Bakgrund: Patienter med substansbruksyndrom ökar i vården och därmed sjukvårdspersonalens kontakt med denna patientgrupp. Sjukvårdpersonal har ansvar för att ge vård till patienter på lika villkor samt ha ett gott bemötande.  Sjukvårdpersonalens attityder inverkar på patientens upplevelse av bemötande och vårdkvaliteten vilket i sin tur påverkar deras tillit till sjukvården.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Syfte: Syftet med studien var att undersöka vårdpersonals erfarenheter av att vårda samt attityder till patienter med substansbruksyndrom på avdelningar där inte endast missbruksvård bedrivs. Metod: En litteraturstudie genomfördes och inkluderade 10 artiklar med kvalitativ ansats. Dessa har granskats, analyserats och sammanställts med hjälp en integrativ litteraturöversikt. Sökningarna utfördes i databaserna Cinahl, PsychInfo och Pubmed. Resultat: Tre huvudkategorier och sju subkategorier identifierades. De tre huvudkategorierna innefattade: Synen på och erfarenheter av patienter med missbruksproblematik, Synen på att vårda patienter med missbruk, och Synen på uppkomst och ansvar över missbruk.  Slutsats: Vårdpersonals attityder till patienter med missbruk varierar, dock visar studien på att det förekommer negativa attityder till dessa patienter. Det resulterar i att vården ofta blir mer uppgiftsorienterad och mindre individorienterad. Litteraturstudien visar även att vårdpersonal med erfarenhet och utbildning inom missbruk generellt har en mer positiv attityd till patienter med missbruksproblematik. Det tyder på att det behövs mer utbildning av vårdpersonal för att negativa attityder gentemot patienter med missbruksproblematik ska undvikas. / Background:The number of patients with substance use disorder are increasing within the healthcare system, therefore is also the contact between this patient group and the healthcare personnel becoming more frequent. It is the healthcare personnel’s responsibility to give equal care to all patients, including a respectful treatment. The attitude of the healthcare personnel will influence the patient’s experiences of how they are approached and the quality of the care they receive, which in turn affects the patients trust in the healthcare system.  Aim:The Aim of this study was to explore healthcare personnel’s experience of caring for patients with substance use disorder and their attitudes towards this patient group, in non-specialist settings.  Method:A literature study was conducted including 10 articles with a qualitative approach. These articles have been reviewed, analysed and compiled with help of an integrative literature review. Database searches have been executed in Cinahl, PsychInfo and Pubmed. Result:Three major categories and seven subcategories were identified. The three major categories included: The view and experiences of patients with substance misuse, The view on care for patients with substance misuse, and The view on responsibility and origin of misuse. Conclusion:Attitude towards patients with substance use disorder varies among healthcare personnel, however this study indicates that the attitudes are predominantly negative. This results in a care that are often more task oriented, and less orientated toward the individual. Furthermore, the literature study also demonstrates that more educated and experienced healthcare personnel usually express a more positive attitude toward this group of patients. This indicates that there is a need to educate healthcare personnel to avoid negative attitudes towards patients with substance use disorder.

