Medicine and Health Sciences Commons^™

Treatment Outcomes From The Tdc: A Look At Smoking Cessation Among Patients With Co-Occurring Disorders, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings •Smoking abstinence at end of program:

–Intent to treat analysis: 32.2%(83/258) –Among program completers: 41.3%(83/201)

•Significant predictors of abstinence : –Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder. –Having a lower CO level at program enrolment was a significant predictor of being more likely to quit –Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Gender-Specific Profiles Of Tobacco Use Among Non-Institutionalized People With Serious Mental Illness, Joy L. Johnson, Pamela A. Ratner, Leslie A. Malchy, Chizimuzo T.C. Okoli, Ric M. Procyshyn, Joan L. Bottorff, Marlee Groening, Annette Schultz, Marg Osborne

Chizimuzo T.C. Okoli

Background: In many countries, smoking remains the leading preventable cause of death. In North America, reductions in population smoking levels are stabilising and, in recent years, those involved in tobacco control programming have turned their attention to particular segments of society that are at greatest risk for tobacco use. One such group is people with mental illness. A picture of tobacco use patterns among those with mental illness is beginning to emerge; however, there are several unanswered questions. In particular, most studies have been limited to particular in-patient groups. In addition, while it is recognised that men and women differ …

Smoking Cessation Outcomes Among Individuals With Co-Occurring Substance Use Disorder History And Mental Illness, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

BACKGROUND: A history of substance use disorder and/or mental illness is associated with tobacco use. However, there is limited information available on tobacco dependence treatment outcomes in such populations. OBJECTIVES: To examine the effects of a history of substance use disorder and/or mental illness on smoking cessation outcomes. METHODS: Data from 202 participants enrolled in a tobacco treatment program were analyzed. Information on sociodemographics, tobacco use and quit attempt history, social supports for quitting, Fagerstrom Test for Nicotine Dependence scores, importance and confidence in quitting smoking, expired carbon monoxide level, substance use history, mental health history, and previous pharmacotherapy use …

Intensive Treatment Of Tobacco Dependence In An Out - Patient Addictions Services Setting, Milan Khara, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

BACKGROUND

• Drug treatment populations are disproportionately affected by morbidity and mortality attributable to tobacco use. However, with appropriately intensive intervention, individuals in drug treatment settings can succeed in their efforts towards smoking cessation.

• The Tobacco Dependence Clinic (TDC) is a program that provides smoking cessation counseling and up to 26 weeks of free pharmacotherapy for clients through Vancouver Coastal Health Addiction Services, British Columbia, Canada.

• The purpose of this study is to provide evaluation data (in terms of program completion and smoking cessation outcomes) from the TDC.

Young Women’S Responses To Smoking And Breast Cancer Risk Information, Joan L. Bottorff, Stephanie Barclay Mckeown, Joanne Carey, Rebecca Haines, Chizimuzo T.C. Okoli, Kenneth C. Johnson, Julie Easley, Roberta Ferrence, Lynne Baillie, Erin Ptolemy

Chizimuzo T.C. Okoli

Current evidence confirms that young women who smoke or who have regular long-term exposure to secondhand smoke (SHS) have an increased risk of developing premenopausal breast cancer. The aim of this research was to examine the responses of young women to health information about the links between active smoking and SHS exposure and breast cancer and obtain their advice about messaging approaches. Data were collected in focus groups with 46 women, divided in three age cohorts: 15–17, 18–19 and 20–24 and organized according to smoking status (smoking, non-smoking and mixed smoking status groups). The discussion questions were preceded by information …

Smoking Cessation In Patients With Substance Use Disorders: The Vancouver Coastal Health Tobacco Dependence Clinic, Milan Khara, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings •Smoking abstinence at end of program:

–Intent to treat analysis: 32.2%(83/258) –Among program completers: 41.3%(83/201)

•Significant predictors of abstinence : –Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder. –Having a lower CO level at program enrolment was a significant predictor of being more likely to quit –Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

The Effect Of Acupressure On Constipation, Quality Of Life, And Depressive Symptoms In Cancer Patients With Constipation, Eun Jin Lee

University of Kentucky Doctoral Dissertations

Constipation is the most common gastrointestinal complaint in the United States, resulting in about 2 million annual visits to the doctor.

The purposes of this dissertation were to: 1) describe four theories of traditional Korean medicine; 2) review mechanisms of acupuncture and moxibustion and develop a conceptual model; 3) review findings from randomized controlled trials that tested the effects of acupressure used for the management of symptoms such nausea, pain, and dyspnea; 4) examine the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) in heart failure patients with constipation compared to those with gastrointestinal disease; 5) describe how Korean …

Tobacco-Free Prison Policies And Health Outcomes Among Inmates, Alison R. Connell

University of Kentucky Doctoral Dissertations

This study was the first to examine the effect of tobacco policies in prisons on the health of inmates. Kentucky has two types of tobacco policies in its 16 state prisons: indoor smoke-free policies, where smoking is allowed outdoors and tobacco-free policies, in which no tobacco of any kind is allowed on the grounds of the prison. The smoking rate of inmates is three times higher than that of current smokers in the non-incarcerated population which results in high rates of tobacco-related health conditions such as heart disease and lung cancer.

