Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-24T06:23:08.871Z Has data issue: false hasContentIssue false
  • English
  • Français

Health student regard for substance-using patients as measured by the Medical Condition Regard Scale: a systematic review

Published online by Cambridge University Press:  11 May 2017

K. Ducray  and
M. Pilch
K. Ducray*
Affiliation:
HSE National Drug Treatment Centre, Dublin, Ireland School of Psychology, National University of Ireland, Galway, Ireland
M. Pilch
Affiliation:
Doctor of Psychological Science in Clinical Psychology for Qualified Clinicians Programme, School of Psychology, National University of Ireland, Galway, Ireland
*
*Address for correspondence: K. Ducray, HSE National Drug Treatment Centre, 30-31 Pearse Street, Dublin 2, Dublin, Ireland. (Email: ducrayk@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

As clinical impartiality is an accepted basic principle of ethical practice, any proactive exercises that may inform selection, training, clinical placements, and other interventions, which promote future positive and equitable professional conduct, thus guarding against future discriminatory attitudes are germane. Within this context, the purpose of this review was to identify trends and patterns in health student, namely future practitioners’, regard for substance-using patients using the Medical Condition Regard Scale.

Methods

Six electronic databases were systematically searched for studies that used the Medical Condition Regard Scale as an outcome measure in assessing health student regard for drug-using patients. Academics who had published in this area were also consulted to recommend texts that would complement the above citation sourcing process. Following an elimination of duplicates, the application of inclusion and exclusion criteria, as well as conducting citation searches, 16 studies were incorporated in the final review. Although the quality of all included studies was satisfactory, no study was free from a potential source of bias.

Results

This review found that patients with drug-use problems were consistently held in the lowest echelons of regard by trainee health practitioners. The impact of sex, age, year of course, and personal exposure to mental health difficulties in predicting negative regard was unclear.

Conclusions

Unless addressed, patients with drug problems may have a high potential for future treatment marginalisation by tomorrow’s health professionals. This scenario needs to be proactively managed by all stakeholders through a greater investment in educational and clinical training placement opportunities.

