Nurse Practitioner Conceptions of Capability Providing Medication and Safe Supply for Opioid Use Disorder in Primary Care: A Phenomenographic Study
Bibliographic record
Abstract
AIMS: To explore how nurse practitioners experienced and understood development of their capability providing medication for opioid use disorder and safe supply in North American primary care settings. DESIGN: A phenomenographic approach was applied to the study design, recruitment, and analysis. METHODS: Semi-structured interviews were conducted with 21 nurse practitioners via Zoom between July and September 2022 to elicit participant experiences and understanding of capability development when treating opioid use disorder. Participants worked in primary care settings in New England, United States and Ontario, Canada. Data was analysed using a phenomenographic approach. RESULTS: Five categories of description representing conceptions of capability development in treating opioid use disorder were identified through iterative data analysis. Capability development was experienced as a process of developing foundational practice knowledge; integrating knowledge with existing practices; evolving practice perspectives; adaptation of practice and becoming expert. CONCLUSION: Capability attributes included creative thinking, risk taking and adapting existing practice in the service of person-centered care and harm reduction. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Nurse practitioners have potential to increase access to treatment for opioid use disorder and demonstrated ability and willingness to engage in this work. IMPACT: Nurse practitioners' participation as experts and leaders may be further leveraged in practice and policy development to enhance access to opioid use disorder treatment in primary care settings, including mentoring newer prescribers. REPORTING METHOD: Consolidated Criteria for Reporting Qualitative Studies (COREQ) EQUATOR guideline. PATIENT AND PUBLIC CONTRIBUTION: There were no patient or public contributions to this research study.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".