Personalized Nursing: An Effective Intervention Model for Use with Drug-Dependent Women in an Emergency Room

Abstract

One hundred and fifty five drug-dependent women in an urban hospital emergency room in Detroit, Michigan, were the subjects for this 3-year exploratory field study. Subjects were women who told the emergency room staff that while they wanted assistance with their presenting health problems, they wanted no assistance with their drug addiction. The women were randomly assigned to either the experimental or control study group. Both groups received a pretest in the emergency room, a posttest between 8 and 12 weeks after their emergency room visit, and a follow-up test 6 months after the posttest. In addition, the experimental women were seen by project nurses, primarily in their homes, for a maximum of eight visits on a once-a-week basis. The experimental women were treated using "Personalized Nursing", a nursing intervention model, which focused on providing assistance for client-identified concerns. It was hypothesized that interaction with the Personalized Nursing Intervention Model would be associated with: (1) a decrease in daily drug cost and (2) a decrease in perceived stress. Results show that while there were no differences between the study groups at the pretest interview, the experimental group reported a lower daily drug cost (F(1, 95) = 2.90; p = 0.09), a lower daily heroin cost (U = 165; p = 0.01), less perceived stress (F(1, 84) = 3.00; p = 0.09) and emotional distress (F(1, 83) = 3.70; p = 0.06) than control subjects at the 8-week posttest. The experimental subjects also reported less perceived stress (t(65) = -2.35; p = 0.02) at 6-month follow-up than control subjects. It was found that results could be improved if members of the experimental clients'' social networks were treated simultaneously and if project nurses were correctly utilizing the model. Implications for substance abuse treatment programs are discussed. The encouraging results of this exploratory study warrant follow-up and replication.