Optimizing Pain Care for Individuals with Opioid Use Disorder by Addressing Stigma in Nurses

Student summary

Why This Research Matters

This article introduces a research project focused on improving pain care for individuals with opioid use disorder (OUD) by addressing stigma among nurses. The problem it highlights is that while providing quality, patient-centered pain care is essential in nursing practice, this goal can be significantly obstructed for people with OUD due to both the complexities of managing their pain and pervasive societal and professional stigma. This stigma often stems from insufficient education about addiction, limited clinical training on treating individuals with substance use issues, and broader negative attitudes towards those with OUD. Such biases can compromise the quality of care delivered by nurses.

The research project aims to develop and pilot an intervention called Stigma-reduction Training and Addiction Resources for Registered Nurses (STAR-RN). This intervention is designed specifically for hospital-based nurses who play a critical role in assessing pain, advocating for relief, and making clinical decisions. STAR-RN will be co-developed with individuals who have lived experience of OUD and bedside nurses themselves to ensure it's clinically relevant, practical, and grounded in real-world contexts.

The project has two main aims: first, the development of the STAR-RN intervention itself; second, a pilot study to evaluate its feasibility (how easy is it to implement?), acceptability (do nurses find it useful and engaging?), and preliminary effectiveness. The success of this pilot will be measured by changes in several key areas among participating nurses: their level of stigma towards individuals with OUD, their knowledge about pain management for people with substance use issues, and their self-efficacy or confidence in making clinical decisions related to pain care for these patients.

For nursing students, it's important to understand the framing of this problem. The project acknowledges that nurses are on the front lines but may lack adequate preparation or face internalized biases regarding OUD. Students should appraise how this research directly addresses a gap in current practice and education by proposing an intervention co-created with end-users (nurses) and those affected by the issue (individuals with lived experience of OUD). The use of Intervention Mapping as a framework for development, along with community-based participatory research methods, suggests a structured yet collaborative approach to creating something that is both evidence-informed and practical.

Regarding source rights, it's crucial to note that this record comes from NIH RePORTER, which provides public project metadata. While the abstract gives details about the proposed intervention and its goals, it does not contain any actual research findings or data because it describes a *project summary* for funding purposes (a K23 award). The full text of such grant proposals is typically available through links like the one provided in the source URL: https://reporter.nih.gov/project-details/11369341. This means that while we can understand what the researchers plan to do and why it's important, we cannot assess its actual outcomes or effectiveness from this abstract alone.

A nurse would reason from this evidence by recognizing a critical need for targeted education and support within their profession. The STAR-RN project offers a potential solution to reduce stigma, thereby improving patient care experiences and clinical decision-making for individuals with OUD who are hospitalized. It underscores the importance of ongoing professional development in areas like addiction science and pain management, especially when these conditions intersect.

The article emphasizes that this work is innovative because it integrates both stigma reduction and pain content into a single, nurse-centered intervention designed specifically for hospital-based nurses—a group often overlooked in existing efforts to improve care for people with complex needs. The digital and modular format of STAR-RN also suggests potential for scalability and adaptability across different healthcare settings.

In summary, this research project is about tackling a significant barrier—stigma—to providing high-quality pain care for individuals with OUD by equipping nurses with better knowledge, resources, and confidence through the development of an evidence- and theory-informed training program. It highlights how addressing systemic issues like stigma can lead to improved patient outcomes in nursing practice.

Faculty notes

Educational Relevance

This NIH-funded K23 research project outlines a significant initiative aimed at enhancing pain care for individuals with opioid use disorder (OUD) by directly targeting nurse-related stigma, a known barrier to effective treatment. The core problem addressed is the dual challenge of complex pain management needs in OUD patients and the pervasive stigma held by nurses towards this population, which can compromise patient-centered care. This stigma often originates from insufficient education about addiction, limited clinical training on treating substance use disorders, and ingrained societal attitudes.

The project proposes to develop and pilot an intervention titled Stigma-reduction Training and Addiction Resources for Registered Nurses (STAR-RN). This is a critical step as nurses are pivotal in assessing pain, advocating for relief, and making crucial clinical decisions. STAR-RN will be co-developed with individuals who have lived experience of OUD and bedside nurses themselves using Intervention Mapping methodology and community-based participatory research approaches. This collaborative design ensures the intervention's relevance to real-world nursing practice.

The project has two specific aims: firstly, the development phase of the STAR-RN intervention; secondly, a pilot study designed to evaluate its feasibility (ease of implementation), acceptability (engagement by nurses), and preliminary effectiveness. The latter will be measured through changes in nurse-reported stigma towards individuals with OUD, their knowledge regarding pain management for this specific population, and their self-efficacy or confidence in making clinical decisions related to pain care during hospitalization.

The innovation of STAR-RN lies in its integration of both stigma reduction and specialized pain content into a unified, nurse-centered intervention. It is specifically tailored for hospital-based nurses, who represent an under-targeted workforce compared to other healthcare providers. The digital and modular nature of the training promises scalability and adaptability across various clinical settings.

This project aligns with NIDA's strategic priorities by identifying stigma as a modifiable barrier to care and focusing on pragmatic, provider-level solutions to improve outcomes for individuals facing complex pain and substance use needs in acute care environments. The K23 award itself signifies an investment in the principal investigator (Kara Pavone) to develop independent research skills in addiction science, intervention design, qualitative methods, and interdisciplinary team science.

For faculty, this project serves as a valuable model for designing interventions that address both knowledge deficits and attitudinal barriers within healthcare professions. It underscores the importance of involving end-users (clinicians) and affected populations (individuals with lived experience) in research aimed at improving clinical practice. The use of established frameworks like Intervention Mapping provides a robust structure for intervention development, while community-based participatory research enhances its potential impact by ensuring cultural competence and practical applicability.

The project's focus on hospital nurses is particularly noteworthy; this group often lacks targeted training despite their critical role in acute care settings where OUD patients frequently present. The pilot study design allows for initial assessment of the intervention's core components before potentially larger-scale implementation or further refinement.