THE IMPACT OF HEALTH PROFESSIONALS’ ATTITUDES AND KNOWLEDGE ON THE QUALITY OF CARE FOR DRUG-DEPENDENTS Authors: Molina Mula J; Hernández Sánchez D; Carnicero Viñals Eva; Castaño Fernández, AI; Clar Aragón F, Gelabert Binimelis A, González Trujillo A, López Alabarce JA, Montalbán Romero M, Sanz Álvarez E, Simonet Bennassar M, Vilardell Balash M Balearic Nursing Research Group in Drug-Dependence (GIBED, in Spanish)

Some Dates Very important public health problem The World Health Report, 2000

BackgroundsBackgrounds The training curricula of health professional about drug- dependence is very low. (Pinikahana, 2002; Pillon, 2003; Rassool, 2006; Fornili, 2007; Kelleher, 2009) The training programs can improve confidence in working with drug addicts and professional attitude towards them (Gerace, 1995; Karam-Hage, 2001) Research in the field of attitudes is relatively low, however, influence the quality of care. The attitudes and knowledge can play a crucial role in treatment failure (Carroll, 1993 y Kelleher, 2007 y 2009)

GoalGoal Analyze the factors involved in the professionals’ attitudes from the Substance-Related Disorders Literature review phases: -1 st Phase: Structured literature search in PubMed, Cochrane Library Plus, CINAHL, Cuiden, Cuiden Plus, EBSCOhost, IBECS y PSICODOC, Spanish Medical MeSH. -2 nd Phase: Targeted literature search and contacted several authors via and fax. -3 rd Phase: Methodological and thematic analysis of selected scientific articles. -4 th Phase: Compilation of instruments for measuring knowledge and attitudes 1.Translation concepts to documentary language or descriptors (DECS). 2.Combining the descriptors by Boolean operators. 3.Selecting Metasearch Engine: EBSCOhost including CIHNAL, FRANCIS, Psycinfo and Academy Search Premier. 4.Specific data bases: Pubmed; Ibecs and IME. 5.EBP data bases: Cochrane Library Plus. 1.Translation concepts to documentary language or descriptors (DECS). 2.Combining the descriptors by Boolean operators. 3.Selecting Metasearch Engine: EBSCOhost including CIHNAL, FRANCIS, Psycinfo and Academy Search Premier. 4.Specific data bases: Pubmed; Ibecs and IME. 5.EBP data bases: Cochrane Library Plus.

Material and Methods DESCRIPTORSPANISHENGLISH Main 1 Rol ProfesionalProfessional Role Main 2 Trastornos Relacionados con SustanciasSubstance-Related Disorders Secondary 1 Percepción SocialSocial Perception Secondary 2 Capacitación ProfesionalProfessional Training Bibliographic search strategy with Boolean 1Main 1 + Main 2: Professional Role AND Substance-Related Disorders 2Main 2 + Secondary 1 + Main 1: Substance-Related Disorders AND Social Perception AND Professional Role 3Main 2 + Secondary 2: Substance-Related Disorders AND Professional Training

Results (Selection of articles) Likert Scale

Results (Characteristics of studies) TYPES OF STUDIESMETHOLOGY OF THE STUDIES DESCRIPTIVE36QUANTITATIVE31 REVIEWS15QUALITATIVE6 INTERVENTION4MIXED7 TECHNICAL REPORT2SYSTEMATICS REVIEWS 15 PREVALENCE1 COHORT1

Results (Topics)

Results (Measuring instruments) Topics: -Drug-dependences: 21 -Alcohol: 12 -Others: 5 Questionnaries: Questionnaries: SAAS, SAES, NEADA, AAPQ, Survey of National Drug Plan, Addiction Psychiatry Survey, CAGE, AUDIT, AUDIT-C, FAST, PAT, Marcus Alcoholism Questionnaire, Seaman e Mannello… Qualitative: semistructured interviews (8), focus groups (4) and structured interviews (1)

Discussion 1.Individual beliefs, age, gender, ethnicity and religion influence professional attitudes towards drug addicts (Howard & Chung, 2000; Nordqvist, Johansson, Lindqvist & Bendtsen, 2006) 2.Professional attitudes depend on the different roles, socialization and type and nature of contact with these patients (Carroll, 1993) 3.Health professionals’ lack of training in substance abuse ((Nordqvist, Johansson, Lindqvist & Bendtsen, 2006; Deehan, McCambridge, Ball & Strang, 2002) 4.The institution where professionals work affects care of drug-dependents (Bard, 2006)

Challenges 1.The need for professionals to separate themselves from their preconceived notions when attending drug dependents’ needs (Storani & Tavares, 2008) 2.The need to change the training currently being provided and the need for the strong presence of this kind of training in undergraduate and postgraduate curricula (Nkowane & Saxena, 2004) 3.The need to act on early detection and preventive intervention in this area (Pillon, Ramos, Villar & Rassool, 2004; León, 2005) 4.Nurses’ historically greater role in caring for drug addicts, compared with other groups of health professionals, and the fact that they are the key workers in drug-dependence (Howard & Chung, 2000)

Proposal Descriptive study Validation of questionnaries Analytical study Observational Phase Interviews with health professionals Focus groups with drug addicts Qualitative Phase

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