6. Nursing care for persons with drug addiction

The critical or emotionally over-involved attitude toward the patient is, namely, expressed emotion; according to this alternative model, there might not be a causal relationship between the highly expressed emotion (EE) of significant others and relapse; they might be jointly related to a third variable (severity of illness). Combine these two models by postulating feedback loops from behaviors of patient to attitudes and behaviors of significant others, thereby creating

This model views the social environment as stressful life events and highly expressed emotion. The occurrence of key life events leading to a high level of environmental stress interacts with preexisting biological vulnerability factors and increases the likelihood that psychotic symptoms will return. Additionally, critical and emotionally over-involved attitudes at least partially represent responses to the heavy burden that mental illness places on significant others and that the persons who have a more severe, relapse-prone form of illness place the heaviest

For stressful life events, empirical data indicated that stressful life events rule on independent of the patient's behavior are more common in the weeks immediately before relapse. Additionally, the initial findings showed the roles of stress factors in other aspects of the early course of drug use that have significant associations with social functioning. Moreover, stressors in the form of stressful life events are realized as factors that interact with preexisting vulnerability

All of expressed emotion, both negatively expressed emotion and positively emotional expressed

This model indicated that the outcomes were social function, psychotic symptoms, and occu-

Social function (social dysfunction) is a hallmark characteristic of PDD that has important implications for the development, course, and outcome of illness. Additionally, social dysfunction generally worsens over the course of the disorder and is often resistant to drug treatment [31, 32]. Psychotic symptoms are a central element of drug use and are the outcome factors that reverse to other factors. Coping, self-efficacy, EE, stressful life events, and social functioning lead to the

Occupational functioning of drug use is associated with a significant decrease in such functioning. "Less than 20% of individuals with PDD can maintain regular employment, and there is a relationship between psychotic symptoms and occupational functioning among PDD." Empirically derived factor structures have shown that symptoms fall into five components. One such factor structure is derived from the following components: positive, negative, hostility, cognitive,

Occupational functioning is defined as competency with one's task performance associated with valued roles, sense of self-satisfaction, productivity, communication/interaction skills, leisure and rest in response to demands of the internal and/or external environment, and

characteristics to produce vicious circles, which lead, in turn, to psychotic episodes.

emotion, and stressful life events were included in nursing implementation for PDD.

severity of psychotic symptoms that are exacerbated by drug use.

bidirectional influence patterns [29, 30].

burden on significant others.

58 Drug Addiction

5.5. Outcomes

pational functioning.

and emotional discomfort.

Nursing interventions are helping PDD acknowledge the drug addiction and facilitating development of effective coping skills, medication self-efficacy, information-processing skills, occupational skill, and social skill by using the nursing process to (a) assessment information and health-care needs of PDD and (b) identified nursing diagnosis based on NANDA International (NANDA-1) classification system. Nursing diagnosis of PDD includes acute confusion, ineffective coping, and dysfunctional family process:

Figure 1. Vulnerability-stress model of nursing intervention for PDD adapted from vulnerability-stress model [28–30].


Professional nurse is working as an integral part of the multidisciplinary treatment team in caring of symptomatic care, limits setting, structured support, psychoeducation, and referrals for continuing care in the community. Family and caregivers are significant in the treatment program to be the part of resolving the problem and feelings surrounding the persons' drug use to facilitate recovery sessions.

6.1.3. Implementation

to perform to personal hygiene or grooming.

hunger, fatigue, and so forth.

physical presence is the reality.

to process abstractions or complexities is impaired.

security for the PDD.

related to medical illness.

7.1.1. Assessment data

• Insight

7. Evaluation of nursing outcomes

7.1. Nursing diagnosis: ineffective denial

anxiety and/or fear, leading to the detriment of health.

• Dose and frequency of drug use or dependence

1. Assessment data include hallucinations, disorientation, fear, low concentrate, and ability

Nursing Care for Persons with Drug Addiction http://dx.doi.org/10.5772/intechopen.73334 61

2. Be alert to the PDD's physical needs because of crucial. He or she may not attend to

3. Observe the PDD's patterns of food and fluid intake; monitor and record intake, output,

4. Monitor the PDD's elimination patterns by using PRN medication to the PDD to maintain

5. Calming activities before bedtime facilitate rest and sleep. Institute relaxing, quieting

6. Present reality by spending time with the PDD to facilitate reality orientation because your

7. Reorient the PDD to person, place, and time as necessary, by using the PDD's name often and by telling the PDD your name, the date, the place and situation, and so forth because

8. Evaluate the use of touch with the PDD. Touch can be reassuring and may provide

9. Be simple, direct, and concise when speaking to the PDD. Talk with the PDD about concrete or familiar things; avoid ideological or theoretical discussions. The PDD's ability

10. \*Direct activities toward helping the PDD accept and remain in contact with reality; use recreational or occupational therapy when appropriate. The greater the PDD's reality

The family or significant others may have difficulty understanding that psychotic behavior is

Conscious or unconscious attempt to disavow the knowledge or meaning of an event to reduce

contact and involvement in activities, the less time he or she will deal in unreality.

11. Provide information and explanations to the PDD's family or significant others.

reminding the PDD of surroundings, people, and time increases reality contact.

and daily weight. Adequate nutrition is important for the PDD's well-being.

bowel regularity. Constipation is a frequent side effect of major tranquilizers.

activities before bedtime (tepid bath, warm milk, quiet environment).
