Doctor of Nursing Practice (DNP) Final Projects
The Doctor of Nursing Practice Final Projects collection contains the completed works of students from the DNP Program at Arizona State University's College of Nursing and Health Innovation. These projects are the culminating product of the curricula and demonstrate clinical scholarship.
Filtering by
- All Subjects: Residential Treatment
- All Subjects: Counseling
Design: The primary hypothesis was that active participation as defined by contact with a sponsor of an hour or more per week, as measured by the impact on affective characteristics correlated with increased levels of sobriety, when measured by the AWARE questionnaire (Advance Warning of Relapse) within 7 days of entry and prior to discharge (within 30 days). Setting: The project took place in a residential treatment facility in Phoenix, Arizona.
Participants: There were 12 clients from a men’s house and 12 clients from a woman’s house, all of which were going through recovery. Intervention: The educational session explained what a sponsor is and the importance of finding one early as a key role in relapse prevention.
Measurements: Pre and post-test results were compared to see if there was an impact on the predictability of relapse and sponsorship. The paired t-test was performed to compare the two means of AWARE scores. A lower score on the AWARE questionnaire indicates a person is more likely to succeed in sobriety.
Findings: Based on 24 samples collected, the mean scores within the first seven days were 91.17 with a standard deviation of 18.59 and the mean score prior to discharge were 72.78 with a standard deviation (SD) of 20.02. The mean difference between the two scores was 18.39 (SD=2.84). There was a significant effect of the relapse prevention program which included sponsorship, t (22) = 4.79, p < 0.001.
Conclusion: Implications for practice include increased time with sponsors to reduce rates of relapse. Future concerns include good fit matching which may reduce rates of relapse even further.
In the United States obesity continues to be a growing issue in the adult population, which is compounded by the fact that many people have had antidepressant therapy at some point in their lives. Health problems such as metabolic syndrome, diabetes, skeleton/joint issues and more can stem from obesity. These comorbid health care problems can increase the costs at the state and federal levels. This paper will examine obesity and its relation to antidepressant therapy in depressed adults that are obese or endeavoring to avoid further weight gain. Research indicates that antidepressant therapies have shown a greater propensity towards weight gain, though few research studies show weight loss.
Intervention: 10 minutes of nutritional counseling during office visits. Setting: Family psychiatric clinic in the southwest of the United States.
Methods: Data collection process: Depressed adults on antidepressant therapies were randomly selected.
Instrumentation: Weight scale, National Literacy Scale, pamphlet (for teaching) and height scale. Data collected was at baseline, 4 weeks and 8 weeks.
Outcomes: 14 Participants agreed to the project, 10 completed to the 4-week mark and 4 finished the project to the 8-week mark. 10 female participants and 4 male participants. The remaining 4 participants showed 1.6% reduction in body mass index, which correlated with an increase in nutritional learning from baseline to 8-weeks.
Recommendations: Nutritional counseling is a non-pharmacological intervention for achieving and a desired weight, which has shown positive results in varying populations and clinical situations.
Opioid overdose is now the leading cause of unintentional injury related mortality in the U.S. with two people dying each day as a result of opioid overdose in Arizona. Among patients treated for opioid use disorder, chronic pain is frequently cited as the reason for opioid use. Treatment of chronic pain with long-term use of opioids is linked to increased medication tolerance, worsened pain sensitivity, and psychological symptoms. Acceptance of chronic pain is the individual’s ability to be willing to endure pain and their ability and willingness to participate in activities despite experiencing chronic pain. Increased acceptance of chronic pain has been shown to lower pain intensity, promote recovery of individuals’ emotional and physical abilities, and lessen use of pain medication including opioids.
Purpose: The purpose of this evidence-based practice project was to examine the feasibility of using acceptance of chronic pain, pain severity, and pain interference as measures to evaluate the effectiveness of a multimodal residential treatment program for opioid abuse.
Methods: Two surveys, the CPAQ and BPI were administered shortly after admission (T1) and after 21-25 days (T2) to evaluate project feasibility.
Results: Six participants were enrolled. Three participants completed T1 and T2 surveys. Three participants were lost to follow-up. Mean scores for Chronic Pain Acceptance were T1 = 79 (SD = 17.0) and T2 = 78.67 (SD = 5.0). All surveys were easy to administer and participants answered all questions.
Conclusion: Chronic pain acceptance may be a feasible and meaningful measure with which to evaluate residential treatment programs. Further research is needed to evaluate acceptance of chronic pain with long-term opioid abstinence and overdose deaths.
The chronic nature of substance use disorder requires continuity of care after residential treatment. Only a small proportion of patients, however, adhere to aftercare follow-up plans and the relapse rates remain between 40- 80% within a year post-discharge. Synthesis of evidence showed that facilitated referral (FR) significantly increased follow- up adherence and resulted to positive outcomes. The study aimed to examine the effectiveness of FR in improving access, follow-up adherence and engagement to aftercare services, and relapse rate after a month post- discharge.
After the Institutional Review Board approval, 30 participants were recruited in two residential treatment facilities. Questionnaires, the Assessment of Warning Signs of Relapse and Health leads surveys were utilized to collect data. Data were analyzed using descriptive statistics, McNemar, and Wilcoxon signed rank tests. Results showed that FR significantly increased access to many community aftercare services (p<.05). A significant reduction in relapse risk post-intervention was also noted (Z= -3.180, p= .001). Additionally, most participants discharged with scheduled appointments followed-up and had continued engagement with aftercare services. Eight participants maintained sobriety and 18 were lost to follow-up a month post-discharge, while four relapsed in the facility.
Overall, FR increased access to needed aftercare services and significantly decreased the relapse percentage risk post-discharge. FR is a promising intervention that can be implemented for practice. Future research is recommended to further examine the correlation with follow-up adherence and continuous engagement to aftercare services, and relapse rate at 30 days after discharge.