Exploring mental health nursing student competence and confidence in treating novel psychoactive substance related health issues in the UK

Abstract

Context and aims

Novel psychoactive substances (NPS) present a significant challenge to healthcare professionals working in the UK, with them being involved in a substantial proportion of drug-related deaths and hospitalisations in recent years. Healthcare professionals report feeling ill-prepared to respond to the issue, and cite lack of education, knowledge and feelings of under-confidence in relation to NPS as being of particular concern.

One area that has not been researched thus far is student nurses’ feelings of competence and confidence in relation to NPS. The author proposes that this area requires urgent investigation, given that many within this population will soon be primary caregivers to individuals who consume NPS.

This study aimed to provide nascent data on the subject described above and utilised a mixed-method approach.

Methodology

The initial phase of this was a series of overview of reviews from which an evidence-based presentation was produced. Five participants were recruited from Abertay University’s undergraduate nursing programme through email invite in April 2023. They completed two identical quantitative questionnaires where basic demographic data and information regarding their perceived levels of knowledge and confidence surrounding NPS were assessed - one before and one after watching the presentation. An online focus group followed via Microsoft Teams, where the same five participants were asked how they felt their knowledge and confidence in the topic related to feelings of competence. Upon completion of this, gathered quantitative and qualitative data was triangulated. Quantitative data was analysed using Microsoft Excel, whilst qualitative data was performed manually using a thematic analysis process. Triangulation of data was also performed manually.

Results

Findings suggested that participants greatly valued knowledge on clinical vigilance/awareness about NPS and utilised this as a vehicle through which to interpret NPS-related issues experienced during practice placements. Educational gaps that remained were the lived experience of service users, and the use of psychosocial interventions in managing NPS-related harms. Competence was perceived as being associated with experiential learning and working with more established professionals. Qualitative data suggests that a relationship may exist between qualities of previous healthcare experience and confidence and competence in treating NPS, though quantitative data proved too under-powered to support this during the triangulation process.

Discussion

The results were considered in the light of research regarding the theory practice gap, which was used as a model by which to account for the value placed on clinical vigilance/awareness over other themes by participants, where it was suggested that the relative absence of associated skills seen in this theme may explain why it was more readily internally accepted as an area of confidence. Discussion also touched on participants’ suggestion that input in the form of lived experience was felt as valuable to their continued education, and evidence was found that supported this claim. It then turned to the issue of continuous professional development (CPD) in the context of substance misuse more generally, where it was found that this is an often-neglected area, despite the fact that well produced CPD can address identified educational needs in healthcare professionals.

Conclusion

The thesis concludes by recounting the study, as well as its principal findings. Firstly, that clinical vigilance and awareness was a highly valued theme amongst participants, seemingly due in large part to its ability to act as a lens by which to understand NPS-related phenomena observed in practice. Secondly, that lived experience content from relevant service-user populations is considered as a highly valuable addition to any educational resource concerning psychosocial interventions - one that was seemingly viewed by participants as necessary to increase feelings of confidence in this theme.

The conclusion suggests that the study is subject to limitations, largely on the basis of its small sample size, though if considered – as intended – to be a small scale exploratory/pilot study in a relatively data-poor field of research using a mixed method design, then it can be seen as relatively robust.

It then ends by discussing the anomaly that although health professionals in the field of substance misuse have expressed a need for greater support in education/CPD, this is not addressed by Scottish or local-level government strategies, despite the current public health crisis caused by record levels of drug-related-deaths that the country has been experiencing in recent years.

Date of Award	1 Mar 2024
Original language	English
Awarding Institution	Abertay University
Supervisor	Mhairi Thurston (Supervisor), Anne Savage (Supervisor) & Jude Kelly (Supervisor)