Mechling Brandy M, Ahern Nancy R, Palumbo Ruthanne
School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina.
J Child Adolesc Psychiatr Nurs. 2018 Oct;31(2-3):53-60. doi: 10.1111/jcap.12209. Epub 2018 Oct 8.
Opioid use disorder (OUD) has reached epidemic proportions in the United States. Children of parents with OUD are an unrepresented population, who often suffer consequences from their parent's substance abuse disorder. Such children may incur numerous psychosocial and physical losses. Without intervention, they are more likely to be diagnosed with a mental illness and/or substance use disorder (SUD).
This paper examines the experiences of children of parents with OUD using Boss's theory of ambiguous loss (AL) as a lens.
Children growing up with a parent who has an OUD experience AL through that parent's physical absence and psychological presence (e.g., the parent is out opioid-seeking or in rehab or jail) and psychological absence but physical presence (e.g., the parent is high or in withdrawal, or is preoccupied with obtaining opioids). Evidence supports the fact that OUDs affect parenting, produce changes in the parent-child relationship, and often impact child development. Interventions that are child-focused are lacking.
The application of AL theory to this problem can enhance health professionals' understanding and need for developmentally specific interventions to care for this population. Interventions should focus on diminishing stigma and promoting psychosocial wellness and resiliency for children of parents with an OUD.
阿片类药物使用障碍（OUD）在美国已达到流行程度。患有OUD的父母的子女是一个未被关注的群体，他们经常因父母的物质使用障碍而遭受后果。这些孩子可能会遭受许多心理社会和身体上的损失。如果不进行干预，他们更有可能被诊断出患有精神疾病和/或物质使用障碍（SUD）。
本文以博斯的模糊丧失（AL）理论为视角，审视患有OUD的父母的子女的经历。
与患有OUD的父母一起长大的孩子会通过父母的身体缺席和心理存在（例如，父母外出寻找阿片类药物、在戒毒所或监狱）以及心理缺席但身体存在（例如，父母处于兴奋状态或正在戒毒，或一心只想获取阿片类药物）来体验AL。有证据支持这样一个事实，即OUD会影响养育方式，导致亲子关系发生变化，并常常影响儿童发育。目前缺乏以儿童为重点的干预措施。
将AL理论应用于这个问题可以提高卫生专业人员对为这一群体提供针对特定发育阶段的干预措施的理解和需求。干预措施应侧重于减少污名化，并促进患有OUD的父母的子女的心理社会健康和恢复力。
