The Role of the Registered Nurse Working in Substance Use Disorder Treatment: A Hermeneutic Study

Nurse led models of care for outpatient substance use disorder treatment: A scoping review

AIM

To map key characteristics and describe nurse led models of care for the treatment of persons with substance use disorders (SUDs) in the outpatient setting.

DESIGN

A scoping review.

METHODS

Conducted in accordance with the JBI methodology. The PRISMA-ScR checklist was used.

DATA SOURCES

Pubmed, CINAHL Complete (EBSCOhost), Cochrane Library, APA PsycNet and Scopus were searched from 1999 to May 2022 and updated on 28 November 2023. A handsearch and a grey literature search was conducted.

RESULTS

Title and abstract screening was performed on 774 articles resulting in 88 articles for full text screening. Full text screening yielded 13 articles that met inclusion criteria.

CONCLUSION

Existing nurse-led models of care for SUDS are scarce and limited in scope, with the majority focused on treating opioid use disorder. Additional research is needed to develop, test, and implement efficacious nurse-led models of care for the treatment and management of SUDs.

IMPLICATIONS TO CLINICAL PRACTICE

Nurse led models of care have demonstrated their efficacy and quality in the management of other chronic diseases. As we move forward with innovative solutions for individuals with addiction, nurse led models of care can be a mechanism to deliver high quality, evidence-based care for SUDs.

IMPACT

SUDs are chronic diseases that impact individuals, families, and communities. SUDs require a biopsychosocial approach to treatment. Globally, nurses are well positioned to provide high quality care to mitigate the impact of SUDs. This scoping review mapped the extant literature on nurse led models of care for substance use disorder treatment in the outpatient setting finding that additional research is needed to develop, test and implement evidence-based interventions to care for individuals, families, and communities experiencing SUDs.

REPORTING METHOD

PRISMA checklist for scoping reviews. No patient or public contribution were part of this study.

PROTOCOL REGISTRATION

Open Science Framework accessible at: https://doi.org/10.17605/OSF.IO/NSW7V.

Stigma towards a nursing specialty: A qualitative analysis of the perceptions of the addiction nursing workforce

Addiction nurses are highly skilled providers of holistic care and ensuring workforce sustainability is key to providing quality care to a traditionally marginalised group of healthcare consumers. The aim of this study was to explore perceived stigma towards the addiction nursing speciality, addiction nursing (also known as alcohol and other drug nursing) and its impact on workforce sustainability, retention and recruitment. Secondary analysis of qualitative interview data with nurses (n = 50) and survey data (n = 337) was conducted as part of a workforce mapping exercise in 2019. COREQ reporting guidelines were used. After structural coding was applied, three themes emerged: stigma experienced by clients of alcohol and other drug treatment services, stigma experienced by addiction nurses and a lack of awareness of the specialty of addiction nursing itself. Participants overwhelmingly felt that these forms of stigma made addiction nursing less attractive to new entrants, particularly new nurses and posed a threat to the sustainability of the specialty. The findings from this study indicate that urgent attention is required to address stigma towards individuals who use alcohol and other drugs, and the nurses providing care for them. Furthermore, creating awareness of the addiction nursing specialty is paramount to ensure workforce sustainability and to improve care for individuals who use alcohol and other drugs. Beyond addiction nurses, our results indicate that stigma towards other specialties (such as mental health nursing) is a substantive barrier to workforce sustainability.

Latent Dirichlet allocation topic modeling of free-text responses exploring the negative impact of the early COVID-19 pandemic on research in nursing

AIM

To derive latent topics from free-text responses on the negative impact of the pandemic on research activities and determine similarities and differences in the resulting themes between academic-based and clinical-based researchers.

METHODS

We performed a secondary analysis of free-text responses from a cross-sectional online survey conducted by the Japan Academy of Nursing Science of its members in early 2020. The participants were categorized into two groups by workplace (academic-based and clinical-based researchers). Latent Dirichlet allocation (LDA) topic modeling was used to extract latent topics statistically and list important keywords/text associated with the topics. After organizing similar topics by principal component analysis (PCA), we finally derived topic-associated themes by reading the keywords/texts and determining the similarity and differences of the themes between the two groups.

RESULTS

A total of 201 respondents (163 academic-based and 38 clinical-based researchers) provided free-text responses. LDA identified eight and three latent topics for the academic-based and clinical-based researchers, respectively. While PCA re-grouped the eight topics derived from the former group into four themes, no merging of the topics from the latter group was performed resulting in three themes. The only theme common to the two groups was "barriers to conducting research," with the remaining themes differing between the groups.