A literature review discussed the evolution of tobacco policies …

Cognitive Therapy For The Treatment Of Depressive Symptoms In Patients With Heart Failure, Rebecca L. Dekker

University of Kentucky Doctoral Dissertations

Depressive symptoms are common in patients with heart failure (HF) and adversely affect mortality, morbidity, and health-related quality of life. Cognitive therapy (CT) has been proposed as a non-pharmacological treatment for depressive symptoms in patients with HF. However, there is currently little evidence to support use of CT in patients with HF.

The purpose of this dissertation was to develop and test a brief, nurse-delivered CT intervention for the treatment of depressive symptoms in patients with HF. Prior to testing the intervention, preliminary work was conducted resulting in four manuscripts: 1) a review of the evidence for CT in treating …

Health System Processes, Clinician Attitudes, And Referrals To Tobacco Treatment Programs, Karma Bryan Cassidy

University of Kentucky Doctoral Dissertations

Assisting smokers to quit and stay quit is the most important intervention clinicians can undertake to improve the length and quality of life of patients who use tobacco. The chronic, relapsing nature of tobacco dependence complicates tobacco treatment. Tobacco treatment counseling programs provide on-going support to help patients avoid relapse. Assistance with a referral increases the likelihood that patients will participate in counseling, but few clinicians regularly assist with referrals to tobacco treatment programs. This dissertation examined health system processes and clinician attitudes that influence the likelihood that clinicians will refer their patients for tobacco treatment counseling.

Three papers examined …

Intensive Tobacco Dependence Treatment For Clients With Substance Use Disorder And/Or Mental Illness, Milan Khara, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

BACKGROUND •Drug treatment populations are disproportionately affected by morbidity and mortality due to tobacco use. However, with appropriately intensive intervention, individuals in drug treatment settings can succeed in their efforts towards smoking cessation. •The Tobacco Dependence Clinic (TDC) is a program that provides smoking cessation counseling and up to 26 weeks of free pharmacotherapy for clients through Vancouver Coastal Health Addiction Services , British Columbia, Canada. There are currently three clinic sites: Pacific Spirit, Three Bridges, and Downtown Community Health Centre (DCHC). •The purpose of this study is to provide 2-year pilot evaluation data (in terms of program completion and …

Health Promotion And Health Education: Nursing Students’ Perspectives, Kathleen Ann Halcomb

University of Kentucky Doctoral Dissertations

The purpose of this study was to determine student nurses’ perceptions of (1) the role of the nurse in health promotion, and (2) how the concept of health promotion is presented in nursing curricula. Research questions for this study included the following: 1) Can nursing students explain the difference between health education and health promotion? 2) What have nursing students been exposed to within their curriculum regarding health promotion? 3) What health promoting behaviors are nursing faculty role modeling as perceived by nursing students? 4) What is the role of the nurse in implementing health promotion as perceived by nursing …

Cardiac Rhythm During Mechanical Ventilation And Weaning From Ventilation, Muna Hassan Hammash

University of Kentucky Doctoral Dissertations

The transition from mechanical ventilation (MV) to spontaneous ventilation during weaning is associated with hemodynamic alterations and autonomic nervous system (ANS) alterations (reflected by heart rate variability [HRV]). Although cardiac dysrhythmias are an important manifestation of hemodynamic alterations, development of dysrhythmias during MV and weaning and subsequent impact on length of MV has received little attention.

The purposes of this dissertation were to 1) evaluate the relationship of heart rate variability (HRV) during weaning to the development of cardiac dysrhythmias and 2) determine the relationship of cardiac dysrhythmias to length of MV.

A convenience sample of 35 patients (66.7% men; …

What Nurses Say: Communication Behaviors Associated With The Competent Nursing Handoff, Anne Claiborne Ray Streeter

University of Kentucky Doctoral Dissertations

Communication competence and medical communication competence served as the theoretical framework for this research that seeks to identify specific communication behaviors associated with what nurses say constitute a communicatively competent patient handoff at the nursing change of shift. Data collected from 286 nurses responding to an online modified Medical Communication Competence Scale posted at www.allnurses.com supported the hypotheses that information exchange (information giving, seeking and verifying) and socioemotional communication behaviors are rated more highly in the best patient handoffs than in the worst ones. Research questions found that the incoming nursing role rated behaviors associated with information verifying and socioemotional …

Evaluation Of Testing And Implementation Of Evidence-Based Rn Bedside Swallow Screen For Dysphagia: A Clinical Practice Change, Edith Matesic

DNP Projects

Stroke patients initially experience dysphagia approximately 42 - 67% of the time with noted improvement reducing rates to approximately 43% at seven days post-acute event (Perry & Love, 2001). The dysphagia experienced by these patients makes them at high risk to develop aspiration pneumonia. Overall, the financial impact of reducing aspiration pneumonia reduces the national cost of morbidity, mortality, and disability burden in this population. There is no generally recognized swallow screen. Program evaluation objectives were to establish a valid, reliable, cost effective, and easy to administer evidence RN bedside swallow screen for dysphagia to keep acute stroke patients safe …