Irene Kane

Effects of Screening, Brief Intervention, and Referral to Treatment (SBIRT) Education and Training on Nursing Students’ Attitudes Toward Working With Patients Who Use Alcohol and Drugs

ABSTRACT Background: Screening, Brief Intervention, and Referral to Treatment (SBIRT) can reduce alcohol use and negative health outcomes in patients with risky substance use. However, negative attitudes that some health care professionals have toward patients who use substances are a barrier to implementing SBIRT. Methods: The University of Pittsburgh School of Nursing, in partnership with the Institute for Research, Education, and Training in Addictions (IRETA), developed a curriculum to train baccalaureate student nurses to deliver SBIRT. Results: Following SBIRT education and training, students’ perceived attitudes toward patients who use alcohol became more positive. Less robust changes were found for attitudes related to patients who use drugs. Conclusions: Nurses composing the largest group of healthcare workers are in key positions to screen, intervene, and provide education about substance use.

Concurrent muscle hurt and perceived exertion of children during resistance exercise.

PURPOSE Rating of muscle hurt (RMH) and RPE were concurrently measured for 10- to 14-yr-old females (n = 50) and males (n = 50) performing unilateral biceps curl (BC) and knee extension (KE) isotonic exercise. METHODS BC and KE exercises were counterbalanced within subjects. Three counterbalanced, 10 repetition sets (30%, 50%, and 70% one repetition maximum (1-RM)) were performed for both exercises. RMH and RPE were obtained for active muscles using the Childrens OMNI-Hurt Scale and the Childrens OMNI-Resistance Exercise Scale of Perceived Exertion, respectively. RESULTS For both females and males, RMH ranged across sets from 1.5 to 6.0 during BC and 3.2 to 6.7 during KE. RPE ranged from 3.4 to 8.3 during BC and 5.0 to 8.9 during KE. Ratings expressed as percent scores were lower (P < 0.01) for RMH than for RPE at the 30%, 50%, and 70% 1-RM during BC and KE for females and males. Regression coefficients for weight lifted as a function of RMH ranged from r = 0.67 to r = 0.87 (P < 0.01) for BC and KE. Correlations between RMH and RPE ranged from r = 0.19 to r = 0.82 across sets for both genders. CONCLUSIONS Female and male children can concurrently and differentially rate their perceived intensity of muscle hurt and exertion during upper and lower body resistance exercise using numerical category metrics (i.e., OMNI scales) having construct-specific pictorial and verbal descriptors.

Combined use of the postpartum depression screening scale (PDSS) and Edinburgh postnatal depression scale (EPDS) to identify antenatal depression among Chinese pregnant women with obstetric complications.

The purpose of the present study was to evaluate antenatal depression screening employing two scales: the Postpartum Depression Screening Scale (PDSS) and Edinburgh Postnatal Depression Scale (EPDS) for the population of Chinese pregnant women with obstetric complications. A convenience sample of 842 Chinese pregnant women with complications participated in this study. The PDSS total score correlated strongly with the EPDS total score (r=0.652, p=0.000). Each tool performed extremely well for detecting major and major/minor depressions with PDSS resulting in a better psychometric performance than EPDS (p<0.01). If combined use, the recommended EPDS cut-off score was 8/9 for major depression, at which the sensitivity (71.6%) and specificity (87.6%) were the best, and the recommended PDSS cut-off score was 79/80 for major depression, along with its best sensitivity (86.4%) and specificity (100%). The study concluded that EPDS and PDSS appear to be reliable assessments for major and minor depression among the Chinese pregnant women with obstetric complications. Combined use of these tools should consider lower cutoff scores to reduce the misdiagnosis and improve the screening validity.

Predicted and Actual Exercise Discomfort in Middle School Children

PURPOSE The purpose of this study was to use a match-mismatch paradigm to examine childrens exercise discomfort during an aerobic shuttle run. METHODS Thirty-four middle school females (n = 18) and males (n = 16) aged 11-14 yr participated. An Exercise Discomfort Index (EDI) was calculated as a rating of perceived exertion for the overall body (Childrens OMNI Scale) x a rating of perceived muscle hurt (Childrens OMNI Muscle Hurt Scale). Measurements were obtained immediately before (i.e., predicted) and after (i.e., actual) performance of the nationally standardized Progressive Aerobic Cardiovascular Endurance Run (PACER) shuttle test of aerobic fitness. Self-report physical activity and sport participation history were obtained before PACER performance. RESULTS Two-way ANOVA (gender x assessment time point) showed a significant main effect for assessment time point: predicted EDI (means +/- SD = 25.9 +/- 20.1) was greater than actual EDI (means +/- SD = 19.4 +/- 17.8) for the total group (P = 0.021). However, neither the main effect of gender nor the gender x assessment time point interaction was significant. Idiographic analysis showed that overpredictors of discomfort reported less time (5.25 median h x wk(-1)) and engaged in less recreational activity than underpredictors (11.14 median h x wk(-1)). However, no significant relation (P = 0.508) was observed between PACER laps completed and exercise discomfort. CONCLUSIONS The sample of middle school children in this study predicted greater exercise discomfort than actually experienced when performing a PACER test. It is possible that a discomfort construct plays an important role in the initiation and maintenance of childrens aerobic exercise, providing a basis for physical activity interventions.

Identifying at risk individuals for drug and alcohol dependence: teaching the competency to students in classroom and clinical settings.

