Change theory and the impact of an educational program on the case-finding activities of registered nurses in the early identification of alcohol-related problems.

摘要

The purpose of this study was to determine the impact of an educational program on the case-finding activities of registered nurses in the early identification of alcohol-related problems, which included nurses asking patients about their drinking patterns. The educational program was developed and implemented using Rogers' (1983) diffusion of innovations theory as a framework for change.;A nonequivalent control group design was used for the study. The sample consisted of 58 subjects; 28 in the experimental group and 30 in the control group. The subjects in each of the two treatment groups were drawn from three acute care facilities.;In order to evaluate the program's effectiveness, pretests and posttests were administered to test knowledge, attitudes and case finding activities of the nurse. Knowledge was tested through use of a multiple-choice test, attitudes through the five subscales of the Seaman-Mannello Scale and case-finding through nurse-patient interactions, or vignettes, created to provide a realistic situation in which the nurse interviews a patient for the purpose of completing an admission interview.;The educational program was five weeks in length preceded by a pretest and ending with a posttest. In Rogers' (1983) words, it presented "how to" and "principles" knowledge, i.e., the knowledge and skills to engage in case-finding activities. Topics, which were part of the program, were presented by experts in the field of alcohol studies.;Rogers' (1983) theory suggests that there are certain factors that influence the rate at which individuals adopt innovations. To shed further light on this subject, a research question was developed. It was answered by correlation of selected antecedent variables and the subjects' performance on the instruments used to test the hypotheses.;Findings of the study indicate that the posttest scores for knowledge, the scores on two of the subscales for the attitude instrument plus one major variable on Vignette ;A number of recommendations for nursing educators at the preservice and inservice levels, clinicians, researchers and nursing service administrators were made. The recommendations pertain to theory and clinical experiences in basic nursing curricula and inservice programs, the use of vignettes for teaching purposes and evaluation, and implementation of the Standards of Addictions Nursing in nursing service departments.