How is Nursing Care Provided for Cardiovascular Patients with Substance Use Disorders?

Background: Patients with cardiovascular diseases who also suffer from substance use disorders face distinct challenges in nursing care. Similarly, nurses encounter various caregiving challenges. Therefore, this study aims to explore the nursing care process for patients with co-occurring cardiovascular diseases and substance use disorders. Materials and Methods: This grounded theory study, informed by Strauss and Corbin (2015), was conducted at the University of Social Welfare and Rehabilitation Sciences in 2023. The participants consisted of 23 nurses, patients, and other treatment team members, who were purposefully selected from the cardiac and internal cardiac intensive care units of hospitals in Iran. A total of 25 semi-structured interviews were conducted to collect data, with the primary question being: "How is nursing care provided to cardiac patients with substance use disorders?" The primary analysis strategies employed included constant comparison, data questioning, and memo writing. Results: The analysis revealed six main categories: the complexity of care, an inappropriate work environment, and insufficient nurse competency as conditions; discrimination in care and informal care as strategies; and nurse-patient dissatisfaction as consequences. Based on the findings, nurses employ unstructured care to address their most pressing concerns. Conclusions: Nurses encounter various challenges when caring for patients who receive ineffective and unstructured care, which often leads to adverse outcomes. Consequently, developing appropriate care guidelines is essential. Based on the study's findings, nurses, managers, and researchers can collaborate to enhance care quality and improve nurses' professional competence.