Alcohol use and other drug use affect patient healthcare outcomes. This article describes a classroom-to-clinical approach teaching nursing students to utilize motivational interviewing techniques to support patient behavior change. Through the lens of a universal prevention method, nursing students learned about reward circuit activation leading to risky substance use and the difference between addiction and at-risk use. Specific assessment tools and motivational interviewing techniques were presented in the classroom. Students then applied their knowledge in simulation laboratories and clinical rotations.

Telephone-Delivered Physical Activity Intervention for Individuals With Serious Mental Illness A Feasibility Study

BACKGROUND: Obesity is prevalent in individuals with serious mental illness (SMI). OBJECTIVE: The purpose of this study is to examine the feasibility of a telephone-delivered physical activity (PA) intervention for outpatients with serious mental illness to maintain PA and to explore the preliminary efficacy of the intervention on health status. DESIGN: This study used a randomized experimental design. The treatment group received pedometers and eight weekly phone calls; the control group received written information regarding PA. Descriptive statistics were used to analyze data collected at baseline and 8 weeks. RESULTS: Twenty-two subjects with SMI (mean age = 44.09 ± 7.6 years; 54.5% were male) were recruited and 16 subjects completed the study in 8 weeks. PA (z = −2.37, p = .02) increased in the treatment group (n = 8) whereas the control group (n = 8) maintained baseline PA level (z = −1.61, p = .11). Health outcomes were not changed (ps > .05). CONCLUSION: Telephone-delivered intervention is feasible and has the potential to improve PA in individuals with SMI.

The Prevalence of Antenatal Depression and its Related Factors in Chinese Pregnant Women who Present with Obstetrical Complications.

OBJECTIVES The psychological status of Chinese pregnant women who present with obstetrical complications is concerning to Chinese health professionals. This study aimed to investigate the prevalence of antenatal depression and analyzed related risk factors in a population of high-risk Chinese women. DESIGN A large sample size, cross-sectional study. METHODS A total of 842 pregnant women with complications completed the Chinese version of the Postpartum Depression Screen Scale (PDSS) in this cross-sectional study. t-Test, ANOVA and Binary logistic regression tests were used in data analysis of antenatal depression and risk factors. RESULTS The prevalence of major or minor depression in high-risk Chinese pregnant women during antenatal period was 8.3% and 28.9%, respectively. Independent-sample t-test and two-way analysis of variance (ANOVA) indicated significant differences in age, education, occupation and the number of complications (P<0.05). Binary logistic regression analysis indicated a significant negative association between depression and education (P<0.01) with lower educational level (OR: 0.590; 95% CI: 0.424-0.820) associated with a higher risk for depression. A significant positive association was observed between depression and age (P<0.05) with higher age (OR: 1.338; 95% CI: 1.008-1.774) correlated with a higher risk for depression. CONCLUSIONS Women who experienced obstetric complications presented with higher PDSS depression scores. Screening for antenatal depression in high-risk pregnant women to promote early detection of depression and reduce health risks for universal health promotion is recommended.

Alcohol screening a brief intervention: a self-paced program for nurses

Background Nurses are in key positions to plan and implement alcohol screening and brief intervention (aSBI). To simultaneously advance aSBI of nurses in various roles, we developed a self-paced program for Clinical Nurse Leaders, Nurse Informaticists, Nurse Administrators, and Registered Nurses including Advanced Practice Nurses. The content for the program is based on the Centers for Disease Control & Prevention (CDC) 2014 Planning and Implementation Screening and Brief Intervention for Risky Alcohol Use: A Step-by-Step Guide for Primary Care Practices. The objective is to present the results of a cooperative agreement between the Centers for Disease Control & Prevention, Johns Hopkins School of Nursing, and the University of Pittsburgh School of Nursing. The framework used to design the aSBI Program and key aspects of the program will be demonstrated and discussed.

Faculty Buy-In to Teach Alcohol and Drug Use Screening

Educating nursing faculty about the use of an evidence-based practice to screen and intervene earlier along the continuum of alcohol and other drug use, misuse, and dependence is essential in todays health care arena. Misuse of alcohol and other drugs is a significant problem for both individual health and societal economic welfare. The purpose of this article is to describe nursing faculty buy-in for the implementation of an evidence-based addiction training program at a university-based school of nursing. Derived from an academic-community partnership, the training program results suggest implications for continuing education and curriculum innovation in schools of nursing and clinical practice. The training content presented can be used in continuing education for nursing faculty across all types of nursing school programs and professional nursing staff employed in multiple settings. The training program was funded by the Health Resources and Services Administration.

Self-Efficacy and Enjoyment of Middle School Children Performing the Progressive Aerobic Cardiovascular Endurance Run (Pacer)

Self-efficacy and enjoyment were examined among 34 middle school children (M age = 12.5 yr.) performing the Progressive Aerobic Cardiovascular Endurance Run (PACER). Exercise self-efficacy (running) and physical activity enjoyment were measured after viewing a video illustrating the PACER, and subsequently following a PACER test. Significantly greater pre- than post-exercise self-efficacy was reported; enjoyment scores did not differ. Ratings of self-efficacy were higher before exercise than after, but enjoyment scores were not significantly different. A significant correlation was found between post-exercise self-efficacy and enjoyment, but not between pre-exercise self-efficacy and enjoyment. Although positive correlations were found between PACER laps and pre-/post-exercise self-efficacy, correlations with ratings of enjoyment were not significant. Exercise self-efficacy was associated with childrens beliefs about the task-specific PACER aerobic exercise; however, exercise enjoyment was stable. Childrens self-efficacy and enjoyment beliefs should be considered when developing interventional strategies to promote aerobic exercise participation.