Keywords

Addictiondrughealth studentmedical conditionpatient regardsubstance
Type
Review Articles
Information
Irish Journal of Psychological Medicine , Volume 34 , Issue 3 , September 2017 , pp. 183 - 196
Copyright
© College of Psychiatrists of Ireland 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addiction and Health (2014). Drugabuse.gov. Retrieved 4 May 2016 from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/addiction-health Google Scholar
Ahmedani, BK, Kubiak, SP, Rios-Bedoya, CF, Mickus, M, Anthony, JC (2011). Willingness to treat drug dependence and depression: comparisons of future health professionals. Substance Abuse and Rehabilitation 2, 43.Google Scholar
Borch, A, Rantala, V (2015). Addiction: a highly successful, essentially contested concept. The International Journal of Alcohol and Drug Research 4, 1–4.CrossRefGoogle Scholar
Boyle, MJ, Williams, B, Brown, T, Molloy, A, McKenna, L, Molloy, E, Lewis, B (2010). Attitudes of undergraduate health science students towards patients with intellectual disability, substance abuse, and acute mental illness: a cross-sectional study. BMC Medical Education 10, 71–79.CrossRefGoogle ScholarPubMed
Brener, L, Von Hippel, W, Kippax, S (2007). Prejudice among health care workers toward injecting drug-users with hepatitis C: does greater contact lead to less prejudice? International Journal of Drug Policy 18, 381–387.CrossRefGoogle ScholarPubMed
Broadus, AD, Evans, WP (2015). Developing the public attitudes about addiction instrument. Addiction Research & Theory 23, 115–130.CrossRefGoogle Scholar
Brown, T, Williams, B, Boyle, M, Molloy, A, McKenna, L, Molloy, L, Lewis, B (2010). Levels of empathy in undergraduate occupational therapy students. Occupational Therapy International 17, 135–141.CrossRefGoogle ScholarPubMed
Buckley, S, Coleman, J, Davison, I, Khan, KS, Zamora, J, Malick, S, Morley, D, Pollard, D, Ashcroft, T, Popovic, C, Sayers, J (2009). The educational effects of portfolios on undergraduate student learning: a best evidence medical education (BEME) systematic review. BEME guide no. 11. Medical Teacher 31, 282–298.CrossRefGoogle Scholar
Campbell, Library. (2015). Campbellcollaboration.org. Retrieved 20 December 2015, from https://www.campbellcollaboration.org/library.html Google Scholar
Cave, J. (2009). Tackling problem drug use. National Audit Office. Retrieved 4 May 2016, from https://www.nao.org.uk/wp-content/uploads/2010/03/0910297_reviews.pdf Google Scholar
Chappel, JN, Veach, TL (1987). Effect of a course on students’ attitudes toward substance abuse and its treatment. Academic Medicine 62, 394–400.CrossRefGoogle ScholarPubMed
Christison, GW, Haviland, MG (2003). Requiring a one-week addiction treatment experience in a six-week psychiatry clerkship: effects on attitudes toward substance-abusing patients. Teaching and Learning in Medicine 15, 93–97.CrossRefGoogle Scholar
Christison, GW, Haviland, MG, Riggs, ML (2002). The medical condition regard scale. Academic Medicine 77, 257–262.CrossRefGoogle ScholarPubMed
Cochrane Handbook for Systematic Reviews of Interventions (2016). Handbook.cochrane.org. Retrieved 13 April 2016, from (http://handbook.cochrane.org/)Google Scholar
Collins, DJ, Lapsley, HM (2013). The costs of tobacco, alcohol and illicit drug abuse to Australian Society in 2004/05(http://nadk.mesuvawebdevelopment.com.au/files/3013/8551/1279/Collins__Lapsley_Report.pdf). Accessed 4 May 2016.Google Scholar
Dearing, KS, Steadman, S (2008). Challenging stereotyping and bias: a voice simulation study. Journal of Nursing Education 47, 59–65.CrossRefGoogle Scholar
Death, . (2016). Drugabuse.gov. Retrieved 9 May 2016, from https://www.drugabuse.gov/publications/health-consequences-drug-misuse/death Google Scholar
Degenhardt, L, Larney, S, Randall, D, Burns, L, Hall, W (2014). Causes of death in a cohort treated for opioid dependence between 1985 and 2005. Addiction 109, 90–99.CrossRefGoogle Scholar
