Life-Skills Training Program: Its Effect on Self-efficacy Among Patients With Substance Use Disorders
Phase: NA
Conditions: Substance Use Disorders
Sponsor: Ain Shams University

Life-Skills Training Program: Its effect on Self-efficacy among Patients with Substance Use 
Disorders 
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NCT number:         pending                                  document date:   1/4/2023 
 
Official title of the study: Life-Skills Training Program: Its effect on Self-
efficacy among Patients with Substance Use Disorders 
NCT number: Pending  
Date of the document: 1/4/2023 
 
 
 
 
 
 
 
 
 
 
 

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Disorders 
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Introduction 
Substance use disorders is episodic, with periods of abstinence, reduction 
of use, and relapse as the prevailing pattern, often with the course of events being 
influenced by external factors such as the availability of drugs and societal 
pressures (Sapkota, et al., 2019) 
Self-Efficacy (SE) plays an essential role in the maintenance of abstinence 
from drugs and alcohol which is a belief regarding one’s ability to successfully 
resist performing a behavior, and outcome expectancies, meaning the anticipated 
consequences of performing a behavior (Alanazi, et al., 2022). Also, Abstinence 
self-efficacy (ASE) as the belief individuals have in their ability to abstain from 
engaging in an undesired action. ASE includes an individual's level of confidence 
with their ability to abstain from substances for an extended period of time (Niles, 
et al., 2022). 
Overall, Self-efficacy addresses the individual’s perception of control of 
life events and is predictive of a person’s goals and performance and affected with 
negative things such as shame (Bahramabadian, Mojtabaie, & Sabet, 2021). 
Life skills are defined as a group of psychosocial competencies and 
interpersonal skills that help people make informed decisions, solve problems, 
think critically and creatively, communicate effectively, build healthy 

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relationships, empathize with others, and cope with and manage their lives in a 
healthy and productive manner (UNODC, 2023).  
Life skills may be directed toward personal actions or actions toward 
others, as well as toward actions to change the surrounding environment to make it 
conducive to health (WHO, 2023). Bearing the WHO definition in mind, the Basic 
Life Skills curriculum offers youth the emotional, social, and intellectual tools 
needed to achieve success in life – on personal level, interpersonal level, also, 
within their community and workplaces (UNICEF. 2023) 
Drug users often have problems with social and interpersonal relationships. 
The lack of adequate social relationships for patients’ will should various 
negative personal and social consequences for patients’ health, their families, 
friends, and society. Life skills training could effectively improve their social 
communication with parents, family, and friends. Life skills training should be part 
of addiction prevention training programs (Ebrahem, Radwan, & El Amrosy, 
2022). 
Life-skills training program designed to prevent substance use relapse which 
typically combine training about self-management skills (e.g., coping with stress), 
social skills (e.g., assertiveness), and skills to enhance resistance to substance use 
(e.g., opposing peer pressure to use substances) (Paz Castro, et al., 2022).          

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Participation in life skills workshops provides an opportunity for drug addicts to 
meet and communicate with others who have the same problem. The participants 
can share their remedies and approaches to deal with drug abuse, avoid recurrence, 
and handle cravings. They could provide multiparty support to improve the chance 
of keeping away from the drug. Moreover, intra-network social supports are 
against the sense of seclusion, isolation and foster interpersonal relationships 
(Jahanbin, et al., 2017) 
Nurses are well placed to serve a key role in teams seeking to help 
individuals to avoid relapses. They often had critical knowledge about the 
community resources and trends. Also, their ability to provide a wide range of 
interventions ranging from supportive therapy to medical interventions often 
proves to be an asset to patients (Guenzel & McChargue, 2022) 
 
 
 
 
 
 
 

