A Comparison of Two Case Studies Using the Roy Adaptation Model: Parents of Opioid-Dependent Adults and Bariatric Surgery

The authors in this paper demonstrate the utility and versatility of the Roy Adaptation Model (RAM) as applied to two contemporary case studies. The first case uses the RAM model to gain understanding and guide nursing practice to assist the parents of a young adult with an opioid use disorder and depression, and the second case involves using the RAM model to help a woman who recently had bariatric surgery cope and adapt postoperatively in a way that helps her maximize the benefits of having had that procedure. The authors discuss how the RAM provides a holistic approach that can be used to provide high-quality, comprehensive nursing.

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Understanding Shame as an Obstacle: Toward a Global Perspective

Nursing Science Quarterly ◽

10.1177/0894318420987186 ◽

2021 ◽

Vol 34 (2) ◽

pp. 196-201

Author(s):

Jeanne Cummings ◽

Steven L. Baumann

Keyword(s):

Nursing Practice ◽

Global Perspective ◽

Healthcare Team ◽

Roy Adaptation Model ◽

Patient Relationship ◽

Trauma Assessment ◽

Willingness To Disclose ◽

History Of ◽

Vicarious Shame ◽

Adaptation Model

In this paper, the authors suggest that shame is a barrier to many patients’ willingness to disclose their history of trauma to nurses and other members of the healthcare team and that the clinicians participate in this withholding of information because of their experience of vicarious shame. The authors propose that shame and vicarious shame reduce the accuracy of assessment, limit the nurse–patient relationship, and reduce the ability of the healthcare teams to accurately diagnose and treat patients. Shame as a barrier to trauma assessment is also considered in light of the Roy adaptation model and from a global perspective. Implications for education, research, and nursing practice are discussed.

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The Effects of Nursing Education Constructed According to Roy Adaptation Model on Adaptation Process of Patients Undergoing Bariatric Surgery

Bariatric Surgical Practice and Patient Care ◽

10.1089/bari.2020.0030 ◽

2020 ◽

Author(s):

Ezgi Yildiz ◽

Şerife Karagözoğlu

Keyword(s):

Bariatric Surgery ◽

Nursing Education ◽

Roy Adaptation Model ◽

Adaptation Process ◽

Adaptation Model

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Holistic approach to opioid use disorder: Think nitric oxide!

Journal of Opioid Management ◽

10.5055/jom.2019.0543 ◽

2019 ◽

Vol 15 (6) ◽

pp. 521-555 ◽

Cited By ~ 1

Author(s):

Marvin A. Sackner, MD ◽

Jose R. Lopez, MD ◽

Veronica Banderas, BA TR ◽

Jose A. Adams. MD

Keyword(s):

Nitric Oxide ◽

Holistic Approach ◽

Cost Effective ◽

Arterial Disease ◽

Opioid Use Disorder ◽

Opioid Addiction ◽

Opioid Use ◽

Cost Effective Approach ◽

Peripheral Arterial ◽

Endothelial Nitric Oxide

This review deals with opioid addiction, chronic pain, and an innovative, noninvasive technology with simultaneous, beneficial applications for both conditions. This technology, called passive simulated jogging device (GENTLE JOGGER, JD) targets addiction and pain by increasing endothelial nitric oxide (NO) bioavailability. It can be self-administered while sitting or lying without resorting to multitasking thereby allowing watching television or operating a computer while effortless, physical activity is produced from motorized foot pedals repetitively striking a bumper at 175-190 times per minute which adds small pulses to the circulation. This action increases shear stress (friction) to vascular endothelium that stimulates endothelial nitric oxide synthase (eNOS) to increase NO that decreases oxidative stress and inflammation, and, slows accelerated vascular ageing associated with opioids.Since the 1970s, clonidine, lofexidine, and dexmedetomidine have been used off-label to suppress opioid withdrawal symptoms precipitated by excessive release of norepinephrine. These pharmacotherapy aids to withdrawal and tapering opioid dosagadrenoceptor agonists that act through eNOS to inhibit norepinephrine. Increasing NO as with JD and/ or in conjunction with opioid agonists should help stabilization, tapering, withdrawal, and relapses stages of addiction. Nitric oxide as increased with JD technology is antinociceptive as demonstrated in chronic and subacute pain states, viz., fibromyalgia, osteoarthritis, peripheral arterial disease, delayed onset of muscle soreness (DOMS), and sickle cell disease. Jogging device decreases elevated blood pressure that is produced with physical inactivity, a risk to opioid use disorder (OUD). Thus, JD provides holistic, cost-effective approach to opioid addiction as well as chronic and subacute pain.

