• Humor & Opioid Recovery

      Canha, Benjamin; Scrandis, Debra (2019)
      Abstract Background: The prevalence and mortality rates of opioid use disorders (OUD) have drastically increased in recent years in the United States. Narcotics Anonymous (N.A.) is a successful behavioral program supporting recovery for individuals with OUD. Humor may play an important role in maintaining group involvement and continuing support within the culture of the N.A. program. Purpose: The purpose of this study was to understand the ideas, beliefs, attitudes and behaviors of humor in individuals recovering from OUD who are participating in the N.A. program. Design: Qualitative ethnography design was used with three types of complementary data collection methods: observations at meetings and social gatherings, personal interviews, and a focus group session. Results: Instances of humor between N.A. members were noted in observations. Recorded one-on-one interviews with ten members recovering from OUD provided details of various experiences of humor and led to development of five essential themes: Feels Good, Social, Lighten Up, Healing and Alienate. These findings highlight the mostly positive personal and social benefits participants experienced, as well as possible negative effects. A focus group of seven N.A. members provided interactive discussion of humor and discussed the need to become more conscientious of the detrimental effects of humor. Conclusion: The implications of this study suggest the need to explore various humor interventions to assess their relative effectiveness in enhancing recovering, and reducing relapses. Due to the small number of participants, results may not be generalizable to all those with OUD in N.A. or represent the possibly wide range of N.A. meetings. This study added to the depth of knowledge about the effects of humor on this population and their recovery process. The importance of humor and having fun in the recovery of OUD should be more widely recognized by nurses as they help those with OUD, as humor definitely has a role to play in supporting N.A. members’ recovery from OUD.
    • A qualitative analysis of the implementation of a complex intervention: evaluating implementation of the Trauma Survivors Network

      Frey, Katherine Parris; Lipscomb, Jane (2017)
      Background: Annually, two million adults are admitted to US hospitals due to traumatic injury. The trauma recovery process often brings physical and psychological challenges. The Trauma Survivors Network (TSN) is a multimodal program designed to improve outcomes for this population. However, despite early efforts at dissemination, widespread adoption of the program remains low. Understanding barriers and facilitators to adoption and implementation is a common challenge in intervention development and dissemination generally, representing a knowledge gap in planning for the implementation of complex, behavior change interventions more specifically. Purpose: The purpose of this project was to qualitatively assess the implementation of the TSN at 6 trauma centers using a combination of prospective documentation and retrospective interviews. The implementation process at each of the participating centers was analyzed and compared to rate implementation strength. Specific barriers and facilitators to program implementation were identified. Methods: In this qualitative multiple case study, data sources included implementation logs (6), diary entries (147), and semi-structured interviews with key informants (37). Each of the centers was considered an analytic case. Data analysis followed a primarily deductive approach, using a coding framework based on the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Matrices of themes and cases were constructed, allowing the evaluation constructs at the case and study level. Results: The result of this research is the development of a model of program implementation proposing the factors most likely to result in successful implementation of the TSN. Implementation requires leaders at local centers to recognize the need for the program, and working with a dedicated coordinator and engaged opinion leaders, provide the time, support, and resources necessary to demonstrate program continuity and value to staff. This process is facilitated by external, national level support for the program, including the potential incorporation of the TSN into guidelines for trauma center verification, as well as the design of internal processes intended to integrate the program into the center, ensuring acceptance and longevity for the program. The results of this study can assist future adopters of the TSN, improving the likelihood of successful program implementation.