Community psychiatric nurse aftercare for alcoholics: a five-year follow-up study

The aim of this study was to determine if community psychiatric nurse (CPN) aftercare for 1 year improved the 5-year outcome in patients following inpatient treatment for alcohol dependence. A 5-year follow-up study, observer blind, with non-random allocation of subjects to aftercare by CPN for 1 year or standard outpatient care, was used. Subjects had all received inpatient treatment for 6 weeks in a rural alcohol treatment unit. Subjects were traced and assessed in the community 5 years after the index admission. The participants consisted of 127 white male alcoholics. All were first admissions, who had been selected for inpatient treatment and who completed a 6-week inpatient stay. Seventy-three subjects received intensive aftercare by CPN for 1 year, 54 subjects received standard outpatient appointments not due to random allocation but because no CPN was available. Data were collected by semi-structured interview at entry to the trial, namely background epidemiological information, details of drinking history, previous hospital admission, educational, employment and criminal information. At 5-year follow-up, data on drinking status, use of other drugs, hospital admissions, criminal behaviour and gambling, attendance at self-help groups, relationships and employment were collected. Thirty-six per cent of the CPN aftercare group was completely abstinent during the 5 years after treatment compared to 6% of the standard aftercare group (p < 0.001). Subjects receiving CPN aftercare were less likely to report blackouts (p < 0.05) or gambling (p < 0.05). They were more likely to attend hospital meetings (p < 0.0001). CPN aftercare is an effective way of maximizing the effects of inpatient treatment. The effects endured for 5 years after treatment.

Clinic nurses: confronting campus alcohol use on the frontline

Alcohol use is common on college campuses. Nurses in the student health clinic, in collaboration with other health professionals, have a responsibility and an opportunity to assess, intervene, and prevent problems related to the use of alcohol and other drugs. In this article, the author suggests how college health nurses, in everyday practice, can seize opportunities for helping students face their alcohol-related problems.

A model approach to care of a patient with alcohol problems

This paper looks at how theory can be related to nursing practice. The author describes the care of a patient with chronic alcohol misuse problems and shows how Peplau's model of nursing was used to help build trusting relationships and to identify and resolve the patient's problems. The nurses were also able to resolve any difficulties in nursing this patient by developing peer support and improving communication.

Problem drinkers in accident and emergency: health promotion initiatives

Problems caused by excessive alcohol consumption often contribute to Accident and Emergency attendances, giving possible health promotion opportunities to this client group. These could include screening, health education (verbal or written), brief intervention and referral to alcohol services. Accident and Emergency staff rarely take these opportunities. A knowledge of alcohol problems, possible health promotion initiatives and services available alter attitudes and increase the likelihood of staff giving health promotion. Health promotion to problem drinkers should be a routine in Accident and Emergency departments.

Enhancing Nursing Competence with Substance Abusing Clients

Alcohol and other drug abuse, major threats to health, pose challenges for nurses in virtually every practice setting. Progress toward increasing nursing competence in the addictions field is being made through the development of practice standards and model curricula and through federal initiatives to increase faculty expertise in this field. The next critical step is to forge creative collaborative links with practice settings, links that assure that requisite learning is reality-based and in step with the future of health care. This article outlines progress toward improving nursing competence in substance abuse and suggests reality-based learning strategies as a future direction for this important goal for nursing education. Two successful models of collaboration between education and practice, designed to augment basic curriculum and improve nursing knowledge, skills and attitudes related to substance abuse, are described.

Alcohol abuse in older persons: implications for critical care

Alcoholism in the older population is a significant, yet often hidden or unrecognized problem. With the growing older population, a concurrent increase in the number of geriatric patients admitted to critical care settings will occur. An understanding of alcoholism in older persons, coupled with an early recognition of the problem by the critical care nurse, is vital in minimizing the consequences of alcoholism and withdrawal during critical illness. Prompt and appropriate treatment of manifestations of withdrawal is necessary to improve patient outcomes for the elderly individual suffering from alcohol abuse.

The physiological effects of alcohol misuse

Alcoholism is costly both in human and monetary terms. A thorough nursing assessment will lead to early detection and treatment. Further tissue damage and suffering can be reduced by early intervention.

[Effects of nurses' beliefs on their communication with alcoholics]

Alcoholism, one of the most frequent diseases in the world, has been transformed in a serious social problem and in Brazil, it has triplicated in the last decades. As nurses, we understand that alcoholics are sick people that need help and that communication is a fundamental method to achieve nursing's intervention goals. Aiming at giving an adequate nursing care it is necessary to know the reasons why nurses have some adverse attitudes related to alcoholics. This inquietude led us to investigate the restraints that interfere in nurse-alcoholics communication, presented in national and international nursing literature reviewed through MEDLINE and CEPEn catalogue. We observed that the alcoholics' stereotype exists and remains constant through the time; the stereotype belief held by health professionals determines the quality of care the patient receives as well as the focus of research and attitudes presented about alcohol and alcoholics. Therefore, the belief would be presenting a negative influence and keeping back the communication between nurse and the alcoholic.

Biodynamic massage

This paper introduces biodynamic massage, locates it in the field of massage, and body psychotherapy, describes some of its historical development and basic theoretical assumptions. A case study illustrates its usage in an National Health Service facility.

The meaning of alcohol to traditional Muscogee Creek Indians

The purpose of this study was to learn the meaning of alcohol to the traditional Muscogee Creek Indians of eastern Oklahoma. Using Leininger's theory of culture care diversity and universality as the theoretical base, the authors conducted interviews of 24 traditional people to elicit both emic and etic meanings of alcohol. The conceptualization of alcohol as a dichotomy of power to do both good and evil emerged as the central theme. Other meanings of alcohol were explicated in relation to five social structure dimensions. The findings suggest culturally competent nursing implications for preserving, accommodating, and repatterning the meaning of alcohol.

Exploring music intervention with restrained patients

Roy's Adaptation Model is used in a case study approach to begin examining the potential of music intervention in hospitalized, restrained patients. Restraints were removed during the time in which the patient listened to a musical tape through a headset. Mr. D, presented in this case study, was one of the 30 medical-surgical patients who participated. His observable positive behaviors increased from 10 during the preintervention period to 12 during the musical intervention. Mr. D displayed no negative behaviors during the entire study period.

Helping the alcoholic patient recover

The patient may come to your unit because of any of the numerous possible health consequences of alcoholism. Or his dependence may surface after he's admitted for some unrelated problem. In either case, your challenge is to see him through withdrawal and set him on the path to long-term recovery.

Assessment and monitoring of alcohol-related problems

Employers are increasingly requesting employees to submit to screening for alcohol-related problems (ARPs). Holistic assessment, leading to problem identification and treatment, can lead to a reduction in the number of accidents occurring in the workplace. This article argues against the practice of assessment based solely on blood levels of liver enzymes and mean corpuscular volume of erythrocytes and introduces a new diagnostic test which, if used with a full and systematic assessment, may lead to more accuracy in diagnostic interpretation.