This qualitative study explored the challenges and stressors that are experienced by addiction counsellors in providing substance abuse treatment. In order to tap into rich and descriptive information on occupational stress in the addictions field, a modified grounded theory focused on conceptual ordering (Corbin & Strauss, 1998) was used for the research design. Participant sample consisted of 10 addiction counsellors who were recruited using purposeful selection from addiction treatment centres in Ontario, Canada. Data collection was conducted through face-to-face interviews using semi-structured, open-ended questions. Four major categories emerged from the data analysis using systematic thematic analysis: 1) Sources of Stress, 2) Signs and Consequences of Stress, 3) Stress Management and Intervention, and 4) Resiliency Against Stress. Results from this study contribute to the understanding of occupational stress in addictions counsellors. Implications for addiction organizations, educators, and counsellors are discussed.

This qualitative study explored the challenges and stressors that are experienced by addiction counsellors in providing substance abuse treatment. In order to tap into rich and descriptive information on occupational stress in the addictions field, a modified grounded theory focused on conceptual ordering (Corbin & Strauss, 1998) was used for the research design. Participant sample consisted of 10 addiction counsellors who were recruited using purposeful selection from addiction treatment centres in Ontario, Canada. Data collection was conducted through face-to-face interviews using semi-structured, open-ended questions. Four major categories emerged from the data analysis using systematic thematic analysis: 1) Sources of Stress, 2) Signs and Consequences of Stress, 3) Stress Management and Intervention, and 4) Resiliency Against Stress. Results from this study contribute to the understanding of occupational stress in addictions counsellors. Implications for addiction organizations, educators, and counsellors are discussed.

Introduction: Breastfeeding offers the substance exposed mother and child potential short and long-term health benefits, with breast milk shown to alleviate the severity of Neonatal Abstinence Syndrome. Substance dependent women, however, have limited success establishing breastfeeding with physical, psychological and institutional factors cited as barriers. This study aimed to develop and test the feasibility of an evidence informed and theory based intervention to support continued breastfeeding for this group. Methods: The research was a two-phase feasibility study. Phase 1 informed intervention development using a mixed methodology approach which included (a) a comprehensive systematic literature review of breastfeeding support for women from disadvantaged groups (b) expert advisory group recommendations and (c) ‘think aloud’ verbal protocols with opioid dependent women. Phase 2 underpinned the evidence with the theoretical constructs of behaviour change, prior to testing the acceptability and implementation fidelity of the intervention in a feasibility study with an embedded small-scale randomised controlled trial. Results: Phase 1 identified the barriers to breastfeeding continuation as low maternal self-efficacy; neonatal feeding difficulties associated with withdrawal and unsupportive healthcare practices. Evidence and theory synthesis resulted in an integrated breastfeeding support model founded on practical, informational, psychological, person-centred and environmental components. Phase 2 demonstrated that the intervention was feasible to implement and acceptable to participants. The randomised controlled trial reported higher rates of continued breastfeeding and a greater level of maternal confidence in breastfeeding ability in the intervention group compared to the control group. Breastfed infants were less likely to require pharmacological management and had corresponding shorter durations of hospitalisation than formula fed infants. Conclusion: The research provided an original contribution to the development of a complex healthcare intervention which is meaningful to both existing research and clinical practice. The findings highlighted the potential of the intervention to support breastfeeding for the substance exposed mother and baby, which has wide ranging implications for the improved health and social equalities of this group.

Introduction: There is a frequent incidence of post-traumatic stress disorder (PTSD) in people with substance use disorder (SUD) and there is also a frequent occurrence of substance use in people with PTSD. Many foreign authors highlight the complications that occur in individuals with this dual diagnosis: higher risk of drop-out from treatment, a higher number of suicide attempts, more serious consequences of substance use, more frequent relapses of both of two diagnoses, etc. The negative impact of this comorbidity on treatment outcomes, highlights the need to focus on improving procedures in the diagnosis of PTSD in people treating from SUD and a need of integrated treatment of both disorders. Many studies also suggest that improving the condition of PTSD increases the likelihood of improvement in substance use. In the Czech Republic, there is a lack of sources that focus on the relationship of these comorbidities and their treatment. Examples of a good practice are also missing. Aims: The aim of this thesis is to introduce the issue of dual diagnosis - PTSD and SUD. The intention of the theoretical part is to present the relationship of these two disorders, with a focus on possible etiology and treatment options. The aim of the practical part is to introduce specific models of integrated...

This qualitative study explored the challenges and stressors that are experienced by addiction counsellors in providing substance abuse treatment. In order to tap into rich and descriptive information on occupational stress in the addictions field, a modified grounded theory focused on conceptual ordering (Corbin & Strauss, 1998) was used for the research design. Participant sample consisted of 10 addiction counsellors who were recruited using purposeful selection from addiction treatment centres in Ontario, Canada. Data collection was conducted through face-to-face interviews using semi-structured, open-ended questions. Four major categories emerged from the data analysis using systematic thematic analysis: 1) Sources of Stress, 2) Signs and Consequences of Stress, 3) Stress Management and Intervention, and 4) Resiliency Against Stress. Results from this study contribute to the understanding of occupational stress in addictions counsellors. Implications for addiction organizations, educators, and counsellors are discussed.