Bakgrund: I Sverige uppskattas att 29500 personer utvecklat ett problematiskt narkotikabruk. Droger påverkar hjärnans delar som är kopplade till känslor av lust och välbehag. Narkotika är beroendeframkallande, hälsofarligt och påverkar hela människan. I samhället förekommer fördomar mot personer som har substansmissbruk vilket kan leda till utanförskap, mindervärdeskänslor och minskad benägenhet att uppsöka sjukhusvård. Syfte: Syftet var att beskriva sjuksköterskors attityder och erfarenheter av att möta personer som har ett substansmissbruk samt att beskriva de valda artiklarnas datainsamlingsmetod. Metod: Litteraturstudie med deskriptiv design. Elva artiklar inkluderades i studien, 4 med enkäter, 1 enkät med öppen fråga och 6 intervjuer. Artikelsökning genomfördes i databaserna Cinahl och Pubmed. Huvudresultat: Sjuksköterskor hade olika uppfattningar om orsaken till missbruk, där det ansågs bero på antingen brist på eget ansvar eller livsomständigheter. Sjuksköterskor beskrev personer som har ett substansmissbruk som manipulativa, våldsamma och krävande vilket byggde på tidigare erfarenheter. Andra sjuksköterskor hade ett holistiskt synsätt och såg människan bakom missbruket. Viktiga faktorer för en god relation var att vara ärlig och rak. Vidare beskrevs också att utbildning och erfarenhet hade betydelse för sjuksköterskans attityder och erfarenhet av personer som har ett substansmissbruk. Slutsats: I mötet spelar erfarenhet av missbruk, människosyn och utbildning stor roll för interaktionen mellan sjuksköterskan och personen som har ett missbruk. Där det råder brist på utbildning och erfarenhet finns känslor av misstro och frustration som leder till avståndstagande. Positiva attityder sammankopplas med sjuksköterskans förmåga att ha en helhetssyn och öppenhet mot personer som har ett missbruk. / Background: In Sweden it´s estimated that 29,500 people have developed a problematic drug abuse. Drugs affect the parts of the brain that affect feelings of desire and pleasure. Drugs are addictive, harmful to health and affects the whole person. The society’s stigma against people who have substance abuse can lead to alienation, inferiority and reduced tendency to seek hospital treatment. Aim: The aim of this literature review were to describe nurses' attitudes and their experience of meeting people who have a substance use disorder and to describe the selected articles method of data collection. Method: A literature study with descriptive design. Eleven articles was included in the study, 4 questionnaire, 1 questionnaire with an open question and 6 interviews. The search of the articles were carried out in the databases Cinahl and Pubmed. Findings: Nurses have different attitudes about the cause of substance use, some considered it to be because of lack of responsibility and others because of life circumstances. Nurses described people who have a substance use disorder as manipulative, violent and demanding, which was based on previous experiences. Other nurses had a more holistic approach and saw the person behind the substance use. Honesty and straightforwardness were important factors in meeting people with substance use disorder. Education and previous experience were important to the nurse's attitudes and experience. Conclusion: Experience, humanity and education played a major part in the interaction between the nurse and the person who has a substance use disorder. Where there is lack of education and experience feelings of distrust and frustration lead to rejection. Positive attitudes were linked to the nurse's ability to have a holistic approach and openness toward people who have a substance use disorder.

ABSTRACT Professors repeatedly warn students against burnout throughout the years of schooling that is required to earn a credential or license to work with persons who suffer from a substance use disorder. Despite these many warnings, burnout amongst practitioners continues to occur. There has been considerable research done over the years on the phenomenon of practitioner burnout, its causes and how to prevent it. Substance use disorder practitioners’ challenges often include high caseloads, difficult cases and lack of self-care. The data collected through an electronic server Survey Monkey allowed for a quantitative cross-sectional analysis which focused on participants’ perceptions of the causes of burnout and methods used for self-care. Respondents were recruited from two substance use disorder treatment programs, participation was voluntary. The analysis highlighted that the survey participants (n=30) view self-care as an appropriate intervention against burnout. These findings present: underlying causes of burnout; effective self-care practices for practitioners who are suffering from burnout; and how practitioners with higher education viewed self-care differently. Among the goals of the research done in this project was to bring awareness to; underlying causes of burnout; solutions to prevent burnout and effective techniques currently being used by practitioners that contributes additional knowledge to social work’s knowledge on burnout and self-care methods for practitioners experiencing burnout symptoms.

This research addresses the use of canine animals in substance abuse treatment. There is research that addresses the importance of animals regarding therapy and mental illness, as well as research on the comorbidity of severe mental illness and substance abuse disorder. However, there is no research that looks at utilizing canines in substance abuse therapy. The purpose of this research was to examine the utilization of canine animals in rehab for those with substance abuse issues. The theoretical foundation for this study is the theory of contextualism. This theory focuses on humans with animals. To address the gap in research, this quasi-experimental quantitative study looked at two independent variables, presence or absence of a canine during treatment, and gender. The method of data collection was obtaining charts of 130 discharged clients, along with retrieval of data regarding days authorized by insurance for treatment. Information was obtained on the number of days that the client stayed in treatment. There was a comparison of the numbers that created a standardization for treatment. There was not significant difference in the average duration of substance abuse treatment when comparing people who attend treatment with their canine compared to those who do not attend treatment with a canine nor was there a difference between the genders. This research may create positive social change by providing an alternative to substance abuse disorder treatment. Not only will this create a positive environment for the client, but it will also provide them the ability to have comfort in a critical time in their lives. This research shows that canines provide something to mankind that we cannot always provide to one another.

