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Author ORCID Identifier



Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program


Year Degree Awarded


Month Degree Awarded


First Advisor

Zucker, Donna

Second Advisor

Jacelon, Cynthia

Third Advisor

Gerber, Daniel

Fourth Advisor

Kalmakis, Karen

Subject Categories

Medicine and Health Sciences | Mental and Social Health | Nursing | Psychiatric and Mental Health Nursing | Substance Abuse and Addiction


The primary aim of the exploratory case study was to explore the injection drug users’ experience with received nursing care while hospitalized on a medical unit. Data were gathered using semistructured interviews with nine injection drug users at two needle exchange services. Five men and four women were interviewed for 27–90 minutes. Travelbee’s (1971) interpersonal nursing model served as the theoretic framework for this study.

Data were analyzed through the process of coding, pattern matching, and the convergence of emerging themes. For the rival case, the theme of Understanding Addiction emerged. For the comparison cases, the overarching themes of Marginalization, Defensiveness, and Repeated Victimization were discovered. Subthemes of Feelings of worthlessness, Mistrust, Unpredictability of care, Self-care management and delay in seeking care were also examined.

The study findings reveal the cyclical process of marginalization, defensiveness, and repeated victimization that these nine injection drug users experienced when receiving care from a nurse on a medical unit. This study led to the findings that suggest that addiction-focused nursing education and role support, implementation of addiction-trained health care teams, and application of Travelbee’s (1971) theory were missing from the injection drug users’ hospital experience. Addiction-trained nurses are essential in providing culturally specific care for substance-dependent individuals across their addiction trajectory.