Identified Organization Issue: Substance Use Disorder

Substance Use Disorder (SUD) represents a pervasive and chronic condition marked by a pattern of compulsive substance consumption, even in the presence of harmful repercussions. This disorder not only affects the individual suffering from it but also extends its impact to families and communities, leading to increased healthcare costs and significant social challenges. The multifaceted nature of SUD demands a comprehensive approach that aligns with holistic nursing principles to effectively navigate the complexities inherent in this health issue (Fawcett, 2005; McEwen & Wills, 2022).

Selected Middle-range theories

Middle-range theories play a critical role in framing the intervention strategies for SUD. Peplau’s Theory of Interpersonal Relations and Riegel’s Middle-Range Theory of Social Isolation in Chronic Illness provide valuable frameworks for addressing both the interpersonal dynamics and the social impediments experienced by those affected with SUD.

Rationale for Theory Selection

Peplau’s Theory of Interpersonal Relations
Peplau’s theory underscores the importance of the therapeutic relationship between nurse and patient, a crucial element in providing care for individuals with SUD. This patient population often endures stigma and mistrust, making it essential for healthcare providers to cultivate an atmosphere of trust and collaboration. By prioritizing these elements, healthcare professionals can significantly enhance patient engagement and adherence to treatment plans (McEwen & Wills, 2022).

Riegel’s Theory of Social Isolation in Chronic Illness
This theory sheds light on the profound effects of social isolation, which frequently complicates the health behaviors and overall outcomes of individuals with SUD. Many patients in this demographic experience isolation stemming from stigma and deteriorating personal relationships. Therefore, addressing these social determinants can lead to markedly improved recovery trajectories (Iovino et al., 2023).

Application of Theories to SUD

Peplau’s Theory of Interpersonal Relations

Peplau’s theory can be implemented in a structured manner throughout the caregiving process, which unfolds in three primary phases: orientation, working, and resolution.

 Orientation Phase: The initial interaction is crucial for establishing trust and defining recovery objectives. During this stage, for instance, a nurse can affirm the patient’s experiences and collaboratively establish concrete goals centered around achieving sobriety and overall well-being.

Working Phase: In this stage, the focus shifts toward collaborative engagement in developing and executing a care plan. This might entail educating the patient about substance withdrawal management techniques while actively encouraging participation in peer support groups.

Resolution Phase: The final stage involves supporting the patient's transition toward independent maintenance of sobriety. This could be facilitated through outpatient counseling sessions or by providing them with valuable self-management resources.

Peplau's framework emphasizes trust and empowerment, which is pivotal in diminishing stigma and enhancing patient engagement (McEwen & Wills, 2022).

Riegel’s Theory of Social Isolation in Chronic Illness

This theory focuses on identifying and addressing social isolation prevalent among patients suffering from SUD.

The first step is thoroughly evaluating the patient’s social support systems. For example, a nurse may uncover limited family involvement but recognize potential avenues for support through community resources.

Secondly, nurses can encourage patients to engage in group therapy sessions or peer support meetings to help rebuild their sense of community and belonging.

Lastly, utilizing technology, such as virtual support groups and telehealth services, offers a way to mitigate the effects of isolation for patients who reside in underserved regions, thereby enhancing their access to necessary care.

Riegel’s theory is instrumental in addressing the social estrangement frequently encountered by SUD patients and fostering robust social networks supporting recovery (Iovino et al., 2023).

Integration of Theories

To illustrate the practical application of these theories, consider a 30-year-old patient struggling with opioid use disorder and facing social isolation. Utilizing Peplau’s Theory, the nurse can develop a therapeutic relationship, guiding the patient in articulating recovery goals that encompass sobriety and the desire to mend fractured family ties. In alignment with Riegel’s Theory, the nurse can orchestrate family counseling sessions and promote connections with peer support