Alcohol education revisited: Exploring how much time we devote to alcohol education in the nursing curriculum

Effectiveness of Clinical Practicum Experience in Drug Addiction Treatment Facilities in Nursing Students' Attitudes Toward Alcohol, Alcohol Use Disorders, and Alcoholics: Systematic Review and Meta-Analysis

ABSTRACT

The aim of this study was to identify, analyze, and synthesize the best evidence on the effectiveness of clinical practicum experience in drug addiction treatment facilities on nursing students' attitudes toward alcohol, alcohol use disorder (AUD), and persons with AUD. This systematic review followed the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and used the System for the Unified Management of the Assessment and Review of Information to assess methodological quality and extract data for meta-analysis. A comprehensive literature search of the EBSCO databases, Embase, PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde, PsycINFO, Scopus, Web of Science, Mednar, Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior, and ProQuest Dissertations & Theses catalog was conducted. The System for the Unified Management of the Assessment and Review of Information tool was used for the extraction and critical evaluation of the selected articles followed by a meta-analysis. After removing duplicates, 2,831 publications were identified, and eight met the inclusion criteria. More positive attitudes were observed after performing practicum experience in specialized services (-1.27, 95% confidence interval [-2.85, -0.30]), and an increase in the motivation and satisfaction among the students to care for patients with AUD was also noted. In conclusion, the review suggests that clinical practicum experience in a drug addiction treatment facility has the potential to change the attitudes of nursing students toward AUD and persons with AUD.

Is the Clinical Practicum in Addiction Treatment Facilities an Effective Educational Intervention to Improve Nursing Students' Attitudes Toward Alcohol Use Disorders?

ABSTRACT

The paucity of education and training on alcohol use disorders (AUDs) in nursing curricula is the main predictor of negative attitudes and results in limited knowledge access and delivery of health care for persons experiencing these problems. Although experts advocate increasing the time devoted to alcohol-related content in a crowded curriculum, didactic strategies for teaching about addiction in prequalifying nursing education have been discussed. This study aimed to verify the effectiveness of an educational experience that integrated clinical practicum experience in addiction treatment facilities for nursing students' attitudes. A quasi-experimental one-group study with pre-and-post 3-month follow-ups was carried out with 108 nursing students who answered the Attitudes Scale toward Alcohol, Alcohol Use Disorder, and Patients with Alcohol Use Disorders. The effect of the clinical practicum was apparent, with statistically significant changes to more positive global attitude scores in all measures. Previous educational intervention for AUDs during nursing education was a predictor of positive attitudes (OR = 7.21, p < .04). Students' self-perceived skills and professional preparation to deliver and direct care for patients with AUDs improved after the intervention, suggesting that clinical practice influenced students' skills for AUD identification across nursing practice. Previous contact with this population with lack of training in substance use disorder seems to favor negative attitude development. Clinical practicum experience in addiction treatment facilities improved nursing students' attitudes toward AUDs and patients with AUDs, and its effects were sustained 3 months later.

Nursing students' attitudes towards alcohol use disorders and related issues: A comparative study in four American countries

The present study identified and compared the attitudes of nursing students from North and South American countries towards alcohol, alcohol use disorders and persons with alcohol use disorders (AUDs). A cross-sectional design and survey approach were used. The sample consisted of 327 nursing students recruited from four nursing schools in metropolitan regions of North and South America. The questionnaire contained questions about sex, age, marital status, home country and other questions about training in substance use disorders during nursing education and previous experiences with substance use disorder patients. To identify nursing students' attitudes, validated English, Spanish and Portuguese versions of the attitudes scale for alcohol, alcoholism and persons with AUDs (EAFAA) were applied. Comparison of the four groups suggested that nursing students in the United States demonstrated more positive attitudes than students from Colombia, Mexico and Brazil. Similar positive attitudes were observed towards individuals with AUDs. Results of the attitudes towards the aetiology of AUDs showed positive attitudes in all samples, suggesting a contemporary understanding of AUDs. Nursing students' attitudes were associated with home country and training in substance use disorders during nursing education. Nursing students' attitudes were generally positive across countries. Idiosyncratic cultural and educational aspects in these countries and world regions likely significantly influenced the attitudes of nursing students towards alcohol and associated issues.

Health Professionals' Attitudes Toward Alcoholism and Associated Issues: A Comparative Study in a Brazilian Sample

Attitudes of health professionals have an effect on the quality of care provided to individuals with alcohol use disorders. The identification of health professionals' attitudes supports strategies that promote positive attitudes and improve the quality of the health care provided to this population. This is a descriptive cross-sectional study with 831 health professionals. Data were collected using the scale of attitudes toward alcohol, alcohol use disorder, and individuals with alcohol use disorders. Pearson test, Analysis of Variance, and Bayesian linear regression were used to analyze the data. There was a predominance of positive attitudes among all professional categories, with the exception of attitudes toward the etiology of alcohol use disorder and attitudes toward alcoholic beverages and their use. The respondent's age and professional category influenced his or her attitudes toward alcohol and associated issues. There are differences in the attitudes of professionals from different professional groups, which may contribute to inconsistencies in the care provided for individuals with alcohol use disorders. The results of our study suggest that strategies regarding the training and continuing education of health professionals that consider the particularities of each profession be instituted to improve professionals' attitudes, thus improving their ability to address issues related to alcohol use disorders and encourage alcoholic patients to engage in treatment.

The Lived Experience of Alcohol Dependence: A Reflective Lifeworld Research among Outpatients in Alcohol Treatment

Alcohol dependence is a major health problem. Existing literature is sparse on the lived experience of alcohol dependency. Nurses may find it difficult to care for patients with alcohol dependence. The purpose of this study was to explore the lived experience of alcohol dependence among outpatients in alcohol treatment to get a comprehensive understanding from the patients' perspective. The study used a phenomenological descriptive approach and in-depth interviews were conducted with five patients in outpatient alcohol treatment. Five constituents illuminated the essence. Alcohol dependence is associated with physical, psychological and relational suffering: feelings of shame emerged as a significant theme.

Knowledge and Perceptions of Undergraduate Nurses towards the Use of Cocaine (Smoked) in a Brazilian Context

The aim of the study was to evaluate the perceptions and knowledge of nursing students on the identification and intervention care among users of cocaine (smoked) patients. A cross-sectional survey design was conducted with 164 undergraduate nursing students of two nursing school from Northeast of Brazil. A questionnaire on knowledge and attitudes and therapeutic commitment towards the use of cocaine (smoked) were used. The students stated that they received contents of substance misuse in the curriculum of nursing. Only 10% of the students reported that they had adequate knowledge on addiction to dealing with cocaine (smoked) users and wish to work with these users. There are positive perceptions on motivation, task specific self-esteem and work satisfaction among students.

Impact of primary healthcare providers' initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial

BACKGROUND

Brief interventions in primary healthcare are cost-effective in reducing drinking problems but poorly implemented in routine practice. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation.

METHODS

In a cluster randomised factorial trial, 120 primary healthcare units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design.

RESULTS

Data from 746 providers from 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore, there were no significant interactions between these characteristics and allocated implementation groups.

CONCLUSIONS

The extent to which providers changed their brief intervention delivery following experience of different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research, more attention is needed to unravel the causal relation between practitioners' attitudes, their actual behaviour and care improvement strategies to enhance implementation science.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01501552.