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提高护士提供精神卫生和物质使用障碍共病护理的能力:一项准实验干预研究。

Enhancing nurses' capacity to provide concurrent mental health and substance use disorder care: A quasi-experimental intervention study.

机构信息

School of Nursing, University of British Columbia, Vancouver, Canada.

Providence Health Care, Vancouver, Canada; British Columbia Centre on Substance Use, Vancouver, Canada.

出版信息

Nurse Educ Today. 2022 Oct;117:105483. doi: 10.1016/j.nedt.2022.105483. Epub 2022 Jul 26.

Abstract

BACKGROUND

Patients experiencing concurrent disorders (i.e., co-occurring mental health and substance use disorders) are prevalent in mental health settings and their health and social outcomes are often poor. This reflects persistent stigma as well as inadequate preparatory training or continuing education for healthcare professionals, including nurses.

OBJECTIVE

To explore the impacts of the 1-day 'Enhancing Concurrent Disorder Care Intervention' on nurses' and student nurses' capacity to deliver care, grounded in current evidence, to patients with concurrent disorders in inpatient mental health settings.

DESIGN

A Quasi-experimental intervention design was used with pre- and post-test components, guided by the STROBE checklist for observational studies.

SETTINGS

Five acute mental health units across two hospitals in British Columbia, Canada, as well as two schools of nursing representing students completing clinical practicum rotations within these settings.

PARTICIPANTS

Seventy-six nurses (Registered Nurses and Registered Psychiatric Nurses) and student nurses practicing in inpatient mental health care.

METHODS

This educational intervention was informed by a pilot study, which included content validation from international concurrent disorder experts, and further refined through collaborative processes with lived experience and nurse partners. Intervention impacts were examined using online surveys conducted prior to the intervention and within two weeks post-intervention. Surveys assessed knowledge and attitudes about concurrent disorders using a validated instrument and questions developed by the study team. Descriptive statistics alongside paired and independent t-tests and two-way ANOVAs were used to compare survey scores before and after the intervention.

RESULTS

Findings indicate that the intervention was effective in improving participants' knowledge and attitudes toward patients with concurrent disorders across participant groups.

CONCLUSIONS

Enhancing care and outcomes for patients with concurrent disorders is a global priority. Brief educational interventions aimed at nurses can provide an effective, low-barrier mechanism to address knowledge gaps that contribute to harmful care and adverse outcomes.

摘要

背景

同时患有精神健康障碍和物质使用障碍(即并发障碍)的患者在精神健康机构中较为常见,他们的健康和社会结局通常较差。这反映出持续存在的污名化现象,以及医疗保健专业人员(包括护士)准备培训或继续教育不足的问题。

目的

探索为期 1 天的“增强并发障碍护理干预”对护士和护生在精神科住院环境中为并发障碍患者提供基于现有证据的护理能力的影响。

设计

采用准实验干预设计,具有预测试和后测试部分,由观察性研究的 STROBE 清单指导。

设置

加拿大不列颠哥伦比亚省的两家医院的五个急性精神科病房,以及两所代表在这些环境中完成临床实习轮转的护理学校。

参与者

76 名护士(注册护士和注册精神科护士)和实习护士,他们在住院精神卫生护理中工作。

方法

该教育干预措施以一项试点研究为依据,该研究包括国际并发障碍专家的内容验证,并通过与有经验的人以及护士合作伙伴的合作过程进一步完善。使用在线调查在干预前和干预后两周内评估干预的影响。调查使用经过验证的工具和研究团队开发的问题评估对并发障碍的知识和态度。使用描述性统计以及配对和独立 t 检验以及双向方差分析来比较干预前后的调查得分。

结果

研究结果表明,该干预措施在提高参与者对并发障碍患者的知识和态度方面对所有参与者群体均有效。

结论

增强对并发障碍患者的护理和结局是全球重点。针对护士的简短教育干预措施可以为解决导致不良护理和不良结局的知识差距提供一种有效、低门槛的机制。

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