Quality substance abuse treatment is needed to help fight the battle against drug addiction. This qualitative study was designed to explore some of the approaches to eye movement desensitization (EMDR) therapy that therapists trained in Parnell's adapted EMDR model use in conjunction with treatment for addictions. The purpose of this narrative inquiry was to investigate the experience of therapists who incorporate substance abuse treatment with Parnell's adapted EMDR model when treating trauma and substance use disorders. The population studied comprised licensed mental health therapists who had completed Parnell's EMDR training and implemented Parnell's modified EMDR protocol in their professional practice. The data from 9 participant interviews were coded and NVIVO data analysis software was used to identify key concepts and themes including deviations from Parnell's modified protocol, incorporating addiction treatment within the modified protocol, and the importance of the resourcing phase in the modified protocol. The study findings provided a deeper understanding of the types of addiction therapies that therapists are using in conjunction with Parnell's EMDR model. The results also showed that that participants perceived Parnell's EMDR model, combined with addiction therapeutic techniques and approaches, as beneficial in treating those with trauma and substance use disorders. By integrating addiction therapies with Parnell's EMDR protocol, EMDR certified trainers may better educate EMDR trainees about useful strategies for treating dual diagnosed clients. The strategies may shorten the client's time in treatment and provide a strong foundation for therapists as they conduct therapy for dual diagnosed people.

Substance use disorders (SUD) and mental health disorders are often thought of as completely separate problems even though these disorders commonly co-occur. Among adolescents who seek treatment for substance use problems, co-occurring mental health problems (MHP) are common. This is concerning because co-occurring disorders among adults have been associated with more severe MHPs, relapsing to substance use sooner, being less likely to maintain abstinence, and other problems. Despite the awareness that co-occurring disorders are problematic for adolescents, few studies have been conducted to understand these problems with an adolescent sample. The purpose of this study was to understand if factors commonly related to co-occurring disorders among adults were the same for adolescents and to examine two measurement models for the dependent variable, substance use. This secondary analysis of data first examined characteristics that are related to MHPs among a sample of adolescents (N=801) who use substances. Factors in three domains were examined: demographics, substance use, social factors. The results indicated that among these adolescents, MHPs were common. Two key factors related to having a MHP were gender and the severity of the SUD. Females and adolescents with more severe SUDs, like dependence, were more likely to have MHPs. Furthermore, severity of the SUD partially mediated the relationship between several of the other factors and MHPs. The type of substance an adolescent reported using was also important. In addition, adolescents who had more peers and more family members who participated in deviant activities had more severe substance use problems and were more likely to have a MHP. In addition to examining the factors related to mental health problems among a substance using population, this study modeled the dependent variable in two different ways which had not been done before and allowed for variance in the measure to be accounted for in the model. MHPs were measured both continuously and categorically. The results of the comparison indicated that there were not major differences between the two models. Implications for social work practice, policy and research are discussed.