Bakgrund: Substansbrukssyndrom är en medicinsk diagnos som medför ohälsa och lidande för individ och samhälle. Ett antal riskfaktorer återfinns som ökar sårbarheten att drabbas av syndromet. Sjuksköterskans roll är central i vården för dessa patienter. Scheels teori om interaktionell omvårdnad för sjuksköterskor tillämpas i detta arbete. Syfte: Att beskriva upplevelser av vårdpersonals bemötande hos patienter med substansbrukssyndrom samt hur upplevelserna påverkat vården och vårdsökandet för dessa patienter. Metod: En litteraturstudie med kvalitativ induktiv ansats och deskriptiv design genomfördes med hjälp av tio vetenskapliga originalartiklar. Resultat: Patienter med substansbrukssyndrom hade enligt artiklarna både positiva, men främst negativa upplevelser av vårdpersonals bemötande. Ett gott bemötande gav bättre vård och ökade benägenheten att söka vård. Negativt bemötande från vårdpersonal påverkade vården negativt och resulterade i lägre vårdkvalitet samt minskade tendensen att söka vård hos patientgruppen. Patienter beskrev stigmatisering som en del av mötet med vårdpersonal. Slutsats: Att lyfta denna patientgrupps erfarenheter är betydelsefullt för att öka förståelsen om hur vi som vårdpersonal ska bemöta dem på bästa sätt. Det är viktigt att sjuksköterskor är medvetna om sina förutfattade meningar och synen på olika patientgrupper för att kunna ge god omvårdnad till alla, däribland patienter som lider av substansbrukssyndrom. / Background: Substance use disorder is a medical diagnosis that brings illness and suffering for the individual and society. There are several risk factors that increase the vulnerability to be affected by the disorder. The nurse’s role is central in the care for these patients. Scheel’s theory on interactive care for nurses is used continuously throughout this paper. Aim: To describe experiences of healthcare personnel’s reception in patients with substance use disorder and how the experiences affected the care and the way these patients seek care. Method: A literature review with a qualitative inductive approach and descriptive design was performed using ten scientific original articles. Results: The reviewed articles showed that patients with substance use disorder had both positive, but above all negative experiences in the reception of healthcare personnel. A good reception resulted in better care and increased the willingness to seek care. Negative receptions from healthcare personnel affected the care negatively and resulted in lower quality of care and decreased the tendency to seek care within the patient group. Patients described stigma as a part of the interaction with healthcare personnel. Conclusion: Raising the experiences of this patient group is essential to improve the understanding of how we as healthcare personnel can receive them in the best way possible. It is important for nurses to be aware of their prejudices and the perception of different groups of patients to be able to give good nursing care to everyone, including patients who suffer from substance use disorder.

Bakgrund Beroende ska ses som en sjukdom och kräver därmed vård anpassad till dess specifika behov. Patienter med substansberoende upplever stigmatisering och har negativa erfarenheter av vården, samtidigt som bemötandet från vårdpersonal är en viktig del i behandlingen för dessa patienter. Omvårdnadsbegreppet tillit är det här arbetets teoretiska utgångspunkt. Tillit är en förutsättning för att god omvårdnad ska kunna ges. Syfte Syftet var att belysa sjuksköterskors upplevelser och erfarenheter av mötet med patienter med substansberoende. Metod Metoden för detta arbete var en litteraturöversikt. Databaserna PubMed, CINAHL och PsycINFO användes för att söka fram artiklar. Femton vetenskapliga artiklar kvalitetsgranskades och sammanställdes i en matris. En integrerad analysmetod användes för att analysera och presentera datan i resultatet. Resultat Fem kategorier identifierades. Dessa var Sjuksköterskans arbets- och förhållningssätt, Attityder och fördomar, Brist på kunskap, Känslan av att inte få veta hela sanningen och Upplevda känslor i patientmötet. Sjuksköterskor upplevde en brist på kunskap gällande substansberoende patienter och även frustration, rädsla och oro i patientmötet. Sjuksköterskorna kände att patienterna inte berättade allt om sin smärta eller substansbruk, och hade mestadels negativa attityder och fördomar mot patienterna. De hade även olika tillvägagångssätt i bemötandet gentemot patienterna. Slutsats Det fanns stora brister i kunskap hos sjuksköterskor angående substansberoende patienter samt stora brister i tilliten dem emellan. Bristen på tillit bidrar till att patienters förtroende för sjuksköterskor minskar. En kompetenshöjning skulle kunna vara en lösning på en del av sjuksköterskornas upplevda problem

