FAR EASTERN UNIVERSITY EVIDENCE BASED NURSING
I. CLINICAL QUESTION: In patient with paranoid schizophrenia do non addictive patients impaired differentially from addictive patients in terms on working memory and multitasking that is relevant in maintaining abstinence. CITATION: Psychiatry 2006; 63: 4909. Swartz M. S., Wagner H. R., Swanson J. W., Stroup T. S. McEvoy J. P., Canive J. M. et al. Substance use in persons with schizophrenia: baseline prevalence and correlates from the NIMH CATIE study. J Nerv Ment Dis 2006; 194: 16472. STUDY CHARACTERISTIC: 1. Patient Included The cognitive prole of schizophrenic patients with and without comorbid substance abuse disorder was compared with that of patients suffering from major depression or alcoholism and healthy participants. 2. Intervention compared Comparison of non addictive-addictive patients in terms of working memory and multi tasking. 3. Outcome monitored (i) the ability to update continuously context information in working memory and to use it for action selection; and (ii) the capacity to divide attention between different sensory input channels and to coordinate verbal and manual responses. 4. Does the study focused on a significant problem in clinical practice? Yes, This study focused on choosing the right intervention to used in the non-addictive compared with the addictive patients to maintain substance abstinence. IV. METHODOLOGY AND DESIGN: 1. Methodology used: Randomized trial 2. Design:
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General intelligence. Two subtests (picture completion and similarities) from a short German version *45+ of the Wechsler Adult Intelligence ScaleRevised [46] Context processing In a variant of a two-back task *47+, 100 1-digit numbers are presented sequentially on a computer screen. Subjects have to press a response key each time the current digit is identical to the penultimate one. Response times (RTs) and the number of hits and false alarms were recorded. served to estimate present-state IQ. Multi-tasking The divided attention task *47+ consists of 100 trials, in which cross-shaped stimuli appear in random locations of a four four stimulus matrix on a screen, while at the same time high- and low-pitched tones are presented in random sequence. 3. Setting The research was conducted at Institute of Cognitive Neuroscience, Department of Neuropsychology, Ruhr-University of Bochum, Germany 4. Data Sources Internal sources: Institute of Cognitive Neuroscience, Department of Neuropsychology, RuhrUniversity of Bochum, Germany External sources: Not specified 5. Subject Selection Inclusion Criteria An IQ above 85 and, for the patients, current hospitalization in a mental health institution and clinical stability. Twenty-three patients suffering from paranoid schizophrenia age range: 2356), 27 patients with a DD of paranoid schizophrenia and SUD age range: 1953), 20 patients diagnosed with alcoholism age range: 2363) and 22 patients with major depressive disorder Patients from the DD group abused either cannabis, both substances or several substances including cocaine and hallucinogens on a regular basis (ICD-10 F19; n = 10). Twenty healthy controls (HC, age range: 2263) with no past or present psychiatric disorder Exclusion Criteria
Exclusion criteria were a history of neurological disorder head trauma involving loss of consciousness 6. Has the original study been replicated? No, the study has not been replicated 7. What were the risk and benefits of nursing action/intervention tested in the study This action/intervention is highly beneficial choosing the right approach in substance abstinence on addicted compared to nonaddicted schizophrenic patients 8. Result of the study: Single-diagnosis schizophrenic patients showed pronounced impairments on measures of online maintenance and use of context information. Their ability to coordinate different sensory input channels (divided attention) was also impaired. Addicted schizophrenics showed evidence of impaired sensory input management and of reduced context sensitivity, when age differences were controlled. V. AUTHORS CONCLUSION AND RECOMMENDATION 1. What contribution to the client health status/Intervention make? It compares the prole of working memory and multi-tasking performance in non-addicted schizophrenic patients and DD patients It also determine the specicity of the decit patterns in the schizophrenic groups by including clinical (major depression and alcoholism) and healthy comparison groups and to assess the potential inuence of psychopathological features such as depressive and psychotic symptoms on cognition in schizophrenia 2. What overall contribution to nursing knowledge does the study make?
Treatment programmes could benet from the conclusions drawn in the present study by trying to incorporate the relatively intact executive abilities in (young) DD patients while including training of divided attention and sensitivity to context information
Evidence Based Nursing
(Stress as a factor on irritable bowel syndrome)
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