CONCLUSIONS

Using LDA topic modeling with PCA, we identified similarities and differences in the themes described in free-text responses about the negative impact of the pandemic between academic-based and clinical-based researchers. Measures to mitigate the negative impact of pandemics on nursing research may need to be tailored separately.

Global utilization of online information for substance use disorder: An infodemiological study of Google and Wikipedia from 2004 to 2022

INTRODUCTION

The increasing number of people who use drugs (PWUDs) can be attributed to the rising online sales of drugs and other related substances. Information on drugs and drug markets has also become easily accessible in web-search engines and social media. Aside from providing direct care, nurses have essential roles in preventing substance use disorder. These roles include health education, liaison, and researcher. Thus, nurses must examine and utilize the Internet, where information and transactions related to these substances are increasing.

DESIGN/METHODS

This study utilized an infodemiological design in exploring the worldwide information utilization for substance use disorder. Data were gathered from Google Trends and Wikimedia Pageview. The data included relative search volumes (RSV), top and rising related queries and topics, and Wikipedia page views between 2004 and 2022. After describing the data, autoregressive integrated mean averaging (ARIMA) models were used to predict future utilization of online information from Google and Wikipedia.

RESULTS

Google trends ranked 37 countries based on the search volumes for substance use disorder. Ethiopia, Finland, the United States, Kenya, and Canada have the highest RSVs, while the lowest-ranked country is Turkey, followed by Mexico, Spain, Japan, and Indonesia. Google searches for substance use disorder-related information increased by more than 900% between 2004 and 2022. In addition, Wikipedia page views for substance use disorder-related information increased by almost 200% between 2015 and 2022. Based on the ARIMA models, RSVs and page views are predicted to increase by about 150% and 120% by December 2025. Top and rising search-related topics and queries revealed that the public increasingly utilized online information to understand specific substances and the possible mental health comorbidities related to substance use disorders. Their recent concerns revolved around diagnostics, specific substances, and specific disorders.

CONCLUSION

The Internet can be of paradoxical use in substance use disorder. It has been previously reported to be increasingly used in drug trades, contributing to the increasing prevalence of substance use disorder. Likewise, the present study's findings revealed that it is increasingly utilized for substance use disorder-related information. Thus, nurses and other healthcare professionals should ensure that online information regarding substance use disorders is accurate and up-to-date.

CLINICAL RELEVANCE

Nurse informaticists can form and lead Internet- and social-media-based health teams that perform national infodemiological investigations to assess online information. In doing so, they can inform, expand, and contextualize ehealth substance use education and strengthen the accessibility and delivery of substance use healthcare. In addition, public health nurses can collaborate to engage patients and communities in identifying harmful substance use disorder information online and creating culturally-appropriate messages that will correct misinformation and improve ehealth literacy, specifically in substance use disorder.

The importance of interdisciplinarity in accommodating patient needs among norwegian nurses

WHAT IS KNOWN ON THE SUBJECT

Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors. Mental health nurses often describe role confusion in relation to other health professionals. Opportunities for interdisciplinary communication with other professionals may benefit health care.

WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE

The current large-scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities. Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so.

WHAT ARE THE IMPLICATIONS OF PRACTICE

The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needs Interdisciplinary teamwork could strengthen nurses' ability to address patient needs Finding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met.

ABSTRACT

INTRODUCTION: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors.

AIM/QUESTION

The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs.

METHOD

A cross-sectional web-based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded.

RESULTS

The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs.

DISCUSSION/IMPLICATION FOR PRACTICE

Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services.

Exploration the Needs of Nursing Care of Drugs Addiction Service Institutions in Indonesia

BACKGROUND: To explores the nurses and health professionals' views about the need for nursing care for drug addiction clients. AIM  To explores the nurses and health professionals' views about the need of nursing care to care for drug addiction clients. METHODOLOGY: This study used qualitative research and the data collection used interviews. The study involved ten nurses and ten health profession recruited from the three government centres of addiction services in the capital city of Indonesia. The analysis of the data using thematic analysis.  RESULTS: There were four themes Gray Area between Nurses and Other Health Workers in handling clients, The Role of Drug Addiction Nurses, Challenges and Strategies in caring for addiction clients and hopes.  CONCLUSION: Nurses in carrying out their duties must be equipped with knowledge, attitudes and special skills. The presence of a psychiatric nurse in the setting of drug addiction services needs to be considered a step in resolving the dilemma of drug addiction nursing services in Indonesia. Exceptional guidance and training for nurses in drug addiction services must be provided to improve nurses' knowledge, skills, abilities, and behaviour in handling drugs addiction clients.

