Abstract:
Substances use is an increasing national concern. Various forms of harmful disorders
have also been noted as posing a national health crisis. Against this background, the aim
of the study was to explore, identify, describe and analyse inpatient substance addiction
and its disorders, and to propose a relevant framework of principles to guide and improve
nursing care in this regard.
The study adopted a combined mixed-methods research approach involving qualitative,
quantitative, using convergent research design in order to maximise both the efficacy of
the methods and sources of data collection and their concurrent analysis, as well as the
eventual findings of the study, which was conducted at three substance addiction
treatment centres in Gauteng Province.
The quantitative aspect of the study was facilitated by means of a comprehensive review
and analysis of admission records belonging to 244 substance addicted inpatients at one
of the selected three treatment centres. The quantitative variables reflected in the
admission records represented the entire range of sociodemographic, help seeking,
substance abuse history, family support, and medical and psychological characteristics
of substance abusers. On the other hand, the study’s qualitative aspect was facilitated by
means of three (3) unstructured in-depth focus groups with selected nurses providing
care to inpatient people addicted to substances. An investigation of 5 (five) inpatient
treatment programmes at the self-same three treatment centres complemented the
qualitative aspect of the study.
For the majority cases of occurrence/ frequency at the treatment centre from which 244
admission records were obtained, the quantitative findings revealed, among others, that
the majority of inpatients (n=224, 91.8%) were Blacks; single (n=223, 90%); at secondary
school (n=207, 84.8%); unemployed (n=232, 95.1%); with the heroin as the most abused
substance by 88.9% (n=217) inpatients followed by cannabis (n=205, 83.6%). The most
critical of these variables was that the majority of the inpatients (n=74, 30.5%) were those
who had been substance abusing for 7-10 years. The implication is most young people
were the most at-risk group as they started substance abuse during the adolescent stages
of their live, which increased the chances of progressing to substance abuse disorders
and poor mental health.
Meanwhile, the qualitative findings derived from the focus group discussions with the
nurses and the five treatment programmes yielded five focal themes and associated
multiple sub-categories. These principal/global themes are: psychological and emotional
impediments to inpatient care; attitudes of patients’ relatives; quality of care by nurses to
support inpatients; nurses’ attitudes; and challenges experienced by nurses. Collectively,
both the quantitative and qualitative findings indicate that substance abuse disorder is a
complex and multifaceted physiological and psychosocial challenge for both the sufferers
and society as a whole. For its management and treatment, nurses should be adequately
trained, and multi-professional teams should be part of a concerted and dedicated effort
to provide care and eradicate the problem convincingly.
The study envisages that its recommendations will contribute towards effective policy
development and implementation based on a viable framework of inmate substance
abuse guidelines to innovatively guide nursing care and management of substance abuse
treatment centres. Such innovation should incorporate continuing professional
development guidelines for different categories of nurses to enhance their skills and also
improve knowledge on mental health implications as well.
