Background: Substance use disorder (SUD) is on the rise globally, and nurses are not prepared to care for this population. Purpose: The purpose was to determine if a 4-hour antistigma intervention improved prelicensure student nurse attitudes and perceived stigma toward people with SUD. Methods: This was a nonrandomized quasi-experimental survey study. Participants completed the 20-item Drug and Drug Problems Perception Questionnaire (DDPPQ), the 8-item Perceived Stigma of Substance Abuse Scale (PSAS), and the 13-item Marlowe-Crowne Social Desirability Scale at baseline and repeated the DDPPQ and PSAS postintervention. Paired t tests were used to determine the mean differences in the total DDPPQ and total PSAS scores. Results: After the antistigma intervention, there was a significant improvement in overall therapeutic attitudes (t = 8.4, df = 108, P < .001) and perceived stigma (t = −2.5, df = 108, P = .01) in undergraduate nursing students (n = 126). Conclusions: Incorporating antistigma educational approaches may lead to more involvement and compassionate care for people with SUD.

Background: The use and awareness of harm reduction education strategies are missing from nursing care of people with substance use disorder (SUD). Purpose: To determine whether targeted training improved nursing students' application of harm reduction education in the clinical setting. Methods: This was an experimental 2-group repeated-measures survey study. Nursing students in a baccalaureate program received targeted training for 3 semesters. Training included presentations by people with lived experience, an addiction-trained physician, and a role-play exercise. Students received harm reduction education and reported on the application of this education. Results: Students in the traditional track cared for more people with SUD than students in the accelerated track. Referral for treatment was the most common education provided, and information related to injection drug use was the least commonly taught education. Conclusions: Targeted training increased the number of harm reduction options nursing students presented to people with SUD in the clinical setting.

Background: Screening, brief intervention and referral to treatment (SBIRT) is an evidence-based set of skills and strategies used by health care providers. Data have suggested SBIRT should be used in detecting persons at risk for substance use and be included in every primary care encounter, as many needing substance abuse treatment do not receive it. Methods: This descriptive study evaluated data for 361 undergraduate student nurses who participated in SBIRT training. Pretraining and 3-month posttraining surveys were used to evaluate changes in trainees' knowledge, attitudes, and skills toward people with substance use disorder. A satisfaction survey immediately after the training measured satisfaction with and usefulness of the training. Results: Eighty-nine percent of students self-reported that the training increased their knowledge and skills related to screening and brief intervention. Ninety-three percent reported that they intended to use these skills in the future. Pre–post measures indicated statistically significant increases in knowledge, confidence, and perceived competence on all measures. Conclusions: Both formative and summative evaluation assisted in improving trainings each semester. These data confirm the need to integrate SBIRT content across the undergraduate nursing curriculum and include faculty and preceptors to improve rates of screening in clinical practice.

Self-care management is at the heart of health and healing. While negotiation between provider and client is important, a person’s awareness of their own health needs and strategies for success often can prevent chronic deterioration. However, not all health needs are known, preventable or easily managed without help. While several chronic conditions can improve with help from providers. Building on what is known and what is working well, a plan for self-care can be created or tested for its effectiveness. Feedback and continued communication are key to sustainability and maintenance of new health behaviors. Currently the U.S. government is aiming to allocate more federal dollars to ensure barriers to accessing healthcare are removed (Artiga & Hinton, 20187; Fink & Mercado, 20238) yet adequate resources are not yet realized. Racism, poverty, stigma, and discriminatory law enforcement practices continue to be barriers to health equity. In this chapter the terms self-management and self-care are interchangeable. Several self-management theories will be described covering the period of 1960 to the present. Studies using case method will illustrate the fit between this research method and effective self-care management. <!----> <!----> <!----> <!---->

Background: Dignity is a complex concept necessary for the adequate treatment of patients in the healthcare setting. Autonomy, self-sufficiency, respect, and equality are concepts used to define dignity. Dignity has not been studied in people who inject drugs (PWID). Objective: This study aimed to determine how PWID maintain or have their dignity threatened during hospitalization in an acute care unit. Design: The qualitative descriptive study was a deductive thematic analysis of secondary data on PWID experiences with received nursing care. In-depth, semistructured interviews were conducted and transcribed verbatim with a constant comparison method for thematic analysis using NVivo. A priori codes of dignity concepts from the literature and dignity scales were used as a guide to examine the nine qualitative transcripts. Findings: The three most common threats to dignity during hospitalization were lack of equality compared with other patients, not feeling valued as an individual, and not feeling respected by the healthcare workers providing care. The three most common protectors of dignity were feeling respected by healthcare workers, having autonomy in treatment choices, and feeling valued as an individual. Conclusions: Protecting dignity significantly affects whether PWID are willing to seek healthcare in the hospital setting. Preserving dignity in PWID during their hospitalizations can encourage this population to seek care earlier. Nurses must be experienced in caring for PWID and provide nonjudgmental care for this population.

Purpose: The purpose of this study was to describe women's experiences seeking treatment for opioid use disorder during pregnancy. Study Design and Methods: This was an exploratory multi-method study to understand women's experiences seeking treatment for opioid use disorder during pregnancy using surveys and interviews. Women pregnant within the past 5 years while using opioids were recruited from a private Facebook group for mothers on medication for opioid use disorder. Members of this group assisted with the development of the survey. Descriptive statistics were used for the 18-question survey and interviews were recorded, transcribed, and analyzed for themes. Results: Twenty-one women completed an online survey, and six participated in an in-depth virtual interview about their experience. Five themes describing their experiences were identified: (1) fear of child protective services, (2) family and partner support, (3) health care providers' reactions, (4) accessing treatment centers, and (5) awareness of support services during pregnancy. Clinical Implications: Participants reported an overall negative experience seeking treatment for opioid use disorder during pregnancy. Nurses can improve the outcomes for pregnant women with opioid use disorder by using a non-stigmatizing approach, promoting early identification, and providing information, including harm reduction education. Facilitation of resources for treatment, mother and child programs, and advocating for partner treatment can improve maternal and neonatal outcomes.