Browsing by Subject "risk behaviors"

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    Assessment of Risk Behaviors in Patients With Opioid Prescriptions: A Study of Indiana’s Inspect Data
    (Wiley, 2017-12) Greene, Marion S.; Chambers, Robert Andrew; Yiannoutsos, Constantin T.; Wright, Eric R.; Steele, Gregory K.; Zollinger, Terrell W.; Health Policy and Management, School of Public Health
    Background and Objectives Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision‐making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients’ likelihood to engage in opioid‐related risk behaviors. Methods Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines. Two binary logistic regression analyses (engaging in at least one risk behaviors; engaging in all four risk behaviors) and an ordinal regression analysis (engaging in 0–4 risk behaviors) were conducted to identify factors associated with these opioid‐related risk behaviors. Results Of the 1,538,120 unique opioid patients included in the study, 18.4% engaged in one, 5.3% in two, 1.6% in three, and .4% in all four risk behaviors. Depending on the model, prescribing a second monthly opioid increased patients’ odds to engage in risk behaviors by a factor of 10 or more and prescribing two or more benzodiazepines annually increased the odds at least 13‐fold. Conclusions and Scientific Significance About one‐fourth of all patients consuming opioids engaged in one or more risk behaviors; higher number of opioid prescriptions and addition of even a small number of benzodiazepine prescriptions dramatically increased these odds. PDMPs can be helpful in identifying opioid users at high‐risk for misuse. This information could be used to target efforts to reduce the prescription drug epidemic.
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    The Paradox of Respect and Risk: Six Lakota Adolescents Speak
    (2009-06-23T21:40:14Z) Isaacson, Mary J; Swenson, Melinda M.; Russell, Kathleen M.; Stiffler, Deborah; Zimmerman, Larry J.
    Adolescence is a time of turbulence as young people stretch parental boundaries, seeking where they fit in society. For many American Indian adolescents this time involves the initiation of dangerous high-risk behaviors. Potential causes posed for this are: loss of identity, loss of cultural values and traditions, lack of positive role modeling and feelings of hopelessness. Survey research has been the predominant method of data collection. Very few studies of Native American youth use storytelling, even though stories are a part of many Indian cultures. The primary purpose of this study was to describe the phenomena of respect and risk from the viewpoint of the Lakota adolescent. I employed hermeneutic phenomenology with photography to help the adolescents illuminate these somewhat abstract concepts. I recruited participants from a single reservation on the Northern Plains. I collected data through non-structured interviews and participant observation. I analyzed the data using hermeneutic phenomenology based on Gadamer. Ecological systems theory provided a framework to assist me in understanding the multiple dimensions present in the adolescent’s stories. The phenomena of respect and risk from the perspective of these Lakota adolescents revealed a paradox. Each can be either positive or negative, depending upon the circumstances or the context of the situation. This paradox became the pattern among the participants. The pattern is the rock (inyan) and the wind (tate). The rock and the wind are deeply interconnected, and the influence of one may impact the other. Three themes emerged from this pattern: role modeling (positive or negative), identity, and feeling valued. These themes are consistent with current research regarding adolescent high-risk behaviors. These stories are significant in that they are personal accounts by these adolescents. This study has implications in nursing education, nursing practice, and health policy. Nursing education must attend to teaching students to listen and to become comfortable working with other cultures. As nurses advocate for future programming, it is essential that the research that guides the policies and programming be community-based action research. As society becomes more diverse, nursing must embrace many perspectives, helping all to achieve the highest quality of health and well-being.