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减少伤害作为一项基本的精神科心理健康护理技能。

Harm Reduction as an Essential Psychiatric Mental Health Nursing Skill.

作者信息

Kameg Brayden

机构信息

Brayden Kameg, PhD, DNP, PMHNP-BC, Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.

出版信息

J Am Psychiatr Nurses Assoc. 2025 Apr 12:10783903251332641. doi: 10.1177/10783903251332641.

Abstract

OBJECTIVE

In 2023, over 20 million individuals in the United States experienced a mental health condition and a co-occurring substance use disorder. As many as 42% of individuals with a mental health condition report past-year illicit drug use, and as many as 6% report past-year opioid use. Given the high rates of psychiatric comorbidity and mortality associated with opioid use disorder, it is imperative that psychiatric mental health nurses not only view opioid use disorder as a brain-based, chronic remitting-relapsing disease but also leverage non-stigmatizing clinical approaches to improve patient outcomes. Harm reduction is a practical and transformative approach that seeks to empower people who use drugs with the choice to live healthy, self-directed, and purpose-filled lives. This article provides an overview of theoretical harm reduction approaches and tangible harm reduction interventions to inform psychiatric mental health nursing practice.

METHODS

Relevant literature was reviewed related to harm reduction and its role in psychiatric mental health nursing practice.

RESULTS

Harm reduction as an ethos is discussed, in addition to practical harm reduction strategies such as opioid antagonists for overdose reversal, fentanyl test strips, syringe service programs, and supervised consumption sites. The importance of patient engagement is highlighted as necessary in improving health outcomes among those who use substances.

CONCLUSIONS

Given the conclusive evidence that a harm reduction approach and associated interventions are lifesaving, it is the ethical duty of psychiatric mental health nurses to implement and advocate for harm reduction across the healthcare continuum.

摘要

目的

2023年,美国有超过2000万人患有精神健康疾病且同时患有物质使用障碍。多达42%的精神健康疾病患者报告过去一年使用过非法药物,多达6%的患者报告过去一年使用过阿片类药物。鉴于与阿片类药物使用障碍相关的精神疾病合并症和死亡率很高,精神科心理健康护士不仅必须将阿片类药物使用障碍视为一种基于大脑的慢性缓解-复发疾病,而且还应采用无歧视的临床方法来改善患者的治疗效果。减少伤害是一种切实可行且具有变革性的方法,旨在赋予吸毒者选择健康、自主和有意义生活的权利。本文概述了减少伤害的理论方法和切实可行的减少伤害干预措施,以为精神科心理健康护理实践提供参考。

方法

回顾了与减少伤害及其在精神科心理健康护理实践中的作用相关的文献。

结果

除了如用于过量逆转的阿片类拮抗剂、芬太尼检测试纸、注射器服务项目和监督消费场所等切实可行的减少伤害策略外,还讨论了减少伤害作为一种理念的问题。强调了患者参与对于改善吸毒者健康结果的必要性。

结论

鉴于有确凿证据表明减少伤害方法及相关干预措施能挽救生命,精神科心理健康护士有道德义务在整个医疗保健过程中实施并倡导减少伤害。

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