Identifying Clients’ Healthcare Needs

The key focus of many global governmental drugs programmes is to reduce the harms caused by substance use and implement health strategies that support people in their recovery (33, 34). This article will cover an evidence-based approach to identify clients’ needs during the development of the HAT recovery model. The steps for implementing a client-centred approach would usually involve two stages, the first is to understand the current health and social outcomes of the current treatment model and the second to engage clients in a two-way conversation about their own personal experiences and needs from their treatment.

Healthy Addiction Treatment (HAT) Recovery Model

When designing the HAT recovery model, it was important to understand the objective aspects of people’s lives; their general and mental health, social relationships, employment status, overall drug use data and the outcomes of the current nursing model. Another important point to consider was the accuracy of the information – if people are not forthcoming then any assessment is seriously flawed. The assessment of clients’ needs for the HAT recovery model was conducted using a survey encouraging people to be open, the interviewers were independent, and all responses were confidential (35).

The assessment survey was designed into two parts, the objective or quantitative data and the subjective or qualitative information. The first part asked questions on age, gender, nationality, country of birth, the level of school and tertiary education attained, main source of income, number of children under their care and accommodation status. Some people with addiction problems live chaotic lives, therefore it is important to understand the clients circumstances.

The Opiate Treatment Index (OTI)

The next part of the objective data focused on the outcomes of current treatment. This data was collected using an internationally validated questionnaire, The Opiate Treatment Index (OTI) (36). By using the OTI the outcomes of treatment could be compared and measured with people in treatment internationally (37). The OTI measured a client’s general health, their mental health, how well they were functioning socially in their daily lives, if they were engaging in any form of criminality, if they were engaging in HIV risk-taking behaviour and finally, the amount and type of drugs they were consuming on a weekly basis. Overall, the OTI assessment revealed people in treatment were generally stable, however, their overall anxiety and depression levels were more than twice what you would expect to find in the general population.

People in treatment may also have histories of childhood traumas. The family tree questionnaire provided information on grandparent and parental alcohol use to provide some historical background of the client’s exposure to possible adverse experiences.

Subjective Data

The second part, the subjective data, asked clients to provide information on their own specific experiences and needs in relation to working with the nurses in addiction services by asking them a number of open-ended questions. This data provided an insight on how clients were working with the addiction service and identified any gaps in the clients’ needs. For example, one of the questions asked, “What is your understanding of the nurse’s role in your treatment and your overall care in this clinic?”, and people were given the opportunity to talk openly and honestly about the role of the nurse in their treatment from their own personal experiences (35). The results of this part enabled the nursing service to understand whether the current focus of treatment was meeting a client’s needs and whether there were any unmet needs that should be addressed by the service.

Client-Centred Approach

Understanding and identifying the needs of people in a health service setting should have a client-centred approach. While this article presented information on how to identify clients’ needs for the development of the HAT recovery nursing model, the process followed a scientifically proven mixed method approach that is widely used in research (38). Firstly, it is important to identify whether the current focus of a service is meeting the needs of its clients, and this can be assessed using objective data. Secondly, getting feedback from the client’s own experiences from using the service and information on their specific needs provides important information to guide the provision of healthcare services.

References

<sup>17. Comiskey C, Galligan K, Flanagan J, Deegan J, Farnann J, Hall A. Clients’ views on the importance of a nurse-led approach and nurse prescribing in the development of the healthy addiction treatment recovery model. Journal of addictions nursing. 2019;30(3):169 – 76.
35. Comiskey C, Galligan K, McDonagh D. Developing an Addiction Nursing Model: An exploratory study examining the evolving role of the nurse and development of a relevant framework for practice within the addiction services. Unpublished2018.
36. Darke S, Hall W, Wodak A, Heather N, Ward J. Development and validation of a multi-dimensional instrument for assessing outcome of treatment among opiate users: the Opiate Treatment Index. British Journal of Addiction. 1992;87(5):733 – 42.
37. Darke S, Ross J, Teesson M. The Australian Treatment Outcome Study (ATOS): what have we learnt about treatment for heroin dependence? Drug Alcohol Rev. 2007;26(1):49 – 54.
38. Creswell JW, Plano Clark VL. Designing and Conducting Mixed Methods Research. Third ed. Los Angeles: Sage Publications; 2018.</sup>