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这是社区所需要的:基于社区的紧急阿片类药物过量培训的成果。

It's what the community demands: Results of community-based emergency opioid overdose trainings.

作者信息

Febres-Cordero Sarah, Smith Daniel J, Wulkan Abigail Z, Béliveau Abigail Julier, Gish Andy, Zine Stella, Fugitt Laurie, Giordano Nicholas A

机构信息

Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia.

M. Louise Fitzpatrick College of Nursing, Villanova, Pennsylvania.

出版信息

Public Health Nurs. 2023 Jan;40(1):44-53. doi: 10.1111/phn.13151. Epub 2022 Nov 14.

Abstract

OBJECTIVES

In response to a surge of drug overdoses involving polysubstance use among Atlanta service industry workers that resulted in the deaths of five people in the Atlanta area in the summer of 2021, a local community of harm reductionists and nurses organized opioid education and naloxone distribution (OEND) training sessions specifically customized for service industry workers in Atlanta. After the sessions, the nurses and harm reductionists asked attendants to participate in a study concerning their response to overdoses. The reason nurses and harm reductionists conducted the study was to determine the efficacy of OEND training adapted for those working in the service industries as well as to evaluate and possibly modify the training sessions for future use. This pre-post study examined if and how participants' knowledge and attitudes toward an opioid-involved overdose changed after engaging with the OEND training. If the study determined that the sessions were successful in teaching service industry workers how to mitigate the immediate and devastating effects of overdose, we recommend expanding and implementing both adaptable training sessions like the OEND training referenced, as well as accompanying studies to improve the training sessions' effectiveness.

DESIGN

The pre-post study used convenience sampling to recruit participants in emergent OEND training. Participants completed an abbreviated version the Opioid Overdose Attitudes Scale (OOAS) which measured how, and to what degree, they changed their attitudes towards overdoses and their responses to them. Participants also completed an abbreviated version of the Opioid Overdose Knowledge Scale (OOKS) which measured how effectively the OEND increased their knowledge when it came to properly responding to an overdose, which included implementing naloxone as part of immediate rehabilitation treatment. Paired nonparametric tests assessed changes in participants' OOAS/OOKS scores.

RESULTS

A total of 161 individuals attended, and 72 consented to be in the study. The sample predominately consisted of white (76.4%) and female (66.7%) adults whose age averaged 34.3 years. Attitude and knowledge score improvements were statistically significant: approximately 11 points (p < .001) and 3 points (p < .001), respectively.

CONCLUSIONS

This rapidly implemented training was associated with improving attitudes and knowledge about responding to an opioid-involved overdose. We recommend expanding the scope of studies like these in order to develop and examine effective, dynamic, and targeted OEND training tailored towards specific community groups and situations, such as polysubstance overdose among service industry workers. As the opioid epidemic worsens, it is critical to equip community members themselves with the skills and tools to recognize and respond to opioid overdoses as a frontline prevention to overdose deaths.

摘要

目标

2021年夏天,亚特兰大服务业工人中涉及多物质使用的药物过量事件激增,导致该地区5人死亡。为此,当地一个由减少伤害主义者和护士组成的团体组织了专门为亚特兰大服务业工人定制的阿片类药物教育和纳洛酮分发(OEND)培训课程。培训课程结束后,护士和减少伤害主义者邀请参与者参加一项关于他们对药物过量反应的研究。护士和减少伤害主义者开展这项研究的目的是确定为服务业工作人员量身定制的OEND培训的效果,并评估培训课程,以便可能对其进行修改以供未来使用。这项前后对照研究考察了参与者在参加OEND培训后,对涉及阿片类药物的过量用药的知识和态度是否以及如何发生了变化。如果该研究确定这些培训课程成功教会了服务业工人如何减轻过量用药的直接和毁灭性影响,我们建议扩大并实施类似所提及的OEND培训这样的适应性培训课程,以及开展配套研究以提高培训课程的有效性。

设计

这项前后对照研究采用便利抽样的方法,在紧急OEND培训中招募参与者。参与者完成了阿片类药物过量态度量表(OOAS)的简化版,该量表衡量了他们对过量用药的态度以及应对方式发生了怎样的变化和变化程度。参与者还完成了阿片类药物过量知识量表(OOKS)的简化版,该量表衡量了OEND培训在让他们正确应对过量用药(包括将纳洛酮作为即时康复治疗的一部分)方面增加知识的效果如何。配对非参数检验评估了参与者OOAS/OOKS分数的变化。

结果

共有161人参加,72人同意参与研究。样本主要由白人(76.4%)和女性(66.7%)成年人组成,平均年龄为34.3岁。态度和知识得分的提高具有统计学意义:分别约为11分(p <.001)和3分(p <.001)。

结论

这项迅速实施的培训与改善对涉及阿片类药物过量用药的应对态度和知识有关。我们建议扩大此类研究的范围,以便开发和检验针对特定社区群体和情况(如服务业工人中的多物质过量用药)的有效、动态且有针对性的OEND培训。随着阿片类药物流行情况恶化,让社区成员自身具备识别和应对阿片类药物过量用药的技能和工具,作为预防过量用药死亡的一线措施至关重要。

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