Date of Award

2023

Document Type

Project

College/School

College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Dr. Courtney Foss

Readers

Eric Fox

Abstract

Purpose: The purpose of this project was to explore OUD patient-reported factors for motivation and retention in a medication-assisted treatment (MAT) program in the Seattle metropolitan area. Method: This mixed methods project collected data via an exploratory, preliminary survey from patients receiving treatment at 11 outpatient medication for opioid use disorder (MOUD) clinics located in three counties in Washington state. The survey contained both qualitative and quantitative questions that addressed factors of motivation, external support, and self-efficacy. The survey was sent via a secure text messaging system. Results: Qualitative analysis developed five themes after coding: supportive factors for retention, health recommendations, risk recognition, motivation, and self-actualization. These themes were consistent with the literature review and the Behavioral Health Model Framework used to guide this project. The quantitative analysis using a Chi-Square analysis tool showed a statistically significant relationship between the “strongly agree” response to confidence in the MOUD program and personal motivation for recovery “I can do this” (p = .027). The second statistically significant relationship was between replying “strongly agree” to sharing experience with other program participants and picking “learning to manage triggers” as a factor that made recovery easier for the patients (p= .01). Implications: Project findings highlighted ARNP practice should steer away from more paternalistic, “scare” -motivation or behavioral change coaching models with OUD patients. Using motivational interviewing skills may better enhance a patient's personal agency and help to foster self-efficacy and self-actualization in patients to improve program retention and patient recovery.

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