5.2. Personal protective factors

Integrated treatment is a combination of treatment modalities from the psychiatric and mental health-care team that focus on conditions simultaneously and work with the coordinated interaction between service providers, or they are working together as one team in the hospital [24, 26]. The integrated programs require mental health staff to coordinate a range of approaches, such as detoxification, medication management, CBT, and MI—which is often

In summary, recommendations for treating PDD covered three broad areas: screening, assessment, and planning; psychosocial and pharmacological treatment; and systems of service provision, with the fundamental issue being that of coordinating across federal and state departments and across area health services and individual agencies. The initial focus when developing treatment plans must be on encouraging a therapeutic alliance with the PDD and on offering MI, CBT, contingency management, skills training along with education and support for family and caregivers, relapse prevention, case management, and promoting positive health support from others (including family members and non-substance-using friends). Furthermore, the use of atypical antipsychotic medications may facilitate adherence since they are associated with fewer side effects and have been shown to benefit persons with PDD. Regardless of whether services follow integrated or parallel models, multidisciplinary treatment team should be well coordinated, take a team approach, have specialist-trained personnel (including 24-hour access),

problematic due to limited resources and the absence of well-defined guidelines.

include a range of program types, and provide for long-term follow-up [4, 20, 25].

The major focus of this paper was focused on nursing intervention in perspective of two types of human responses—reactions to actual health problems or illness (health-restoring responses) and concerns about potential health problems (health-supporting responses) [28]. The vulnerabilitystress model determines the factors that affect schizophrenic psychotic symptoms and integrates a holistic perspective in which both biological and psychological variables explain the onset, course, and psychotic symptoms. Additionally, this model illustrates the interaction between four factors,

The factors of the model are dopaminergic dysfunction, reduced available processing resources, autonomic hyperactivity, and schizotypal personality traits. The dopaminergic dysfunction will reduce the activation of processing resources and affect tonic autonomic hyper activation. The interaction of the personal vulnerability factors and personal protectors leads the vulnerable individual to develop prodromal symptoms of drug use. However, the personal vulnerability factors are associated between the inherited genetic factors and/or early biological factors [28]. These factors have been thought to contribute to vulnerability to congenitally compromise brain

Therefore, nurse should be aware with the assessment about biological factors such as genetic

5. Vulnerability-stress model of drug addiction

which can be further subdivided [28, 29] as follows:

5.1. Personal vulnerability factors

drug use to design nursing intervention.

structure and function.

56 Drug Addiction

These factors include (i) coping skills and self-efficacy and (ii) antipsychotic drug and selfefficacy: for this study, the researcher used the terms of medical use self-efficacy to describe self-efficacy as confidence in one's ability to perform a given task such as taking antipsychotic medications as prescribed.

Nurse should be concerned that the strength of self-efficacy for appropriate antipsychotic use plays an important role to take antipsychotic, continue on treatment program, and balance neurotransmitters in the brain, especially dopamine and norepinephrine, which decrease psychotic symptoms. Thus, psychoeducation of medication self-efficacy program is needed.

Moreover, coping is a behavioral and cognitive effort to cope with situations that are appraised as stressful in PDD's life and the pressure from family members because they often lack the information-processing skills to process optimum behavioral alternatives and the social skills to put these strategies into action [27, 29–31]. For this reason, nurse should enhance coping skills, medication self-efficacy, information-processing skills,and social skill in PDD by designing program interventions that possibly help to make information-processing skills easier than the past by implementation via information system and interactive system such as website, Facebook, and mobile phone.