Previous research describes co-morbid substance use disorders and eating disorders as a complex issue. Research on collaboration between Swedish addiction treatment facilities and Swedish eating disorder care is scarce. The aim of this Bachelor thesis is to analyze and understand how professionals in addiction care and professionals in eating disorder care experience collaboration regarding people with comorbid substance use disorders and eating disorders. The approach of this study is hermeneutic. The bio-psycho-social model and Collaboration Theory are used for data analysis. The data consists of nine semi-structured interviews with professionals working in either regional eating disorder care or municipal addiction care or in an independent addiction treatment facility. The informants work in different Swedish municipalities and regions having varying occupations. Some work in social services, others in medical care. Our results show varying experiences of collaboration among the informants. Some informants think collaboration works well whilst others see room for improvement. Poor collaboration is described by some informants as due to organizational prestige or bureaucracy. Some informants emphasize that referrals between different care units lead to long wait times for the patients/clients during which nobody takes responsibility for the patient, whose health may worsen. The professionals use different strategies, treatments, and methods to treat and recognize comorbidity and to collaborate with other care units. Joint care planning, reaching a consensus and having a holistic viewpoint are methods that the informants use. The informants have different views on which disorder that precedes the other, and also on which treatment is best suited for this type of comorbidity. Several professionals believe that the addiction should be treated primarily. According to the professionals, prerequisites for collaboration are: established contact with other collaborative parties, the knowledge and accessibility of other professionals, patient consent and motivation. An exchange of knowledge at an organisational level is requested, regarding subjects such as collaboration and comorbidity. / Tidigare forskning visar att samsjuklighet i form av missbruk och ätstörning är ett komplext problem. Forskning om samverkan mellan missbruksvård och ätstörningsvård i Sverige är dock ett relativt outforskat område. Denna intervjustudie syftar till att analysera och förstå hur professionella inom missbruksvården och professionella inom ätstörningsvården upplever samverkan gällande personer med samsjuklighet: missbruk och ätstörning. Studien antar en hermeneutisk ansats, det biopsykosociala perspektivet samt samverkansteori används för att analysera empirin. Empirin består av nio semistrukturerade intervjuer med professionella inom regional ätstörningsvård, kommunal missbruksvård och ett fristående behandlingshem. Informanterna arbetar i olika kommuner och regioner samt har olika yrkesbakgrund inom bland annat socialtjänst eller hälso- och sjukvård. I studien framgår de professionellas samverkanupplevelse, arbets- och behandlingssätt av personer med samsjuklighet i form av missbruk och ätstörning. Därtill framgår vilka förutsättningar som enligt informanterna bör ligga till grund för att upprätta samverkan kring klientgruppen. Resultaten visar att de professionellas erfarenheter och upplevelse av samverkan varierar. Att samverkan fungerar väl respektive om samverkan behöver förbättras lyfts fram. Dålig samverkan på grund av prestige eller i form av en byråkratisk klyfta mellan kommun och region identifieras av några informanter. Vissa informanter framhåller att remisskickande mellan vårdenheter leder till långa väntetider, där klienten eller patienten ”bollas runt”. Under väntetiden kan den vårdsökande fara illa. De professionella använder olika arbetssätt och strategier för behandling, för att fånga upp samsjuklighet och för att inleda samverkan. Gemensam vårdplan, samsyn och helhetssyn är några arbetssätt de professionella utgår ifrån. Informanterna har olika syn på vilket sjukdomstillstånd som föregår det andra och ser även olika på vilken behandling som lämpar sig bäst för denna typ av samsjuklighet: flera anser att missbruket bör behandlas först. Upplevda förutsättningar för samverkan är upprättade kontakter med annan samverkanspart, professionellas kunskap, tillgänglighet samt patientens samtycke, initiativtagande och motivation. Organisatorisk kunskapsöverföring om samverkan och samsjuklighet efterfrågas.

Substance use disorders cause significant neurological damage, cognitive impairment, and maladaptive behaviors that negatively affect a person's quality of life. The purpose of this study was to explore the effect gender and primary drugs have on locus of control. Generalized expectancy theory helped to explain the behavior of patients diagnosed with substance use disorders and their inability to control ongoing drug use. The research question focused on to what extent drug-related locus of control scores differ by primary drug (narcotic vs. stimulant), gender (male vs. female), and their interaction. Data measuring locus of control from 553 participants provided a subset of 410 participants who identified narcotics or stimulants as their primary drug. A 2x2 full factorial ANOVA was conducted. The results of this study indicated there is a significant interaction between primary drug use and gender. The results could have positive social change implications for the addiction field because of the value of understanding the interdependency of internal-external thought processes related to drug use, the ability to change stigma associated with addiction and gender, and the value of understanding the need for individualized treatment as locus of control shifts from external to internal. It is recommended that the drug-related locus of control instrument become part of treatment protocol along with evidence-based interventions.

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