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“Opiophobia” lacks a clear definition and measurement, but it is commonly used by researchers and healthcare professionals in pain management to describe the underutilization of opioids by patients, caregivers, prescribers, and other healthcare professionals. This inconsistency complicates research and clinical interventions.
This systematic review aimed to comprehensively evaluate the conceptualization and operationalization of opiophobia across quantitative studies involving adult populations.
Peer-reviewed articles published before July 2024 were retrieved from four bibliographic databases (CINAHL, Embase, MEDLINE, and Scopus) and systematically reviewed. Included studies defined and/or measured opiophobia or opioid stigma among adult patients, family caregivers, and healthcare professionals. The review was conducted in two phases: the first phase provided a comprehensive understanding of study characteristics, while the second phase evaluated the conceptualization and measurement of opiophobia.
Thirty-six articles met inclusion criteria. Studies focused on healthcare professionals (n = 23, 64%); adult patients (n = 13, 33%), including 7 studies involving patients with cancer (19%); healthcare professionals and patients (n = 2, 5%); and family caregivers (n = 1, 3%). Among the studies that defined opiophobia (n = 20, 67%), common definitions included fear, prejudice, reluctance, addiction, exaggeration, underutilization, and inappropriate attitudes/beliefs, respectively. Limitations included the predominance of observational designs (n = 32, 89%) and the use of investigator-developed instruments (n = 27, 73%).
Instruments measuring opiophobia focused on opioid-related fears and behaviors. Instrument items that measured opiophobia primarily focused on fears and behaviors resulting from these fears. It remains unclear whether opiophobia is solely fear-based or also includes poor adherence to prescribed opioids. The wide variations in definitions and the use of mostly investigator-developed measures led to inconsistencies among studies. Further research is needed to design specific interventions and determine delivery times.
Burnout and mental health concerns are prevalent among healthcare workers. Female physicians, nurses, and healthcare staff are at a higher risk of suicide than the general population. Burnout and depression have been known to coexist with suicidal ideation and behaviors.
To identify what is known about the relationship between burnout and depression in the context of suicide among healthcare workers.
Registered scoping review of English language articles indexed to CINAHL, PubMed, and PsychInfo databases with date of publication prior to March 5, 2024.
The review yielded nine eligible studies, all employing observational or descriptive methodologies. Depression was found to be a predictor of suicidal ideation. While burnout was associated with depressive symptoms and found to coexist with suicidal ideation, it was not predictive of ideation. Emotional exhaustion and depersonalization were key components of burnout linked to depression. No studies were found exploring survivorship factors in healthcare professionals. Suggested prevention strategies that need to be tested include mindfulness and cognitive-behavioral skills training, improved workplace conditions, addressing loneliness, and fostering resilience.
Interventional studies are needed to test strategies addressing burnout, depression, suicidal behaviors, and survivorship of suicide attempts. Depression should be considered and evaluated when healthcare workers exhibit symptoms of burnout. Moreover, the Socio-economic Model of Suicide Prevention (i.e., SESM) can be used to categorize suicide prevention measures in healthcare. Burnout and depression interact to influence mental health outcomes among healthcare professionals, with depression playing a more significant role in predicting suicidal ideation. Despite the demonstrated relationships, critical gaps in knowledge exist in understanding survivorship and in the development and testing of effective interventions. Future interventional multisite research is needed using validated tools to identify best practices in suicide prevention for healthcare professionals.
Staff shortages as well as poor nurse and clinician well-being are currently an epidemic within the health workforce and pose a substantial risk to healthcare quality and safety. Creating a strong wellness culture is one strategy to address the issue, but there is a paucity of research that investigates how other types of organizational cultures are related to nurses' mental health and well-being.
To describe the relationships among innovation culture, wellness culture, evidence-based practice (EBP) culture, and clinician well-being (healthy lifestyle behaviors, burnout, depression, stress, anxiety, and job satisfaction).
A cross-sectional descriptive correlational study design was used with a convenience sample of nurses, physicians, and allied health professionals from a Magnet-recognized health system in the United States. An online wellness survey collected data with the variables of interest using valid and reliable scales. Pearson's r correlations assessed the relationship among innovation culture, wellness culture, and EBP culture. A series of regressions examined if each type of culture was associated with clinician well-being.
The analytic sample included 199 respondents. Innovation culture had a strong and significant correlation (p ≤ 0.0001, r > 0.7) with both clinician well-being and EBP cultures. Wellness and EBP cultures also were correlated (p ≤ 0.0001, r = 0.592). Higher ratings of each type of culture were significantly associated with higher job satisfaction as well as higher ratings of both mental and physical health. Further, higher ratings on each culture scale were significantly associated with reduced stress, anxiety, depression, burnout, and job satisfaction.
