There was partial support for the theory. The findings suggest that individuals with co-occurring disorders require support and clinical interventions throughout the entire change process.

Psychometric testing of four transtheoretical model questionnaires for the behavior, completing health care proxies

The purpose of the study was to develop four questionnaires based on the transtheoretical model (TTM) to assess the behavior, completing a healthcare proxy (HCP). The aims were to (a) operationalize the four TTM constructs for completing a HCP and (b) evaluate the psychometric properties of the questionnaires. The questionnaires were constructed and content validity established using an expert panel. Internal consistency values for each questionnaire and subscales within each questionnaire were >.79. Confirmatory factor analysis provided evidence that decisional balance and the processes of change questionnaires each contained two factors. Our data support validity and reliability of the TTM questionnaires related to HCP completion.

The Case for Teaching Patients About the Neurobiological Basis of Addictions

&NA; This article discusses the importance of providing education regarding the neurobiological basis of addictions. The aim of education about the neurobiological underpinnings of addiction is to empower patients, ease their defenses, and reduce the stigma they experience. This article presents a framework for teaching patients about the brains functions. An outline of educational sessions is provided. Education regarding neurochemicals and their relationship to addictions should be part of the neurobiological education to help patients understand the rationale for pharmacological and nutritional interventions.

Advanced Practice Addictions Nursing Specialty Certification

&NA; More than a decade ago, the Addictions Nursing Certification Board (ANCB) recognized the need for certification in this specialty. Presently, leaders in the addictions field are calling for the expansion of knowledge, attitudes, competencies and skills for health professionals in all disciplines in order to effectively identify, intervene, and refer individuals with substance use disorders. Nurses holding the Certified Addictions Registered Nurse (CARN) and the Certified Addictions Registered Nurse, Advanced Practice (CARN‐AP) have a long and strong history in meeting this present day challenge. This article discusses the historical development of the advanced practice specialty certification in addictions nursing. Efforts to promote recognition of master’s prepared nurses with certification in addictions nursing are presented.

Screening, brief intervention, and referral to treatment (SBIRT) as an integral part of nursing practice

ABSTRACT. Substance use screening, brief intervention, and referral to treatment (SBIRT) should be an integral part of the scope of nursing practice. This commentary is an appeal for nurses to advance their knowledge and competencies related to SBIRT. The question of how to move SBIRT into the mainstream of nursing practice was posed to several leaders of federal agencies, health care and nursing organizations, nurse educators, and nurse leaders. The authors provide recommendations for moving this set of clinical strategies (i.e., SBIRT) into day-to-day nursing practice.

HEALTH DIARIES FOR SELF-MONITORING AND SELF-REGULATION: APPLICATIONS TO INDIVIDUALS WITH SERIOUS MENTAL ILLNESS

Various health promotion interventions have been developed for individuals with serious mental illness that address such problems as medication nonadherence and physical inactivity. The beneficial outcomes of these interventions may be enhanced or extended if patients used a tool to monitor their own health habits. A systematic review of studies on health diaries was conducted to inform the development of the Monthly Medication Journal. A self-regulation model is discussed in using health diaries as self-monitoring and self-regulation tools for individuals with various mental health disorders.

Building a Program of Research Based on the Transtheoretical Model

&NA; The purpose of this article is to describe the authors program of research based on the transtheoretical model (TTM) by Prochaska and DiClemente, applied to individuals with addictions and comorbid psychiatric disorders. A brief overview of the TTM is provided. The purpose, findings, and implications for five non‐experimental studies are presented. The concept of patient choice emerges from this program of research. Well‐designed randomized control trials need to be conducted to establish the efficacy of stage‐based treatment for the target population and to examine the role of choice on treatment outcomes. The article addresses the value of being mentored by experts and mentoring others to address the shortage of addictions nurse researchers.

Psychometric Properties of the Decisional Balance for Patient Choice in Substance Abuse Treatment

In the context of patient-centered care and the increasing number of evidence-based substance abuse treatments, outpatient substance abuse treatment programs are poised to provide patients with a menu of options. Not all patients will be ready for such an open choice field in substance abuse treatment and they will undoubtedly differ on how they weigh the risks and benefits of having autonomy to choose their own treatment. Given the lack of an existing valid measure to assess this decision making process, this study sought to establish a measure to assess the relative weight that patients give to the pros and cons of choosing their own substance abuse treatment. Construct validity of the Decisional Balance for Patient Choice in Substance Abuse Treatment was assessed in a sample of 231 outpatients using confirmatory factor analysis. As another validity aspect, the use of decisional balance across a continuum of choice options also was investigated. The model fit was acceptable (CFI = 0.904). Internal consistency of the measure was established. The final 22-item measure revealed sound psychometric properties, but further testing is warranted.

Sleep in Lung Cancer: The Role of Anxiety, Alcohol and Tobacco

&NA; Lung cancer patients constitute a subgroup of cancer patients most at risk for experiencing sleep disturbances. Anxiety is not a significant problem in this population, but may be blunted by alcohol use or smoking. The purpose of this study is to describe anxiety, alcohol use, smoking, and sleep disturbances in a sample of patients with lung cancer. Guided by the classic model of insomnia by Spielman, this study describes anxiety as a predisposing factor, alcohol use and smoking as precipitating factors, and perpetuating factors that maintain or exacerbate sleep disturbances. Nurses across all specialty areas should address these modifiable factors during encounters with patients with lung cancer.