Ding, L, Landon, BE, Wilson, IB, Wong, MD, Shapiro, MF, Cleary, PD (2005). Predictors and consequences of negative physician attitudes toward HIV-infected injection drug users. Archives of Internal Medicine 165, 618–623.CrossRefGoogle ScholarPubMed
Dixon-Woods, M, Agarwal, S, Jones, D, Young, B, Sutton, A (2005). Synthesising qualitative and quantitative evidence: a review of possible methods. Journal of Health Services Research and Policy 10, 45–53.CrossRefGoogle ScholarPubMed
European Drug Report. Trends and Developments. (2015). emcdda.europa.eu. Retrieved 24 January 2016 (from http://www.emcdda.europa.eu/attachements.cfm/att_239505_EN_TDAT15001ENN.pdf).Google Scholar
Ford, R (2011). Interpersonal challenges as a constraint on care: the experience of nurses’ care of patients who use illicit drugs. Contemporary Nurse 37, 241–252.CrossRefGoogle ScholarPubMed
Gilchrist, G, Moskalewicz, J, Slezakova, S, Okruhlica, L, Torrens, M, Vajd, R, Baldacchino, A (2011). Staff regard towards working with substance users: a European multi-centre study. Addiction 106, 1114–1125.CrossRefGoogle ScholarPubMed
Gossop, M, Marsden, J, Stewart, D, Kidd, T (2003). The National Treatment Outcome Research Study (NTORS): 4–5-year follow‐up results. Addiction 98, 291–303.CrossRefGoogle Scholar
Green, BN, Johnson, CD, Adams, A (2006). Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. Journal of Chiropractic Medicine 5, 101–117.CrossRefGoogle ScholarPubMed
Greenhalgh, T, Robert, G, Macfarlane, F, Bate, P, Kyriakidou, O, Peacock, R (2005). Storylines of research in diffusion of innovation: a meta-narrative approach to systematic review. Social Science & Medicine 61, 417–430.CrossRefGoogle ScholarPubMed
Hammer, GP, du Prel, JB, Blettner, M (2009). Avoiding bias in observational studies: part 8 in a series of articles on evaluation of scientific publications. Deutsches Ärzteblatt International 106, 664–668.Google Scholar
Heijnders, M, Van Der Meij, S (2006). The fight against stigma: an overview of stigma-reduction strategies and interventions. Psychology, Health & Medicine 11, 353–363.CrossRefGoogle ScholarPubMed
Hemmerdinger, JM, Stoddart, SD, Lilford, RJ (2007). A systematic review of tests of empathy in medicine. BMC Medical Education 7, 1–24.CrossRefGoogle ScholarPubMed
Higgins, JP, Green, S (2008). Cochrane Handbook for Systematic Reviews of Interventions, vol. 5. Wiley-Blackwell: Chichester.CrossRefGoogle Scholar
Higgins, JPT, Altman, DG, Gotzsche, PC, Juni, P, Moher, D, Oxman, AD, Savovic, J, Schulz, KF, Weeks, L, Sterne, JAC (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. British Medical Journal 343, d5928.Google ScholarPubMed
Hojat, M (2006). Empathy in Patient Care: Antecedents, Development, Measurement, and Outcomes: Antecedents, Development, Measurement, and Outcomes. Springer-Verlag: New York, NY.Google Scholar
JBI Database of Systematic Reviews and Implementation Reports (2016). Journals.lww.com. Retrieved 24 January 2016 from http://journals.lww.com/jbisrir/pages/default.aspx Google Scholar
Kelleher, S, Cotter, P (2009). A descriptive study on emergency department doctors’ and nurses’ knowledge and attitudes concerning substance use and substance users. International Emergency Nursing 17, 3–14.CrossRefGoogle Scholar
Kelm, Z, Womer, J, Walter, JK, Feudtner, C (2014). Interventions to cultivate physician empathy: a systematic review. BMC Medical Education 14, 1–11.CrossRefGoogle ScholarPubMed
Knaak, S, Modgill, G, Patten, SB (2014). Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie 59 (Suppl. 1): S19–S26.CrossRefGoogle ScholarPubMed
Korszun, A, Dinos, S, Ahmed, K, Bhui, K (2012). Medical student attitudes about mental illness: does medical-school education reduce stigma? Academic Psychiatry 36, 197–204.CrossRefGoogle ScholarPubMed
