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城乡社区门诊酒精治疗的获取障碍。

Barriers in the access to alcohol treatment in outpatient clinics in urban and rural community.

作者信息

Wieczorek Łukasz

机构信息

Zakład Badań nad Alkoholizmem i Toksykomaniami IPiN w Warszawie.

出版信息

Psychiatr Pol. 2017 Feb 26;51(1):125-138. doi: 10.12740/PP/60345.

DOI:10.12740/PP/60345
PMID:28455900
Abstract

OBJECTIVES

The aim of the study was identification of the barriers making it notably more challenging to access clinics in urban and rural communities.

METHODS

The method, which was used in this study adopts the qualitative research perspective. The research tool was an interview with a standardized list of desired information. The interviews were conducted with alcohol dependent patients and therapists. 64 interviews were performed in two outpatient clinics located in Warsaw, and in rural area.

RESULTS

Respondents identified similar barriers for the clinics located in Warsaw and in the rural community. Those were: shame associated with seeking help, waiting time for stationary support, meeting intensity, and general clinic condition. Barriers identified by respondents from Warsaw were associated with long waiting time for outpatient treatment and individual appointment, therapeutic offer excluding deaf and mentally ill individuals from the therapy, and unattractive program requiring complete abstinence. Barriers in access to treatment spotted by the respondents from the rural community related to the lack of anonymity of treatment associated with too low number of clinics in the district, lack of choice in terms of preferred facility, commutation time and costs, as well as no inter-institutional cooperation.

CONCLUSIONS

The barriers identified in the study were similar to the ones specified in the research conducted in Poland in the 1990s, and at the end of first decade of 21st century. Barriers were psychological in character and had the form of internal withdrawal and anxiety to start treatment. Certain structural barriers were indicated as well.

摘要

目的

本研究旨在确定那些使得在城市和农村社区就医显著更具挑战性的障碍因素。

方法

本研究采用的方法是定性研究视角。研究工具是一份包含所需信息标准清单的访谈。访谈对象为酒精依赖患者和治疗师。在华沙的两家门诊诊所及农村地区进行了64次访谈。

结果

受访者指出,位于华沙的诊所和农村社区的诊所存在相似的障碍。这些障碍包括:寻求帮助时的羞耻感、住院治疗支持的等待时间、会面强度以及诊所的总体状况。来自华沙的受访者指出的障碍与门诊治疗和个人预约的长时间等待、治疗方案将聋人和精神疾病患者排除在外、要求完全戒酒的缺乏吸引力的项目有关。农村社区的受访者发现的治疗获取障碍与所在地区诊所数量过少导致治疗缺乏匿名性、在首选机构方面缺乏选择、通勤时间和成本以及机构间缺乏合作有关。

结论

本研究中确定的障碍与20世纪90年代以及21世纪第一个十年末在波兰进行的研究所指明的障碍相似。这些障碍具有心理性质,表现为内心的退缩以及对开始治疗的焦虑。同时也指出了某些结构性障碍。

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