Compassion Fatigue and Compassion Satisfaction Among Addiction Nursing Care Providers in Greece: A Mixed Method Study Design

ABSTRACT

The risk of compassion fatigue (CF) for professionals who support and care for individuals and families facing the dual burden of addiction and trauma has been recently recognized. The aim of this mixed methods study was to investigate CF/secondary traumatic stress and compassion satisfaction (CS) in addiction nursing care providers. The Professional Quality of Life Scale was distributed to 21 addiction nurses and 29 nurse assistants in the alcohol and drug dependency centers of a psychiatric hospital in Greece. High CF risk was reported in 22% of participants, whereas 46% expressed high-to-moderate potential for CS. Participants described the long transition from compassion frustration or disengagement at the beginning of their career to CS at later stages. Learning to be compassionate entailed finding the right distance, redefining therapeutic role and expectations, and containing feelings and experiences. Being able to experience CS involved getting satisfaction from small changes, personal and professional growth, and self-care. A compassionate organizational culture, clinical supervision, and ongoing education may protect addiction professionals from absorbing or internalizing unmanageable emotions, which may lead to CF and also help them to gain a deeper understanding of their communication and interactions with individuals fighting addiction.

Changes in Nursing Students' Attitudes and Perceptions After Receipt of Enhanced Substance Use-Related Curricular Content

BACKGROUND

Negative attitudes toward persons who use alcohol and other drugs contribute to suboptimal care. Nurses are in key roles to address the needs of this population, yet they lack the education needed to identify persons who may be at risk because of substance use and intervene accordingly. The purpose of this study was to evaluate the impact of a substance-use-related curriculum on nursing students' attitudes and therapeutic commitment for working with patients with alcohol- and drug-use-related problems.

METHODS

Data were collected for four cohorts of 169 nursing students enrolled in a Master's Entry into Nursing program. Questionnaires included the Person-Centered Alcohol and Alcohol Problems Perception Questionnaire and the Drug and Drug Problems Perception Questionnaire, completed before and after completing the curriculum. Paired samples t test were used to examine pre/post differences for each measure's subscale.

RESULTS

Four of the seven Person-Centered Alcohol and Alcohol Problems Perception Questionnaire subscales showing significant increases were role adequacy, role support, role legitimacy, and general perceptions. Four of the five Drug and Drug Problems Perception Questionnaire subscales showing significant increases were role adequacy, role support, job satisfaction, and role legitimacy; there was a significant change in role-related self-esteem, however, in a negative direction.

CONCLUSIONS

This study adds to the growing evidence of the positive impact of providing evidence-based information and skill development, which enhance alcohol- and drug-related knowledge and competence for nurses entering professional practice.

Perceptions diverge on aspects related to substance use disorder: An analysis of individuals in recovery, physicians, nurses, and medical students

Background: Interactions with healthcare workers can provide effective entrance into treatment, ensuring retention and lifelong recovery for individuals with Substance Use Disorder (SUD). Healthcare providers approach the challenges of patient management with different skills, comfort levels, and viewpoints. Individuals in recovery also provide crucial perspectives relevant to the complex aspects of the drug epidemic. The purpose of this study was to determine if perceptions of SUD diverge among individuals in recovery, physicians, nurses and medical students. Methods: A survey consisting of 29 Likert statements was deployed to physicians, nurses, medical students, and persons with SUD in recovery. Respondents were asked to rate their level of agreement on statements about SUD such as treatment, stigma, medications for opioid use disorder (MOUD), naloxone kits, safe injection sites, and methamphetamine usage. Separate Welch's analysis of variances (ANOVAs) were conducted to determine differences between the respondent groups and each statement. For any statistically significant findings, Games-Howell post-hoc analyses were employed. Results: A total of 523 individuals provided survey responses: individuals in recovery (n = 111), physicians (n = 113), nurses (n = 206), and medical students (n = 93). Survey results revealed the majority of items had statistically significant differences in respondent groups. Perceptions diverged on items related to treatment, stigma, MOUD, take-home naloxone kits, safe injection sites, needle exchange programs, and methamphetamine. Conclusion: As healthcare providers and policymakers develop treatment strategies to engage those with SUD in quality treatment, they will benefit from understanding how different viewpoints on SUD affect treatment for these individuals. These attitudes impact stigma, willingness to prescribe new treatments, and development of clinical relationships. The insight from this study allows for important discussions on the substance use health crisis and further inquiry on why these differences exist and how the diverging viewpoints may impact the lives of persons with SUD.