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母亲重视孩子初级保健的哪些方面?对接受阿片类药物使用障碍治疗的女性观点的定性分析。

What aspects of their child's primary care do mothers value? A qualitative analysis of perspectives of women in treatment for opioid use disorder.

机构信息

Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA, USA.

College of Nursing, Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

Child Care Health Dev. 2021 Jan;47(1):40-46. doi: 10.1111/cch.12811. Epub 2020 Oct 5.

Abstract

BACKGROUND

Preventive paediatric healthcare is essential for infant and child health. Current research, however, suggests that the delivery of routine well child care (WCC) for children affected by maternal opioid use disorder (OUD) could be improved. How mothers perceive interactions with healthcare providers may help identify ways to modify the experience of WCC, which could ultimately improve healthcare utilization, patient satisfaction and clinical outcomes. The objective of this qualitative study was to assess perceptions of WCC among mothers in treatment for OUD.

METHODS

Four focus group sessions of 4-8 participants each (N = 22) were conducted. All study participants were receiving comprehensive behavioural and physical health support and care plus pharmacotherapy for OUD from a single outpatient treatment centre. Focus groups were semi-structured, with a standardized set of open-ended questions and follow-up prompts to engage participants in a fluid discussion. Participants were asked to identify and discuss important aspects of their youngest child's WCC and what they liked and disliked about their child's WCC. Grounded theory analysis was used to identify themes.

RESULTS

Several aspects of WCC were identified as important to the mothers. Main themes identified included (1) mother-provider relationship, (2) communication with healthcare team and (3) support for mother's OUD treatment. Participants discussed their desire to be heard and understood and wanted the entire healthcare team and clinic staff to see them as mothers first and foremost, not merely as individuals with OUD.

CONCLUSION

Future attempts to refine care may consider healthcare models that highlight open communication and personalized care and offer strong support and ongoing encouragement for the mother's OUD treatment and recovery process.

摘要

背景

预防儿科保健对于婴儿和儿童的健康至关重要。然而,目前的研究表明,对于受母体阿片类药物使用障碍(OUD)影响的儿童,常规的儿童保健(WCC)的提供可能需要改进。母亲如何看待与医疗保健提供者的互动,可能有助于确定如何改变 WCC 的体验,这最终可能会改善医疗保健的利用、患者满意度和临床结果。本定性研究的目的是评估接受 OUD 治疗的母亲对 WCC 的看法。

方法

共进行了 4 次每组 4-8 名参与者(N = 22)的焦点小组讨论。所有研究参与者均在一个门诊治疗中心接受全面的行为和身体健康支持以及 OUD 的药物治疗。焦点小组采用半结构化的方式,使用一套标准化的开放式问题和跟进提示,以促使参与者进行流畅的讨论。参与者被要求识别并讨论他们最小的孩子的 WCC 的重要方面,以及他们对孩子的 WCC 的喜欢和不喜欢之处。采用扎根理论分析来识别主题。

结果

确定了 WCC 的几个重要方面。确定的主要主题包括:(1)母亲与提供者的关系;(2)与医疗保健团队的沟通;(3)对母亲 OUD 治疗的支持。参与者讨论了他们被倾听和理解的愿望,并希望整个医疗保健团队和诊所工作人员首先将他们视为母亲,而不仅仅是患有 OUD 的个人。

结论

未来改进护理的尝试可以考虑强调开放沟通和个性化护理的医疗保健模式,并为母亲的 OUD 治疗和康复过程提供强有力的支持和持续的鼓励。

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