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Take Home Injectable Opioids for Opioid Use Disorder During and After the COVID-19 Pandemic Is in Urgent Need: A Case Study

10.21203/rs.3.rs-136113/v1 ◽

2020 ◽

Author(s):

Eugenia Oviedo-Joekes ◽

Scott MacDonald ◽

Charles Boissonneault ◽

Kelli Harper

Keyword(s):

Addiction Treatment ◽

Risk Mitigation ◽

Opioid Use Disorder ◽

Negative Consequences ◽

Opioid Use ◽

Regulatory Structure ◽

Opioid Agonist ◽

Opioid Agonist Treatment ◽

First Case ◽

Opioid Medications

Abstract Background: In North America the opioid poisoning crisis currently faces the unprecedented challenges brought by the COVID-19 pandemic, further straining people and communities already facing structural and individual vulnerabilities. People with opioid use disorder (OUD) are facing unique challenges in response to COVID-19, such as not being able to adopt best practices (e.g., physical distancing) if they’re financially insecure or living in shelters (or homeless). They also have other medical conditions that make them more likely to be immunocompromised and at risk of developing COVID-19. In response to the COVID-19 public health emergency, national and provincial regulatory bodies introduced guidance and exemptions to mitigate the spread of the virus. Among them, clinical guidance for prescribers were issued to allow take home opioid medications for opioid agonist treatment (OAT). Take Home for injectable opioid agonist treatment (iOAT) is only considered within a restrictive regulatory structure, specific to the pandemic. Nevertheless, this risk mitigation guidance allowed carries, mostly daily dispensed, to a population that would not have access to it prior to the pandemic. In this case it is presented and discussed that if a carry was possible during the pandemic, then the carry could continue post COVID-19 to address a gap in our approach to individualize care for people with OUD receiving iOAT.Case Presentation: Here we present the first case of a patient in Canada with long-term OUD that received take home injectable diacetylmorphine to self-isolate in an approved site after being diagnosed with COVID-19 during a visit to the emergency room where he was diagnosed with cellulitis and admitted to receive antibiotics. Conclusion: In the present case we demonstrated that it is feasible to provide iOAT outside the community clinic with no apparent negative consequences. Improving upon and making permanent these recently introduced risk mitigating guidance during COVID-19, have the potential not just to protect during the pandemic, but also to address long-overdue barriers to access evidence-based care in addiction treatment.

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The role of stigma in referrals for medication for opioid use disorder: Three case studies in Montana

10.36855/sor2021.3 ◽

2021 ◽

Author(s):

Brandn Green ◽

Kirsten Smith ◽

Anna Schmitt ◽

Kirsten Krane

Keyword(s):

Case Studies ◽

Opioid Use Disorder ◽

Opioid Use

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Assessing Patients’ Risk for Opioid Use Disorder

AACN Advanced Critical Care ◽

10.4037/aacnacc2019931 ◽

2019 ◽

Vol 30 (4) ◽

pp. 343-352

Author(s):

Barbara St. Marie

Keyword(s):

North America ◽

Patient Care ◽

Nursing Practice ◽

Critical Role ◽

Improve Patient Care ◽

Opioid Use Disorder ◽

Opioid Misuse ◽

Opioid Use ◽

Improve Patient ◽

The Continuum

Opioid use disorder and opioid misuse continue to increase rapidly in prevalence in North America. Nurses play a critical role in managing pain in patients who are at risk for opioid use disorder. The interplay of pain and opioid use disorder provides nurses with an opportunity to address urgent needs while treating patients across the continuum of care. This article reviews strategies for assessing risk for opioid use disorder while treating patients with pain. Implementing these approaches into daily nursing practice may improve patient care and help reduce the incidence of opioid use disorder.

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Community Health Nursing Practice and the Roy Adaptation Model

Public Health Nursing ◽

10.1046/j.1525-1446.1999.00290.x ◽

1999 ◽

Vol 16 (4) ◽

pp. 290-300 ◽

Cited By ~ 7

Author(s):

Elizabeth L. Dixon

Keyword(s):

Community Health ◽

Nursing Practice ◽

Roy Adaptation Model ◽

Community Health Nursing ◽

Health Nursing ◽

Adaptation Model

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Debating Medical Utility, Not Futility: Ethical Dilemmas in Treating Critically Ill People Who Use Injection Drugs

The Journal of Law Medicine & Ethics ◽

10.1177/1073110518782925 ◽

2018 ◽

Vol 46 (2) ◽

pp. 241-251 ◽

Cited By ~ 1

Author(s):

Stephen R. Baldassarri ◽

Ike Lee ◽

Stephen R. Latham ◽

Gail D'Onofrio

Keyword(s):

Critically Ill ◽

Psychiatric Care ◽

Holistic Approach ◽

Opioid Use Disorder ◽

Sustained Remission ◽

Care Providers ◽

Opioid Use ◽

Medication Assisted Treatment ◽

Injection Drugs ◽

Life Saving

Physicians who care for critically ill people with opioid use disorder frequently face medical, legal, and ethical questions related to the provision of life-saving medical care. We examine a complex medical case that illustrates these challenges in a person with relapsing injection drug use. We focus on a specific question: Is futility an appropriate and useful standard by which to determine provision of life-saving care to such individuals? If so, how should such determinations be made? If not, what alternative decisionmaking framework exists? We determine that although futility has been historically utilized as a justification for withholding care in certain settings, it is not a useful standard to apply in cases involving people who use injection drugs for non-medical purposes. Instead, we are welladvised to explore each patient's situation in a holistic approach that includes the patient, family members, and care providers in the decision-making process. The scope of the problem illustrated demonstrates the urgent need to definitively improve outcomes in people who use injection drugs. Increasing access to high quality medication-assisted treatment and psychiatric care for individuals with opioid use disorder will help our patients achieve a sustained remission and allow us to reach this goal.

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