Nurses' Attitudes Toward Patients With Perinatal Substance Use Disorder

To determine the extent of stigmatizing attitudes among perinatal registered nurses in North Carolina, examine correlates of stigmatizing attitudes, and describe nurses' attitudes about patients with perinatal substance use disorder (PSUD).

Explanatory sequential mixed methods.

Participants were recruited through the North Carolina Board of Nursing and included nurses providing care to patients with PSUD in any care setting in North Carolina.

Eighty-three nurses licensed with the North Carolina Board of Nursing completed the survey; nine of these participants were interviewed.

Nurses' attitudes were scored using the Modified Attitudes About Drug Use in Pregnancy (MADUP) scale, and a subsample completed semistructured interviews, which were transcribed and analyzed using thematic analysis.

MADUP scale scores averaged 3.4 (SD = 0.8), and 33% of participants had stigmatizing attitudes toward patients with PSUD. Participants with a bachelor's degree or higher had more positive attitudes than those with a diploma or associate degree (b = -0.603, 95% CI [-1.117, -0.088], p = .022). Three stages emerged from the qualitative data illustrating a continuum in which nurses are positioned related to their knowledge and attitudes toward patients with PSUD.

There is a need for integrated, standardized nursing care and structural education to mitigate stigma toward patients with PSUD and to ensure quality care. A larger national study is recommended for more generalizability of the results.