NURSES' SUBSTANCE ABUSE: STRESS, COPING & SELF-EFFICACY

护士中的药物使用/滥用是一个日益令人担忧的问题。护士 对合法物质(例如，烟草)上瘾不能起到有效的作用 健康行为的典范，而受损的护士代表着一种潜在的 对他们的病人、他们的同事和他们自己都有危险。 这项建议描述了一项旨在检查与以下因素相关的研究 女护士的药物使用/滥用情况。我们的概念框架是由 来自Marlatt和Gordon(95，96)的复吸认知行为模型 预防。在这个模型中，压力被认为是一个直接因素 药物使用/滥用，而个体的应对策略和感觉 自我效能感是压力贡献的调节变量。如果应对是 无效和自我效能感低，那么压力更有可能导致 药物使用/滥用。 这项研究采用前瞻性队列设计，包括重复 对2585名护士进行评估(基线和12个月)，以测试概念性 压力、应对、自我效能感与心理健康的关系模型 物质使用。该模型将在工作和非工作情况下进行测试。 对这些措施的心理测量学性质进行彻底评估， 特别是关于女性护士的目标人群，以及 还将对结构和模型进行相关的改进。 护士将完成上述变量的邮寄调查。两者都有 一波又一波的数据将被组织成更高阶的潜在变量和 采用线性面板分析模型进行分析。该模型将在两个方面进行测试 对于超过12个月的同时效应和时间滞后效应 时间间隔。 本提案中概述的研究提供了一个概念上派生的和 对与风险有关的变量进行严格的方法学评估 护士中的药物使用/滥用。这项研究对 护理人员对药物滥用的认识与防治 在高压力工作中工作的其他与健康相关的专业人员 情况。

Substance use/abuse among nurses is a problem of growing concern. Nurses addicted to legal substances (e.g., tobacco) cannot serve as effective models of healthful behaviors, while impaired nurses represent a potential hazard to their patients, their colleagues and themselves. This proposal describes a study designed to examine factors related to substance use/abuse in female nurses. Our conceptual framework is derived from Marlatt and Gordon's (95, 96) cognitive-behavioral model of relapse prevention. In this model stress is posited to be a direct contributor to substance use/abuse while the individual's coping strategies and sense of self-efficacy are moderators of the contribution of stress. If coping is ineffective and self-efficacy low, then stress is more likely to lead to substance use/abuse. The study employs a prospective cohort design, involving repeated assessments (baseline and 12 months) of 2,585 nurses, to test a conceptual model of interrelationships among stress, coping, self-efficacy and substance use. The model will be tested for work and nonwork situations. A thorough assessment of the psychometric properties of the measures, particularly with regard to the target population of female nurses, and related refinement of constructs and of the model will also be undertaken. Nurses will complete mailed surveys of the variables outlined above. Both waves of data will be organized into higher-order, latent variables and analyzed in a linear panel analysis model. The model will be tested both for contemporaneous effects and time-lagged effects over a 12-month interval. The research outlined in this proposal provides a conceptually derived and methodologically rigorous assessment of variables related to risk for substance use/abuse in nurses. This study has implications for the understanding, preventing and treating of substance abuse in nurses and other health-related professionals who function in high-stress work situations.