Nursing Students' Attitudes Toward and Empathy for Patients With Substance Use Disorder Following Mentorship
Abstract
Background:
Previous studies have shown that nurses have negative attitudes toward caring for patients with substance use disorder (SUD); these negative attitudes also have been noted with nursing students. This study examined nursing students' attitudes toward and empathy for patients with SUD to determine whether there were differences across practice settings.
Method:
Fifty-three students were surveyed before and after a 120-hour mentor-ship practicum; 25 students participated in focus groups.
Results:
Students' empathy scores improved significantly across all practice settings, and students' attitudes improved significantly in all settings except maternal child health. Qualitative analysis revealed themes related to perceived lack of educational preparation, observing generational differences in nursing care, transitioning from fear to empathy, familial exposure, and feelings of helplessness and blame.
Conclusion:
Findings support the need for educational interventions in both academic and professional practice settings. [J Nurs Educ. 2020;59(3):149–153.]
- Alligood M.R., May B.A. (2000). A nursing theory of personal system empathy: Interpreting a conceptualization of empathy in King's interacting systems. Nursing Science Quarterly, 13(3), 243–247.
10.1177/08943180022107645 Crossref Medline, Google Scholar - American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Crossref, Google Scholar
- Colaizzi P. (1978). Psychological research as the phenomenologist views it. In (Eds.), Existential-phenomenological alternatives for psychology (pp. 48–71). New York, NY: Oxford University Press. Google Scholar
- Compton W.M., Thomas Y.F., Stinson F.S., Grant B.F. (2007). Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States–Results from the National Epidemio-logic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 64(5), 566–576.
10.1001/archpsyc.64.5.566 Crossref Medline, Google Scholar - Coomber R., Moyle L., South N. (2016). The normalisation of drug supply: The social supply of drugs as the “other side” of the history of normalisation. Drugs: Education, Prevention and Policy, 23(3), 255–263.
10.3109/09687637.2015.1110565 Crossref, Google Scholar - Cranton P., Taylor E.W. (2012). Transformative learning theory: Seeking a more unified theory. In (Ed.), The handbook of transformative learning: Theory, research, and practice (pp. 3–20). San Francisco, CA: John Wiley & Sons. Google Scholar
- Finnell D.S., Savage C.L., Hansen B.R., Sanchez M., White K.M., Johnson J.A., Seale J.P. (2018). Integrating substance use content in an “overcrowded” nursing curriculum. Nurse Educator, 43(3), 128–131.
10.1097/NNE.0000000000000438 Crossref Medline, Google Scholar - Harling M.R. (2017). Comparisons between the attitudes of student nurses and other health and social care students toward illicit drug use: An attitudinal survey. Nurse Education Today, 48, 153–159.
10.1016/j.nedt.2016.10.012 Crossref Medline, Google Scholar - Harling M.R., Turner W. (2012). Student nurses' attitudes to illicit drugs: A grounded theory study. Nurse Education Today, 32(3), 235–240.
10.1016/j.nedt.2011.05.002 Crossref Medline, Google Scholar - Hojat M., Mangione S., Nasca T.J., Cohen M.J.M., Gonnella J.S., Erdmann J.B., Magee M. (2001). The Jefferson Scale of Physician Empathy: Development and preliminary psychometric data. Educational and Psychological Measurement, 61(2), 349–365.
10.1177/00131640121971158 Crossref, Google Scholar - Jayadevappa R., Chhatre S., Metzger D. (2015). Trend in substance use admissions among older adults. Drug and Alcohol Dependence, 156, e103.
10.1016/j.drugalcdep.2015.07.286 Crossref, Google Scholar - Kreuger R.A., Casey M.A. (2015). Focus groups: A practical guide for applied research (5th ed.). Los Angeles, CA: Sage. Google Scholar
- Lewis L.F., Jarvis L. (2019). Undergraduate nursing students' experiences and attitudes towards working with patients with opioid use disorder in the clinical setting: A qualitative content analysis. Nurse Education Today, 73, 17–22.
10.1016/j.nedt.2018.11.001 Crossref Medline, Google Scholar - Lovan S.R., Wilson M. (2012). Comparing empathy levels in students at the beginning and end of a nursing program. International Journal of Human Caring, 16(3), 28–33.
10.20467/1091-5710.16.3.28 Crossref, Google Scholar - Mezirow J. (1978). Perspective transformation. Adult Education Quarterly, 28(2), 100–110.
10.1177/074171367802800202 Crossref, Google Scholar - Monks R., Topping A., Newell R. (2013). The dissonant care management of illicit drug users in medical wards, the views of nurses and patients: A grounded theory study. Journal of Advanced Nursing, 69(4), 935–946.
