Personalized nursing: an effective intervention model for use with drug-dependent women in an emergency room.

The study indicates that nurses can affect stress and drug use in addicted women. At the 8-week posttest, daily drug cost and daily heroin costs had gone down for the experimental group. However, at the 6-month posttest, daily drug cost and daily heroin cost for the experimental group increased, although it did not reach its initial pre-intervention levels. The increase in drug costs at 6-month followup is probably a result of the lack of nursing intervention after the 8-week period. Interestingly, both the drug costs and heroin costs of the control group went down at 6 months. In other words, the control group decreased use also, only at a slower pace. What accounted for this decrease in use by the control group at 6 months? Several speculations are offered. The single Personalized Nursing Intervention counseling in the ER may have had an impact on the client. Controls who had had the single intervention in the ER were receptive to followup and were easily found. (Originally the single intervention in the ER was not part of the design. However, about 20 clients who had not had Personalized Nursing Intervention in the ER but who just answered the initial questionnaire were never found for followup. Because of the followup and ethical considerations, project staff members instituted the single ER intervention.) Another speculation is that of "burnout," a phenomenon that can be seen in both experimental and control groups. The mean age of the total population was 28.5, number of times arrested was 7.25, and age at first drug use was 16. It appeared that the following factors evoked a desire for change in these women: 1) leading a drug lifestyle for so many years, 2) the approach of age 30, 3) entrance into adolescence of their own children, and 4) the ER episode. Personalized Nursing Intervention could be considered a catalyst toward lifestyle change. Examination of daily drug cost and the Ireton emotional distress score showed trends indicating that the experimentals with network participation made larger gains than the control group or experimentals without networks. Further study on the use of client networks in treatment is indicated.