Problem burden, treatment relationships, and self-efficacy among recovering nurses in a diversion program

Abstract

Nurses returning to work while in treatment for addictions are at risk for relapse to substance use. Little is known about the types of stressors that nurses experience while in treatment programs for addiction, and how the burden of life problems relates to confidence in ability to resist relapse. Recovering nurses enrolled in a diversion program (N = 622) were surveyed. The types of problems that they experience were measured; these were classified into interpersonal problem burden, and health problem burden. In addition, their confidence in ability to resist relapse to substances when in eight high-risk situations were measured using the SCQ-39. During recovery, the most common problems were: financial (45% of respondents), eating/appetite/weight (31%), depression (29%), fatigue (27%), and tension (26%). Self-reported confidence in ability to resist relapse was very high (median 98, 0-100 scale). Logistic regression analyses were used to identify the association of problem burden to high (80-100) vs. low (0-80) confidence in high-risk situations. A lower interpersonal problem burden was associated with higher confidence to resist relapse in the following situations: (1) where there was social pressure to drink or use (p = .01), (2) when having pleasant times with others (p = .02), (3) when experiencing unpleasant emotions (p = .01), and when testing personal control (p = .02). An increased burden of health problems was associated with increased confidence in ability to resist relapse in two high-risk situations: (1) social pressure to drink or use (p = .02), and (2) pleasant times with others (p = .03). These results suggest that the level of problem burden experienced by nurses while in treatment does not increase risk for relapse globally; rather, the type of burden experienced (interpersonal vs. health) is differentially associated with confidence in specific high-risk situations.