10.1111/j.1365-2648.2012.06088.x Crossref Medline, Google Scholar - Morgan B.D. (2014). Nursing attitudes toward patients with substance use disorder in pain. Pain Management Nursing, 15(1), 165–175.
10.1016/j.pmn.2012.08.004 Crossref Medline, Google Scholar - Nash A.J., Marcus M.T., Cron S., Scamp N., Truitt M., McKenna Z. (2017). Preparing nursing students to work with patients with alcohol or drug-related problems. Journal of Addictions Nursing, 28(3), 124–130.
10.1097/JAN.0000000000000189 Crossref Medline, Google Scholar - National Institute on Drug Abuse. (2014). Medical consequences of drug abuse. Retrieved from https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-drug-abuse-nida Google Scholar
- National Institute on Drug Abuse. (2015). Nationwide trends. Retrieved from https://www.drugabuse.gov/publications/drugfacts/nationwide-trends Google Scholar
- Neville K., Roan N. (2014). Challenges in nursing practice: Nurses' perceptions in caring for hospitalized medical-surgical patients with substance abuse/dependence. JONA: The Journal of Nursing Administration, 44(6), 339–346.
10.1097/NNA.0000000000000079 Crossref Medline, Google Scholar - Penprase B., Oakley B., Ternes R., Driscoll D. (2013). Empathy as a determining factor for nursing career selection. Journal of Nursing Education, 52(4), 192–197.
10.3928/01484834-20130314-02 Link, Google Scholar - Polit D.E., Beck C.T. (2017). Trustworthiness and integrity in qualitative research. In (Eds.), Nursing research: Generating and assessing evidence for nursing practice (10th ed., pp. 557–575). Philadelphia, PA: Wolters Kluwer. Google Scholar
- Romisher R., Hill D., Cong X. (2018). Neonatal abstinence syndrome: Exploring nurses' attitudes, knowledge, and practice. Advances in Neonatal Care, 18(2), E3–E11.
10.1097/ANC.0000000000000462. Crossref Medline, Google Scholar - Ross L.E., Vigod S., Wishart J., Waese M., Spence J.D., Oliver J., Shields R. (2015). Barriers and facilitators to primary care for people with mental health and/or substance use issues: A qualitative study. BMC Family Practice, 16, 135.
10.1186/s12875-015-0353-3. Crossref Medline, Google Scholar - Sinclair S., Beamer K., Hack T.F., McClement S., Raffin Bouchal S., Chochinov H.M., Hagen N.A. (2017). Sympathy, empathy, and compassion: A grounded theory study of palliative care patients' understandings, experiences, and preferences. Palliative Medicine, 31(5), 437–447.
10.1177/0269216316663499 Crossref Medline, Google Scholar - Smothers L.Z., Reynolds M.V., McEachern M.M., Derouin M.A., Carter M.B., Muzyk M.A. (2018). Substance use education in schools of nursing: A systematic review of the literature. Nurse Educator, 43(3), 136–139.
10.1097/NNE.0000000000000449 Crossref Medline, Google Scholar - Vaismoradi M., Jordan S., Kangasniemi M. (2015). Patient participation in patient safety and nursing input—A systematic review. Journal of Clinical Nursing, 24(5–6), 627–639.
10.1111/jocn.12664 Crossref Medline, Google Scholar - van Boekel L.C., Brouwers E.P.M., van Weeghel J., Garretsen H.F.L. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: Systematic review. Drug and Alcohol Dependence, 131(1–2), 23–35.
10.1016/j.drugalcdep.2013.02.018 Crossref Medline, Google Scholar - van Boekel L.C., Brouwers E.P.M., van Weeghel J., Garretsen H.F.L. (2014). Healthcare professionals' regard towards working with patients with substance use disorders: Comparison of primary care, psychiatry and specialist addiction services. Drug and Alcohol Dependence, 134, 92–98.
10.1016/j.drugalcdep.2013.09.012 Crossref Medline, Google Scholar - Ward J., Schaal M., Sullivan J., Bowen M.E., Erdmann J.B., Hojat M. (2009). Reliability and validity of the Jefferson Scale of Empathy in undergraduate nursing students. Journal of Nursing Measurement, 17(1), 73–88.
10.1891/1061-3749.17.1.73 Crossref Medline, Google Scholar - Watson H., Maclaren W., Kerr S. (2007). Staff attitudes towards working with drug users: Development of the Drug Problems Perceptions Questionnaire. Addiction, 102(2), 206–215.
10.1111/j.1360-0443.2006.01686.x Crossref Medline, Google Scholar - Williams B., Boyle M., Fielder C. (2015). Empathetic attitudes of undergraduate paramedic and nursing students towards four medical conditions: A three-year longitudinal study. Nurse Education Today, 35(2), e14–e18.
10.1016/j.nedt.2014.12.007 Crossref Medline, Google Scholar

