Help seeking by health professionals for addiction: A mixed studies review.
BACKGROUND
When health professionals practice with active and untreated addiction, it is a complex occupational and professional issue impacting numerous stakeholders. Health professionals are responsive to evidence-based addiction interventions and their return-to-work has been demonstrated to be achievable, sustainable and safe. Facilitating help seeking in health professionals with addiction is a priority for reducing associated risks to their health and to patient safety.


OBJECTIVE
The purpose of this study was to identify the process by which health professionals seek help for addiction, and factors that facilitate and deter help seeking, through a review of the qualitative and quantitative literature.


METHODS
Both phases of this sequential mixed studies review followed the standard systematic review steps of: (1) identifying the review question, (2) defining eligibility criteria, (3) applying an extensive search strategy, (4) independent screening of titles and abstracts, (5) selecting relevant studies based on reviewing the full text, (6) appraising the quality of included studies, and (7) synthesizing the study findings. Our two searches of five databases from 1995 to 2015 resulted in the inclusion of eight qualitative and twenty-three quantitative studies. We first conducted a meta-synthesis of the qualitative literature to garner an understanding of the help seeking process for health professionals for addiction. We then conducted a narrative synthesis of the quantitative studies to generalize these findings through examining the data for convergent, complementary or divergent results.


RESULTS
Synthesis of the included qualitative studies revealed that the professional and experiential context of healthcare compromised the health professional's readiness to seek help for addiction. Typically, a pivotal event initiated the help seeking process. The studies in the quantitative review identified that help seeking most often resulted from reports of adverse events to formal organizations such as their employer and regulatory bodies. This process does not adequately address the scope of health professionals requiring help for addiction. Informal sources such as colleagues and family, often aware of the addiction earlier, preferred referral to voluntary, confidential treatment programs.


CONCLUSIONS
Facilitating the help seeking process for health professionals with addiction in as effective strategy to reduce the associated risks to the health professional, their families and colleagues, their employers and regulatory bodies, and to the general public. Our findings suggest that intervention is possible at multiple points in the help seeking process for health professionals with addiction. Confidential, compassionate and supportive alternatives offer potential for closing this gap.
Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada T6G 1C9. Electronic address: diane.kunyk@ualberta.ca.
Diane
D
Kunyk
Alberta School of Business, University of Alberta, 3-23 Business Building, Edmonton, Alberta, Canada T6G 2R6.
Michelle
M
Inness
Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada T6G 1C9.
Emilene
E
Reisdorfer
Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada T6G 1C9.
Heather
H
Morris
Libraries, University of Alberta, Walter MacKenzie Health Sciences Centre, Edmonton, Alberta, Canada T6G 1C9.
Thane
T
Chambers
D006282:Health Personnel; D006801:Humans; D010342:Patient Acceptance of Health Care; D011363:Professional Impairment; D019966:Substance-Related Disorders / Q000534:rehabilitation*
Addiction/substance use; Health professional; Healthcare professional; Help seeking; Illness and disease/experiences; Research/mixed methods