Kothari, D, Gourevitch, MN, Lee, JD, Grossman, E, Truncali, A, Ark, TK, Kalet, AL (2011). Undergraduate medical education in substance abuse: a review of the quality of the literature. Academic Medicine 86, 98–112.CrossRefGoogle ScholarPubMed
Kubiak, SP, Ahmedani, B, Rios-Bedoya, C, Anthony, J (2011). Stigmatizing clients with mental health conditions: an assessment of social work student attitudes. Social Work in Mental Health 9, 253–271.CrossRefGoogle ScholarPubMed
Lapidow, A (2013). LibGuides: NUTR 369: systematic reviews: search strategies (http://researchguides.library.tufts.edu/c.php?g=249127&p=1658789#12780103). Accessed 11 March 2016.Google Scholar
Li, L, Evans, E, Hser, YI (2010). A marginal structural modeling approach to assess the cumulative effect of drug treatment on later drug use abstinence. Journal of Drug Issues 40, 221–240.CrossRefGoogle ScholarPubMed
Liberati, A, Altman, DG, Tetzlaff, J, Mulrow, C, Gøtzsche, PC, Ioannidis, JPA, Clarke, M, Devereaux, PJ, Kleijnen, J, Moher, D (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Annals of Internal Medicine 151, W-65.CrossRefGoogle ScholarPubMed
Link, BG, Struening, EL, Rahav, M, Phelan, JC, Nuttbrock, L (1997). On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior 38, 177–190.CrossRefGoogle ScholarPubMed
Madhan, MB, Gayathri Haritheertham, G, Lokanath, LG, Naik, ES (2012). Dental students’ regard for patients from often-stigmatized populations: findings from an Indian dental school. Journal of Dental Education 76, 210–217.CrossRefGoogle ScholarPubMed
Mays N, Pope C, Popay J (2005). Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field. Journal of health services research & policy 10 (Suppl. 1), 270, 6–20.Google Scholar
McGinnis, JM, Foege, WH (1993). Actual causes of death in the United States. Journal of the American Medical Association 270, 2207–2212.CrossRefGoogle ScholarPubMed
McKenna, L, Boyle, M, Brown, T, Williams, B, Molloy, A, Lewis, B, Molloy, L (2011). Levels of empathy in undergraduate midwifery students: an Australian cross-sectional study. Women and Birth 24, 80–84.CrossRefGoogle ScholarPubMed
McKenna, L, Boyle, M, Brown, T, Williams, B, Molloy, A, Lewis, B, Molloy, L (2012). Levels of empathy in undergraduate nursing students. International Journal of Nursing Practice 18, 246–251.CrossRefGoogle ScholarPubMed
Meltzer, EC, Suppes, A, Burns, S, Shuman, A, Orfanos, A, Sturiano, CV, Charney, P, Fins, JJ (2013). Stigmatization of substance use disorders among internal medicine residents. Substance Abuse 34, 356–362.CrossRefGoogle ScholarPubMed
Miller, WR, Brown, SA (2009). Why psychologists should treat alcohol and drug problems. In Addictive Behaviors: New Readings on Etiology, Prevention, and Treatment (ed. G. Marlatt and K. E. Witkiewitz), pp. 33–55. American Psychological Association: Washington, DC.CrossRefGoogle Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine 6, e1000097.Google ScholarPubMed
Mulrow, CD (1994). Education and debate systematic reviews: rationale for systematic reviews. British Medical Journal 309, 597–599.CrossRefGoogle Scholar
Norcross, JC, Wampold, BE (2011). Evidence-based therapy relationships: research conclusions and clinical practices. Psychotherapy 48, 98–102.CrossRefGoogle ScholarPubMed
Nutt, RA, Gilchrist, G, Marsa Sambola, F, Baldacchino, AM (2017). Staff regard towards working with patients who have co-morbid depression and substance misuse disorders. An exploratory study. Heroin Addiction and Related Clinical Problems. 19, 5–16.Google Scholar
Office of the United Nations High Commissioner for Human Rights (2008). The right to health (http://www.ohchr.org/Documents/Publications/Factsheet31.pdf). Accessed 4 May 2016.Google Scholar
Petry, N (2015). Behavioral Addictions: DSM-5 ® and Beyond . Oxford University Press: New York, NY.CrossRefGoogle Scholar
