The determinants of nurses' therapeutic attitude to patients who use illicit drugs and implications for workforce development.
OBJECTIVE
To examine the determinants of generalist nurses' therapeutic attitude to patients who use illicit drugs, and to model workforce development initiatives.


BACKGROUND
Individuals who use illicit drugs rely heavily on healthcare in emergency departments and inpatient hospital wards. Little is known about the determinants of generalist nurses' therapeutic attitude to provide care, therefore limiting our understanding of the important issues for workforce development.


METHODS
The study was a cross-sectional survey of registrants on the Australian Capital Territory Nurses Registration Roll 2002 (N = 3241, 50% response rate). The associations between variables and nurses' therapeutic attitude were examined by multi-variable linear regression analysis.


METHODS
Nurses' therapeutic attitude was assessed using a modified version of the Alcohol and Alcohol Problems Perception Questionnaire. Personal characteristics, attitudes to illicit drugs and professional practice variables such as drug and alcohol education, experience with the patient group and role support were examined using a mix of standardised and new questions.


RESULTS
Professional practice variables explained 53% of the variation of nurses' therapeutic attitude, the most important being role support. Although a negative attitude to illicit drugs had a statistically significant association with therapeutic attitude, it added less than 1% to the variation explained. Personal characteristics showed no association.


CONCLUSIONS
Generalist nurses struggle to provide care to this patient group. Role support was found to be the strongest driver of nurses' therapeutic attitude, and workplace illicit drug education was only useful in combination with high role support.


CONCLUSIONS
Nurses' caring role with patients who use illicit drugs is complex and demanding. Nursing workforce development must focus on increasing nurses' role support, in terms of appropriately skilled staff readily available for consultation and advice. Support for nurses, in the form of evidence-based practice standards and appropriate time allocation, is also important.
Ford
Rosemary
R
School of Nursing, Australian Catholic University, Fitzroy, Australia. rosemary.ford@acu.edu.au
Bammer
Gabriele
G
Becker
Niels
N
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001315:Australia; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D009726:Nurses / Q000145:classification / Q000523:psychology*; D019966:Substance-Related Disorders / Q000451:nursing*; D011795:Surveys and Questionnaires