Personal and Professional Attitudes Associated with Nurses’ Motivation to Work with Patients with Opioid use and Opioid Use-Related Problems

Abstract

Background Opioid use and opioid use-related problems contribute significantly to increased morbidity rates and premature deaths as well as an increased economic burden. Nurses have key roles in providing care to this patient population; however, they often report low motivation toward working with these patients. Examining personal and professional attitudes associated with nurses’ motivation to work with this population can present a valuable opportunity to enhance their willingness to intervene at an earlier stage when patients do not have a diagnosable opioid use disorder. Methods A descriptive, correlational design was used. Nurses were recruited from four hospital settings in Southwestern Pennsylvania. Data on nurses’ demographic/background characteristics, personal attitudes, professional attitudes, and motivation related to working with patients with opioid use and opioid use-related problems were collected via a paper/pencil survey and analyzed using linear regression. Results A sample of 234 nurses were included in the final analyses. Personal attitudes associated with nurses’ motivation included personal experience with a family member related to alcohol and/or other drugs, and stigma perceptions (familiarity, perceived dangerousness, fear, social distance and personal responsibility beliefs). Professional attitudes associated with nurses’ motivation included working experience with substance use (SU), SU education as continuing education or other educational resources, role security, therapeutic commitment, role responsibility, and self-efficacy. Conclusions This study's findings provide valuable information regarding the bivariate relationships between nurses’ personal attitudes, professional attitudes, and motivation to work with patients with opioid use and opioid use-related problems. The study provides a base for future studies aimed at developing interventions to enhance nurses’ motivation to work with this patient population particularly related to preventing the progression of opioid use to a diagnosable disorder.

Attitudes, Self-Efficacy, and Practices Related to Opioid Risk Assessment and Mitigation: A Comparison of Health Care Professionals in Rural Communities

“…Values clarification has been successfully used with abortion providers to help them improve attitudes and behavioral intentions toward abortion care 23 . Integration of values clarification around substance use into professional training curriculums may help HCPs to improve their overall awareness of implicit bias toward substance use and increase confidence and motivation to work with patients with opioid misuse and related problems 24 …”

“…23 Integration of values clarification around substance use into professional training curriculums may help HCPs to improve their overall awareness of implicit bias toward substance use and increase confidence and motivation to work with patients with opioid misuse and related problems. 24 Opioid risk assessment and mitigation While HCPs largely reported similar self-efficacy to practice opioid risk assessment and mitigation, pregnancy HCPs felt significantly more skilled than non-pregnancy HCPs in referring patients with OUD to treatment programs. Linkage or referrals to specialized opioid-related care is a common barrier for HCPs.…”

American Academy of Nursing Expert Panel Consensus Statement on leveraging equity in policy to improve recognition and treatment of mental health, substance use disorders, and nurse suicide

“…Although SUD and addictions were recognized in the early 1990s as disorders which change brain function ( Koob, 1992 ), strategies to assess and treat occupational groups like nurses who experience disorders of substance use are underdeveloped ( Mahmoud et al, 2020 ; Smiley & Reneau, 2020 ; van Boekel et al, 2013 ). Significant challenges remain despite efforts to promote nurses’ competence in identifying colleagues who may be at risk for suicide because of substance use.…”

A model to understand antecedents of nursing attitudes and perceptions influencing outcomes of patients with SUD

“…A second formational influence is the nursing experience. Nurses' personal experiences also have a strong influence on the care they give (Aschenbrenner et al, 2016;Mahmoud, El Shiekh, et al, 2021;Mahmoud, Finnell, et al, 2021;Oates et al, 2017).…”

“…Nurses also harbor negative attitudes toward patients with SUD, perceiving them as difficult, noncompliant, drug‐seeking, demanding, unhygienic, and aggressive (Morley et al, 2015). In addition, nurses reportedly feel unsafe when caring for patients with SUD (Mahmoud, Finnell, et al, 2021), primarily due to inconsistent reactions to substance use withdrawal or response to care interventions. Many nurses feel conflicted when administering pain medications for fear of contributing to the patient's addiction (Horner et al, 2019).…”