Petticrew, M, Roberts, H (2005). Systematic reviews in the social sciences A PRACTICAL GUIDE (http://www.cebma.org/wp-content/uploads/pettigrew-roberts-sr-in-the-soc-sc.pdf). Accessed 4 May 2016.Google Scholar
PROSPERO (n.d.). International prospective register of systematic reviews (http://www.crd.york.ac.uk/prospero/). Accessed 4 January 2016.Google Scholar
Rose, D, Thornicroft, G, Pinfold, V, Kassam, A (2007). 250 labels used to stigmatise people with mental illness. BMC Health Services Research 7, 97.CrossRefGoogle ScholarPubMed
Simpson, DD (2004). A conceptual framework for drug treatment process and outcomes. Journal of Substance Abuse Treatment 27, 99–121.CrossRefGoogle ScholarPubMed
Stuart, H, Chen, SP, Christie, R, Dobson, K, Kirsh, B, Knaak, S, Koller, M, Krupa, T, Lauria-Horner, B, Luong, D, Modgill, G (2014). Opening minds: the Mental Health Commission of Canada’s anti-stigma initiative: opening minds in Canada: targeting change. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie 59 (Suppl. 1): S13.CrossRefGoogle ScholarPubMed
Substance and Drug Dependency (2013). Retrieved 4 May 2016 from http://www.drugsandalcohol.ie/20185/1/Substance_and_Drug_Dependency.pdf Google Scholar
Systematic reviews and meta-analyses: a step-by-step guide (2016). Ccace.ed.ac.uk. Retrieved 9 May 2016 from http://www.ccace.ed.ac.uk/research/software-resources/systematic-reviews-and-meta-analyses Google Scholar
van Boekel, LC, Brouwers, EPM, van Weeghel, J, Garretsen, HFL (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug and Alcohol Dependence 131, 23–35.CrossRefGoogle ScholarPubMed
Volkow, ND (2010). What is comorbidity? From the director (https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf). Accessed 13 May 2016.Google Scholar
Williams, B, Boyle, M, Brightwell, R, Devenish, S, Hartley, P, McCall, M, McMullen, P, Munro, G, O’Meara, P, Webb, V (2012). Paramedic empathy levels: results from seven Australian universities. International Journal of Emergency Services 1, 111–121.CrossRefGoogle Scholar
Williams, B, Boyle, M, Brightwell, R, Devenish, S, Hartley, P, McCall, M, McMullen, P, Munro, G, O’Meara, P, Webb, H, Weber, A (2013a). The Medical Condition Regard Scale: measuring attitudes in paramedic students. Australasian Journal of Paramedicine 10, 1–7.Google Scholar
Williams, B, Boyle, M, Earl, T (2013b). Measurement of empathy levels in undergraduate paramedic students. Prehospital and Disaster Medicine 28, 145–149.CrossRefGoogle ScholarPubMed
Williams, B, Boyle, M, Fielder, C (2015a). Empathetic attitudes of undergraduate paramedic and nursing students towards four medical conditions: a three-year longitudinal study. Nurse Education Today 35, 14–18.CrossRefGoogle ScholarPubMed
Williams, BA, Boyle, MJ, Howard, S (2015b). Attitudes of paramedic students towards specific medical conditions: a four-year study. Internet Journal of Allied Health Sciences and Practice 13, 1–7.Google Scholar
World Health Organisation (2015). The International Statistical Classification of Diseases and Related Health Problems, ICD-10. World Health Organisation: Geneva.Google Scholar
WMA - The World Medical Association-WMA Declaration of Geneva (2016). Wma.net. Retrieved 14 May 2016 from https://www.wma.net/policies-post/wma-declaration-of-geneva/ CrossRefGoogle Scholar
Yamaguchi, S, Wu, SI, Biswas, M, Yate, M, Aoki, Y, Barley, EA, Thornicroft, G (2013). Effects of short-term interventions to reduce mental health-related stigma in university or college students: a systematic review. The Journal of Nervous and Mental Disease 201, 490–503.CrossRefGoogle ScholarPubMed
Yang, L., Link, B. (2015). Measurement of Attitudes, Beliefs and Behaviors of Mental Health and Mental Illness. nationalacademies.org. Retrieved 15 February 2016 from http://sites.nationalacademies.org/cs/groups/dbassesite/documents/webpage/dbasse_170048.pdf.Google Scholar