Shedding Light on the Barriers to Providing Quality Nursing Care for Patients With Substance Abuse: A Qualitative Content Analysis

Barriers to providing quality care for patients with substance use disorders from the perspective of baccalaureate nursing students: A descriptive qualitative study

BACKGROUND

With Iran facing an epidemic in substance use disorders, nursing students are increasingly encountering people impacted by substance misuse. Providing care for this group brings with it many barriers and challenges. These serious barriers have not been a priority in Iranian nurse education.

OBJECTIVES

To describe barriers to providing quality care for people with substance use disorders from the perspective of nursing students.

DESIGN

A descriptive qualitative study, using content analysis was used to address the study aim.

SETTING AND PARTICIPANTS

Purposive sampling was used to recruit participants. Participants were 34 baccalaureate nursing students from different academic semesters studying at two medical sciences universities in Iran.

METHODS

Data were collected using semi-structured interviews from July 2022 to October 2022. Granheim & Lundman's method for qualitative content analysis was used to analyze data.

RESULTS

The barriers to providing quality care for people with substance use disorders were described through the major theme: "lack of communication skills and difficulty finding language for therapeutic communication with people with substance use disorders". Based on nursing student perspectives, a lack of communication and language for therapeutic communication was described through the three barriers of: 1. "possessing or witnessing prejudiced attitudes and stereotypes", 2 "negative role models", and 3. "Knowledge deficit in self or others".

CONCLUSION

The result of this study showed that nursing students interact with people with substance use disorders through prejudiced attitudes, negative stereotypes, and knowledge deficits. Academic education should include practical techniques to reduce negative stereotypes and moral distress among nursing students as well as strategies to manage tough ethical situations and decrease prejudiced attitudes. Nurses and clinical educators must be attentive to their power to influence nursing students and should model appropriate unbiased behavior and language.

The burden of boundedness and the implication for nursing: A scoping review

Background

In the COVID‐19 pandemic, many people experienced temporal boundedness in different ways (e.g., home, country, persons, and rules). However, being bound is also a permanent experience for chronically ill or handicapped people with sometimes serious consequences. To be able to recognize the phenomenon, a clear definition is necessary. In the literature, though, boundedness shows up as a very multifaceted phenomenon.

Objectives

Exploring and conceptualizing the phenomenon of boundedness taking into account the various forms and the consequences for nursing.

Methods

A scoping review using the framework of Arksey and O'Malley and the PRISMA statement (PRISMA‐ScR) to verify the fullness of the review.

Data Sources

Online dictionaries and theoretical and empirical publications in CINAHL, Medline via PubMed, PsycINFO, PsycArticles, Scopus, WISO. A total of 34 sources were included.

Results

Boundedness as a contextual concept is ambiguous. There are three basic causes: an acquired condition, personal obligations, arranged conditions, two principal courses: enduring and temporary, and seven types of being bound: to one or more person(s), to a place/position, to/in an object, to thoughts/opinions, to activities, to/in substances and to time. Examples of types are bedbound, culture‐bound, homebound, time‐bound, wheelchair‐bound and are particularly relevant for care. The consequences are manifold, physically, as well as mentally, and socially.

Conclusion

To reduce or avoid the burdens caused by boundedness, the concept must be implemented in nursing education and nursing practice. To this end, nursing research must further specify the types of boundedness in concept analyses and develop suitable interventions.