Bakgrund Missbrukssyndrom är vanligt förekommande i samhället och innebär en skadlig användning av olika substanser t.ex. alkohol och droger. Användningen pågår trots negativa konsekvenser för personens livssituation och ökar risken för en instabil hälsa. Vilket leder till ett ökat behov av hälso- och sjukvård. Forskning har visat att personer med missbrukssyndrom upplevde utanförskap, stigmatisering och skam vid kontakt med sjukvården.  Syftet Att beskriva sjuksköterskors upplevelser av att möta personer med missbrukssyndrom och sjuksköterskans attityder i vårdmötet, samt att beskriva inkluderade artiklars undersökningsgrupper.  Metod En beskrivande litteraturstudie. Tio artiklar inkluderandes i resultatet. Artikelsökning gjordes i databaserna PubMed och Cinahl. Diskussion fördes mellan författarna för att sammanställa ett objektivt resultat.   Huvudresultat Sjuksköterskor hade skilda meningar om missbrukssyndrom var en sjukdom. Personer med missbrukssyndrom ansågs som oansvariga över sitt hälsotillstånd enligt sjuksköterskor. Sjuksköterskorna beskrev hur de upplevde patientgruppen som oberäknelig och manipulativ samt att den orsakade ökad arbetsbelastning. Vidare uppkom en känsla av frustration över den egna misstron och osäkerheten kring patientgruppen. Önskemål om utbildning uttrycktes. Enligt sjuksköterskorna var tålmodighet och att vara stödjande viktiga delar i vårdandet samt att inte spegla det egna tyckandet.   Slutsatser Beroende på om sjuksköterskor såg missbrukssyndromet som ett sjukdomstillstånd eller som självförvållat, framkom positiva eller negativa attityder och upplevelser. Kunskap och utbildning inom missbrukssyndrom behövs för att upprätthålla ett etiskt förhållningssätt i sjuksköterskans profession. / Background Substance-use disorder is common in society and involves harmful use of different substances, for example. alcohol and drugs. The use is in progress despite adverse consequences for the person's life situation and increases the risk of unstable health. Which leads to an increased need for healthcare. Research has shown that people with substance-use disorder experience exclusion, stigma and shame in contact with healthcare   Aim To describe nursing experience of meeting people with substance-use disorder and the nurse's attitudes in the healthcare meeting, as well as describing the survey articles of the included articles.   Method A descriptive literature study. Ten items are included in the result. Article search was made in the PubMed and Cinahl databases. Discussion was conducted between the authors to compile an objective result.   Results Nurses had different opinions about if substance-use disorder were a disease or not. Persons with substance-use disorder were considered irresponsible for their health status according to nurses. Nurses described how they experienced the patient group as erratic and manipulative and that caused increased workload. Furthermore, a sense of frustration arose over their own missile and the uncertainty surrounding the patient group. Requests for education were expressed. According to the nurses, patience and support were important parts of care and to not reflect their own opinion.   Conclusion Depending on whether nurses saw the substance-use disorder as a state of illness or as self-inflicted, positive or negative attitudes and experiences have emerged. Knowledge and education in substance-use disorder is necessary to maintain an ethical approach within the nurse's profession.

Bakgrund: I bakgrunden beskrivs aspekter på sjuksköterskans yrkesroll samt omvårdnadsansvar inom både vården i allmänhet och beroendevården. Vidare beskrivs patientgruppen och dess problematik samt begreppet medberoende och hur det kan försvåra valet av omvårdnad. Syfte: Syftet med denna undersökning var att undersöka sjuksköterskans syn på vad som kännetecknar god omvårdnad och medberoende inom den slutna beroendevården samt vad som skiljer dem åt. Metod: Studien har en kvalitativ design med induktiv ansats. Sju sjuksköterskor intervjuades på en beroendeenhet i Stockholm enligt ostrukturerad metod. Materialet analyserades sedan med kvalitativ innehållsanalys. Resultat: Resultatet utmynnade i tre kategorier: Sjuksköterskans syn på vad som utgör god omvårdnad inom beroendevården, Sjuksköterskans syn på fenomenet medberoende inom beroendevården samt Sjuksköterskans uppfattning kring var gränsen går mellan god omvårdnad och medberoende. I resultatet kom det bland annat fram att sjuksköterskan inte har några större problem med att skilja på de båda begreppen god omvårdnad och medberoende, men att det är svårare i praktiken. Diskussion: Resultatet i studien diskuterades i relation till tidigare forskning, relevant litteratur och Ida Jean Orlandos interaktionsteori. I diskussionen kommer det bland annat fram hur sjuksköterskans omvårdnadsansvar kan gå över i ett medberoende. / Background: The background describes aspects of the nurse’s profession and care responsibility within both general care and in dependent care. Furthermore, it describes the patient group with its problems, the concept of co-dependency and how it can impact the choice of nursing.   Aim: The aim of this study has been to explore nurses’ view of what characterizes good care and co-dependency within the closed depending care. Method: This study has a qualitative design with an inductive approach. Seven nurses at a   depending care unit in Stockholm were interviewed using an unstructured method. The material was then analyzed using qualitative content analysis. Results: The result from the interviews developed into three categories: The nurse’s view of what   constitutes good care within depending care, The view of the phenomenon of co-dependency within depending care and finally, The nurse’s perception of what differentiates good care and co-dependency. The result reveals, among   other things, the fact that while the nurse, intellectually, had no major problems in separating the concepts of good care and co-dependency, in practice it proved to be harder to implement. Discussions: The results are discussed in the context of previous research, other relevant literature and from Ida Jean Orlando’s interaction theory. In the discussion it reveals, among other things, how the nurses responsibility of care can develop into co-dependency.

