Departments of Psychiatry and Medicine, University of Rochester School of Medicine, Women's Initiative Supporting Health, Center for Community Health, Rochester, NY 14642, USA.
J Subst Abuse Treat. 2014 Feb;46(2):150-7. doi: 10.1016/j.jsat.2013.08.017. Epub 2013 Sep 24.
We explored healthcare-related experiences of women drug court participants through combining context from the socio-ecological model with motivation needs for health behavior as indicated by self-determination theory. Five focus groups with 8 women drug court participants, 8 court staff, and 9 community service providers were examined using qualitative framework analysis. Themes emerged across the socio-ecological model and were cross-mapped with self-determination theory-defined motivation needs for autonomy, relatedness, and competence. Socio-ecological levels contained experiences either supporting or eroding women's motivation needs: (1) intrapersonal challenges participants termed an "evil cycle" of relapse, recidivism, trauma, and life challenges; (2) interpersonal context of parenting and stigma involving features of this "evil cycle"; (3) institutions with logistical barriers to legal and medical assistance; (4) community resources inadequate to support living and employment needs. Self-determination theory helps explain motivation required to address the women's healthcare needs and multiple demands at all levels of the socio-ecological model.
我们通过将社会生态模型中的背景与自我决定理论所表明的健康行为动机需求相结合，探索了女性参与药物法庭的与医疗保健相关的经验。对 8 名女性药物法庭参与者、8 名法庭工作人员和 9 名社区服务提供者进行了 5 次焦点小组讨论，采用定性框架分析法进行了研究。主题出现在社会生态模型中，并与自我决定理论定义的自主、相关和能力的动机需求进行了交叉映射。社会生态层面包含了支持或削弱女性动机需求的体验：（1）个体内部挑战，参与者称之为“恶性循环”，即复发、累犯、创伤和生活挑战；（2）涉及这种“恶性循环”特征的亲子关系和污名化的人际环境；（3）机构存在法律和医疗援助方面的后勤障碍；（4）社区资源不足以满足生活和就业需求。自我决定理论有助于解释为满足女性医疗保健需求和社会生态模型各个层面的多重需求所需的动机。