This is the first study to establish correlations among innovation culture, EBP culture, and wellness culture as well as to find that these three types of cultures are associated with clinician well-being outcomes and job satisfaction. Since culture strongly impacts the healthcare workforce's mental health and job satisfaction, leaders need to focus on an organizational-wide strategic approach that builds a sustained culture that supports clinician well-being, innovation, and EBP.
On average, about 17% of new graduate registered nurses (NGN) leave within the first year of employment, leading to high turnover costs. A mentorship program can improve NGN retention and positively impact patient care. A significant opportunity exists for healthcare organizations to protect the investment of NGN.
To implement an evidence-based mentorship program to improve NGN retention.
A 3-month mentorship program was implemented at a Magnet-designated Midwest 1300-bed integrated community-based healthcare center. Twenty matched pairs participated in the program, which was guided by the American Medical-Surgical Nurses Mentorship Program.
Data included results from 18 mentor-to-mentee pairs that completed the 3-month program. Post-implementation confidence/competency scores showed a slight increase from baseline. Intent to stay and job satisfaction scores were moderately high post-implementation. The average program satisfaction score for both groups was 69.5%. The cost of the program was about $4000. All mentees remained employed 3 months post-implementation, which resulted in the organization avoiding a turnover loss of approximately $480,000.
An evidence-based practice approach was used to address NGN turnover at a midwestern healthcare center. The initiative retained the first cohort of NGN while showing an organizational return on investment. Implementation of a 3-month mentorship program is cost-effective and can impact NGN retention and turnover.
An estimated 20% of emergency department (ED) patients require respiratory support (RS). Evidence suggests that nasal high flow (NHF) reduces RS need.
This review compared NHF to conventional oxygen therapy (COT) or noninvasive ventilation (NIV) in adult ED patients.
The systematic review (SR) and meta-analysis (MA) methods reflect the Cochrane Collaboration methodology. Six databases were searched for randomized controlled trials (RCTs) comparing NHF to COT or NIV use in the ED. Three summary estimates were reported: (1) need to escalate care, (2) mortality, and (3) adverse events (AEs).
This SR and MA included 18 RCTs (n = 1874 participants). Two of the five MA conclusions were statistically significant. Compared with COT, NHF reduced the risk of escalation by 45% (RR 0.55; 95% CI [0.33, 0.92], p = .02, NNT = 32); however, no statistically significant differences in risk of mortality (RR 1.02; 95% CI [0.68, 1.54]; p = .91) and AE (RR 0.98; 95% CI [0.61, 1.59]; p = .94) outcomes were found. Compared with NIV, NHF increased the risk of escalation by 60% (RR 1.60; 95% CI [1.10, 2.33]; p = .01); mortality risk was not statistically significant (RR 1.23, 95% CI [0.78, 1.95]; p = .37).
Evidence-based decision-making regarding RS in the ED is challenging. ED clinicians have at times had to rely on non-ED evidence to support their practice. Compared with COT, NHF was seen to be superior and reduced the risk of escalation. Conversely, for this same outcome, NIV was superior to NHF. However, substantial clinical heterogeneity was seen in the NIV delivered. Research considering NHF versus NIV is needed. COVID-19 has exposed the research gaps and slowed the progress of ED research.
Today's nursing workforce is expected to know how to identify and understand research methods and procedures and apply the most current evidence into daily practice. However, teaching evidence-based practice (EBP) in an undergraduate nursing curriculum poses unique challenges in overcoming students' perception of content relevancy to their educational experience, but also offers opportunities for innovation to facilitate critical thinking and clinical application.
The aim of this article is to report on how teaching and learning innovation was infused into a research and evidence-based practice course and the effect on students' perceptions of course values and effectiveness.
We used a Plan-Do-Study-Act approach to introduce innovation in an undergraduate course within a university setting. Final student course evaluations were used to measure outcomes on a 5-point Likert scale (1 = low and 5 = high) on the following dimensions: (1) value of overall educational experience, (2) relevancy of course content, (3) improvement in critical thinking, and (4) level of student-instructor interaction.
Overall course evaluation scores improved greatly from 2.69 to 3.90 between Spring 2020 and Fall 2021. This finding remained relatively consistent across subsequent semesters (3.79 [Spring 2022], 3.84 [Fall 2022]). Students also reported appreciation and increased engagement and interest with the material after transitioning from examinations to a project-based assignment that allowed them to walk through the steps of EBP in class.
We identified and implemented several innovative strategies to improve student outcomes and increase the relevance of the course content. These innovations can be easily incorporated at other universities to enhance delivery and student engagement in this content that is essential to advancing quality care in nursing and developing future nurse scientists and practice leaders who care, lead, and inspire.
FreshRSS 