The severity of the substance addiction consequences (SAC) is often the reason for seeking help and joining medication-based programs. However, little has been explored about the nature and extent of the consequences, the outcomes of these programs and of nursing consultations. This cross-sectional study with a nursing-assisted sample, enrolled on a methadone or an alcohol aversion therapy program, aims to find out the most severe indicators of SAC and identify factors to effective self-management of this consequences. The most severe indicators were "anxiety," "maintaining employment," "sadness," "problems with self-supporting," and "problems with family relationships." Patients most likely to have severe SAC are those with Hepatitis B (HBs), with mood disorders, and those who consume cannabis. The factors that can contribute to a more effective SAC self-management are to stop consumption, enrolling in and complying with the therapeutic project related to addiction and comorbidities.
Structured intervention programs are an important resource for supporting people with substance addiction. Although evidence suggests that they improve health outcomes, such as specific symptoms, less is known about their impact on patients’ ability to self-manage the consequences of substance addiction. The aim of this review is to scope outpatient intervention programs focused on the self-management of substance addiction consequences. Approach. This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. MEDLINE and CINAHL (through Ebsco), Psychology & Behavioral Sciences Collection (including PsycINFO) and Web of Science were screened to identify articles published in the last 10 years. Only primary research was included. Out of 891 records, 19 were eligible for this review—12 randomized controlled trials (RCT), 6 quasi-experimental study and 1 observational study. Those studies reported group interventions (10), individual interventions (8) and 1 mixed approach. The most common interventions were based on motivational strategies, relapse prevention and definition of active plans for risky situations. 10 studies reported positive effects. The identification of structured programs may support the development of new approaches focused on empowerment and quality of life of people with substance addiction. Programs to empower patients for self-management of substance addiction consequences are often complex and rely on health professionals’ commitment. Nevertheless, they are a feasible approach that seems to benefit patients managing chronic conditions associated with substance addiction.
The complexity of the problems related to the harmful use of substances requires regular questioning of practices. This article aims to explore the acceptability and applicability of an intervention programme for patients with problematic substance use. Qualitative study. Data collection, through a focus group with 6 nurses and 6 semi-structured interviews with patients under treatment. We have used lexicographic textual analysis. From the focus group, 151 text segments were analysed, retaining 85.8% of the total for the creation of five classes. An analysis of similarity led to the formation of two central nuclei, represented by the words “Nursing” and “Intervention”. From interviews, 252 text segments were analysed, retaining 71.83% for the creation of 5 classes. An analysis of similarity led to the formation of three central nuclei, represented by the words “want”, “programme” and “see”. Nurses recognise the need for a more structured and flexible approach focused on people’s needs. Users also affirm the need for flexible interventions, without a pre-established time frame, that promote labour integration, therapeutic support for abstinence and management of comorbidities.
Resumo A complexidade dos problemas relacionados com o uso problemático de substâncias requer questionamento regular das práticas. O objetivo deste artigo é explorar a aceitabilidade e a aplicabilidade de um programa de intervenção com pessoas dependentes de substâncias. Estudo qualitativo. Recolha de dados, realizada através de 1 grupo focal com 6 enfermeiros e 6 entrevistas semiestruturadas a usuários em tratamento. Utilizou-se à análise textual lexicográfica. No grupo focal, foram analisados 151 segmentos de texto, retendo 85,8% do total para a criação de cinco classes. A análise de similitude conduziu à formação de dois núcleos centrais, representados pelas palavras: Enfermeiro e Intervenção. Das entrevistas, foram analisados 252 segmentos de texto, retendo 71,83% para a criação de 5 classes. A análise de similitude conduziu à formação de três núcleos centrais, representados pelas palavras: querer, programa e ver. Os enfermeiros reconhecem a necessidade de uma abordagem mais estruturada, centrada nas necessidades das pessoas e flexível. Os usuários, acrescentam a necessidade de ser flexível, sem tempo definido à partida, promovendo trabalho, suporte terapêutico para abstinência e gestão das comorbilidades.
Therapeutic interventions for people with problematic use of psychoactive substances can help tackle specific needs related to substance addiction consequences. This modified e-Delphi study aimed to establish consensus on a training program for self-management of substance addiction consequences. The study was conducted between February and April 2022, with an experts’ sample of 28 participants in the first round and 24 in the second. A priori consensus criteria were defined for each round. The results revealed a very strong consensus was achieved on the structure of the program and on clinical areas, such as the problematic use of substances, general health knowledge, health-seeking behavior and adherence, self-knowledge and well-being, social role and personal dignity, and family process. Additionally, over 80% participant consensus was achieved on an extensive number of interventions categorized as psychoeducational, psychotherapeutic, socio therapeutic, brief interventions, social skills training, problem solving techniques, relaxation techniques, and counseling. These findings may be able to fulfill a gap concerning structured treatment approaches for people with problematic use of psychoactive substances. Supporting self-management of the consequences of substance addiction and its application can change nurses’ interventions.
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