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Significant of the study 
Substance use disorders are highly prevalent among youth and adult 
populations. It is estimated that 10% of adolescents and between 20% and 30% of 
adults (Centers for Disease Control CDC, 2021). The prevalence of substance use 
disorders is 5.9% in Egypt, the population between 15-25 is the most exposed to 
substance abuse and between 25-35 years is the most requested for treatment 
(Addiction Treatment and Abuse Fund, 2022). Relapse rates after treatment have 
been shown in other surveys to be as high as 40–75% in the 3 weeks to 6 months 
following treatment (Moradinazar, et al., 2020). 
The recovery (management and rehabilitation) processes from substance use 
disorders are not inclusive enough and confine members to physical attendance for 
the purpose of detoxification, neglecting the important factors such as life skills, 
social, cultural, economic, environmental, and family factors. Since after 
detoxification of the substances users return to their family and society, there can’t 
be expect a perfect quit without considering these factors carefully (Jepkorir, 
2023). 
Life skill educational program to enhance self-efficacy as a preventive 
approach in which it focuses on the development of personal and social skills. 
Previous studies revealed that there were few studies about the effects of life skills 
training on relapse prevention among patients with substances use disorders 

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(Volkow, 2020).  Therefore, the present study is an attempt to introduce a safe and 
reasonable training program that help patients with substance use disorders to 
enhance abstinence self-efficacy.  
Aim of the study 
The study aims: to evaluate the effect of life-skills training program on self-
efficacy among patients with substance use disorders. 
The aim of this study will be achieved through the following objectives: 
1- Assessing self-efficacy among patients with “substance use disorders”. 
2- Assessing risk for relapse among patients with “substance use disorders”. 
3- Developing life skills training program for self-efficacy among patients 
with substance-use disorders based on identified their needs. 
4- Implementing the developed life skills training program of relapse 
prevention among patients with substance-use disorders. 
5- Evaluating the effect of implementing life skills training program on self-
efficacy among patients with “substance-use disorders”. 
Research Hypothesis 

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Life skills training program will have a positive effect on self-efficacy among 
patients with substance-use disorders. 
 
Subjects & Methods 
Study design 
A quasi-experimental research design on one group (pre-post) test will be 
used to conduct the current study. 
Study setting 
The study will be conducted at Alabbasya Mental Health Hospital in Cairo. It 
is the oldest and biggest hospital for psychiatric illnesses in Egypt, affiliated to 
General Secretariat of Mental Health and Addiction Treatment of the Ministry of 
Health. It was established in 1883 A.D over an area of 68 acres. Its capacity is 
1950 beds. The hospital structure is divided into such as, sections: Twenty-one old 
free sections, four illegal sections (forensic), two new buildings one of them for 
males that included addiction treatment and rehabilitation department in new 
building (2nd -3rd -4th) floor included detox ward about 30 bed, rehabilitation ward 
60 bed, and dual ward, and another one for females. also, clinics such as, 
outpatient clinic - addiction clinic - children clinic - adolescent clinic - daycare 

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clinic - aging clinic - dental clinic - electroencephalogram clinic and electro 
compulsive therapy clinic. 
 
 
Subjects 
A purposive sample will be obtained from patients with “substances use 
disorders” who meet inclusion criteria during their existence in the previously 
mentioned setting. 
Inclusion criteria: 
- 
Age: from 20 years to 50 years. 
- 
Had history of one episode of relapse 
- 
Free from any physical disease such as diabetes, hypertension, viral 
hepatitis etc.) 
- 
Free from other Psychiatric disorders. 
Sample size 
Based on power analysis; Type I error (α) =0.05 with confidence level (1-α) 
=0.95 and Type II error (β) = 85%, by power test (1- β) =0.15, sample size was 

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calculated according to the following equation that has been adopted from (Gupta, 
et al, 2016) 
N= 𝟐(𝒁𝜶+ 𝐱[𝟏ି𝛃])𝟐× 𝑺𝑫𝟐/𝒅𝟐 
Where: n is the sample size, Zα and Z (1-β) are constant values for 
convention values of α and β values where Zα =1.96 when α=0.05 and Z (1-β) 
=1.036 when β =0.20, SD is the standard deviation obtained from previous study 
Moshki, et al., (2014) and d is the effect size. 
N= 2(1.96 + 1.03)ଶ× 7.7ଶ/5ଶ =42.4 
Therefore, the minimal sample size was found to be =50 participants  
Tools of data collection 
Tool I: Interview Questionnaire 
It will be designed by the researcher and reviewed by supervisors. It will be 
written in the Arabic language for gathering data in relation to the following parts: 
Patients' characteristics. such as age, marital status, residence, 
qualifications, starting and years of substance use…. etc. 
Clinical data (addiction History). about substances as types of substance, 
onset, duration, route, etc. 
Tool II: Alcohol Abstinence Self-Efficacy Scale (AASE) 