Multiyear trends showing high rates of alcohol and opioid-related misuse as well as opioid-related deaths have renewed attention on both access to and the quality of substance use treatment. In response, diverse healthcare systems that care for the Medicaid population have begun implementing large-scale transformations including new services and provider training requirements. The Centers for Medicaid and Medicare Services has urged state Medicaid programs to use Sections 1115 waiver demonstrations as vehicles for substance use treatment delivery system transformation. For many states, undertaking the Section 1115 waiver demonstration means moving from very limited benefits to a full continuum of new services. States’ ability to achieve such transformations is unknown since demonstration processes are under-reported and considered implementation “black boxes”. Substance use treatment delivery changes are also occurring at the community level, where several hospitals systems have implemented new services to meet the needs of their patient population. However, the influence of these new care models on patient service utilization is unknown. In this dissertation, I use comparative case study design and qualitative content analysis to examine the pre-implementation decision-making processes that Medicaid policymakers in California, Virginia and West Virginia experienced when deciding to enhance their substance use treatment service delivery systems using Sections 1115 waivers. I qualitatively describe how broad sociocultural and local organizational factors influenced Medicaid agencies’ ability to expand access to treatment. I also present a taxonomy of implementation strategies used to translate Medicaid policy into clinical services available in the community. Finally, I present a latent transition analysis to reveal how the nature of substance use treatment services available to patients may influence their service utilization over time. This final quantitative analysis is set within the context of a safety net hospital that provides a comprehensive, low barrier access model for substance use treatment, and primarily serves Medicaid beneficiaries. Results of this dissertation illuminate processes and outcomes associated with pre-, mid-, and post-implementation activities targeting improvements in the delivery of substance use treatment services. / 2023-01-19T00:00:00Z

The aim of this study is to investigate professionals’ working experience with elderly peoplewith substance use disorders and how drug or alcohol abuse affects their work with theirclients. The most important areas of focus are professionals’ views on older clients’ substanceand alcohol abuse, moral or ethical dilemmas in relation to work and the elderly’s needs forsupport and help according to professionals. To identify these problems, a qualitative methodwas used with semi-structured interviews, interviewing a total of 8 professionals in twonursing homes specializing in older clients with substance use disorder and a rehabilitationcenter aimed at ages 40 to 70. Interview data was analyzed with thematization and coding.Analysis of the material was carried out using theories such as care perspectives, ethics forsocial workers and ageism. The results of the study indicate that most professionals whowork with this target group lack the knowledge of geriatrics combined with substance abuseknowledge. A comparison is drawn between the two institutions and their organizationalrules regarding alcohol or drug consumption by clients. The study further highlights thestaff's experience of finding themselves between organizational rules, professional rules andtheir own values ​​and beliefs. The results show that professionals are struggling with the lackof rules. In addition to that the results of this study show that stereotypical perceptions ofolder people tend to influence professionals as well as other social institutions that work withthis target group. The study also addresses the issue of inadequate treatment efforts aimed atolder people and a mapping of their alcohol and drug habits.