Testing Nursing Sensitive Outcomes in Out-Patient Drug Addicts, with “Nursing Role Effectiveness Model”

Abstract

Our aim was to identify factors that contribute to a better outcome in drug users and to understand the effectiveness of nursing interventions, by applying "Nursing Role Effectiveness Model" (NREM). It's a correlational, cross-sectional study with 180 drug users in a methadone program, randomly selected from three community services. We identified that treatment time, lower co-morbidities, less poly-drug use, family support and being employed contribute to a better quality of life, better mental health, less substance addiction consequences and more satisfaction with nursing care (p < 0.05). Those data were also related with nursing interventions using Structural Equation Model and we found that nursing care contributes 29% to health outcome improvement. The model revealed itself adequate to assess the effectiveness of nursing interventions (X: 82.51/(34) = 2.426; p < 0.01, NFI = 0.927, CFI = 0.955, RFI = 0.903, GFI = 0.917, PGFI = 0.567, PCFI = 0.722, PNFI = 0.700, RMSEA = 0.089). Compared with the NREM original model, our findings reveal new relationships between the users' structural variables and the health outcomes and also relationship between units' structural variables and nurses' structural variables.

Exploring the utility of the Nursing Role Effectiveness Model in evaluating nursing contributions in primary health care: A scoping review

“… 1 Doran et al (); 2 Doran et al (); 3 Doran et al (); 4 Endacott et al (); 5 Gazarian, Moineddin, and Agha (); 6 Kossman and Scheidenhelm (); 7 Manojlovich (); 8 Manojlovich et al (); 9 Salgueiro et al (); 10 Saunders (); 11 White et al (); 12 Doran et al (); 13 Landesman et al (); 14 Rondinelli et al, ; 15 Tarlier (); 16 Seabra et al (). …”

“…The second article that used the NREM in ambulatory care was completed by Seabra, Amendoeira, and Sà (). Specifically, they examined the NREM in the context of an outpatient drug unit for patients with a methadone addiction to determine how effective nursing interventions are in relation to the patient outcomes when treating patients with substance addictive behaviours.…”

“…Two studies used the NREM as an organizing framework to guide selection of the study variables in primary health care. Tarlier Canada (Curnew, 2017 ,3,4,9,10,12,13,15 Sex 3,4,10,12,15 Ethnicity 3,10 Medical Diagnosis 3,5,9,10,12,15 Severity of Illness 4,5,8,9,14,15 Cognitive Status 1,13 Comorbidities 10,13,15 Severity of Illness 13 Baseline Functional Ability 13 Nurse Characteristics: Age 9,7,14 Sex 7,14 Ethnicity 7,14 Education 3,9,7,13,14,15 Experience 4,5,7,13,14,15 Skill Level 9,13,15 Salgueiro et al (2014); 10 Saunders (2011); 11 White et al (2015); 12 Doran et al (2014); 13 Landesman et al (2003); 14 Rondinelli et al, 2014;15 Tarlier (2006); 16 Seabra et al (2017). Note: original Nursing Role Effectiveness Model articles and review papers are not included in table. outcome could be considered reasonable to examine in primary health care.…”

Referral to the national network of integrated care: the nurses’ perception

“…The participants stated that, in detriment of the referral for the patients to the ECCI, they were referred to the inpatient services of the RNCCI network, due to the fact that the patients need continuous care and the ECCI schedules are not adequate to their real needs, such as elucidated in the excerpts of the interviews: (results) (16,27) .…”

“…A number of studies carried out in the context of outpatient care have shown that nursing interventions have contributed to improving the results of the patients (27) . NREM has the potential to identify specific results generated by the care provided by nurses, highlighting the role and responsibility of the Nursing profession, and justifying its importance in making decisions about health policies (16) .…”