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It was adapted by the researcher from DiClemente et al., (1994) to assess 
personal confidence against taken substance. It consists of 40 items for assessing 
self-efficacy. It includes 4 domain parts unranked: negative effect (1-5-9-13-17-21-
25-29-33-37), social/positive situations (2-6-10-14-18-22-26-30-34-38), physical 
and other concern (3-7-11-15-19-23-27-31-35-39),  and craving and urges(4-8-12-
16-20-24-28-32-36-38). Every domain includes 10 items. 
Scoring system. Each statement was rated on 5 points as a Likert Skill Scale 
ranged by statistical from (1) No Confidence, (2) Low Confidence, (3) Middle 
Confidence, (4) High Confidence, and (5) Excellent Confidence. The total score 
ranged from 40:200 ranged as, Low self-efficacy 40 < 120, Middle self-efficacy 
121 < 160, and High self-efficacy 161 < 200. 
Validity: 
     The one tool will be formulated and submitted to (5) experts in psychiatric and 
mental health nursing or other specialty who will review the content of the tools 
for their comprehensiveness, accuracy, clarity, and relevance. 
Reliability: 
Cronbach’s Alpha will be used to determine the internal reliability of the tool. 
 
Preparatory Phase 

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This phase will be included reviewing of literature related to substance use 
disorder, relapse prevention, this served study tools for data collection. During this 
phase, the researcher also will be visited the selected place to be acquainted with 
the staff and the study settings.  
Ethical considerations: 
Research approval obtained from the faculty of Nursing- Ain Shams 
University Ethical Committee before starting the study. The researcher explained 
the aim and objectives of the study to patients with substance use disorder included 
in the study before starting. Written approval obtained from patients with 
substance use disorders before inclusion in the study. They guarantee that all the 
gathered data will be used confidentially and will be used for research purposes 
only. The researcher maintain anonymity and confidentiality of subjects’ data 
included in the study. Patients with substance use disorder will be informed that 
they allow for withdrawal from study at any time. 
Administrative design 
Approval will be obtained through an issued letter from the dean of faculty of 
nursing to directors of the previously mentioned setting. The researcher will be met 
by the director to explain the purpose and methods of data collection and obtain 
participants consent of share in the study after explain anything such as, related to 
study and rights of withdrawal, free from harm. Data collected from the studied 
sample will be revised, coded, and entered using a personal computer (PC). 

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Computerized data entry and statistical analysis will be conducted using the 
statistical package for social sciences (SPSS). 
Pilot study 
The pilot study will be done on 10% (5 Patients) of the sample to examine 
the clarity of tools and to estimate time needed to fill in the study tools. Based on 
the results, modifications will be done (if necessary). Subjects included in the pilot 
study will be excluded from the study if major modifications are required. 
Field work 
- 
The researcher will explain the aim of the study and the components of 
the tools to the studied patients. 
- 
The researcher will distribute a questionnaire to the studied patients to 
assess their self-efficacy. 
- 
The researcher will distribute a questionnaire to the patients studied to 
assess the risk of relapse. 
- 
The researcher trained patients in improving their life-skills. 
Life-skills Training Program  
Life-Skills Training program will be developed by the researcher and 
reviewed by supervisors for Enhance self-efficacy among patients with substance 
use disorders. After reviewing the past and current related literature through 

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teaching the patients how to identify, plan and participate in relapse prevention. 
The program will cover an overview of substance use disorders, relapse 
prevention, self-efficacy, and many of life skills such as problems solving, 
assertiveness, negotiation, refusal, time management, meditation, emotional 
regulations, and non-violence communication skills.  
Results 
The results of the study will be presented in tables and figures that are easy to 
understand and will be analyzed for inferring information and the proper 
comments will be stated. 
Discussion 
The results will be discussed in the light of available national and 
international studies. 
Conclusion 
It will be derived from the finding of the study based on the research  
hypothesis. 
Recommendations 
It will be derived from the discussion based on the findings of the study. 
Summary 

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It will include a brief description of the study process. 
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