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吸毒者如何体验治疗?对初级保健中阿片类药物替代治疗观点的定性分析(iCARE研究)。

How do people who use drugs experience treatment? A qualitative analysis of views about opioid substitution treatment in primary care (iCARE study).

作者信息

Alves Paula Cristina Gomes, Stevenson Fiona A, Mylan Sophie, Pires Nuno, Winstock Adam, Ford Chris

机构信息

Institute for Lifecourse Development, University of Greenwich, London, UK

Primary Care and Population Health, University College London, London, UK.

出版信息

BMJ Open. 2021 Feb 10;11(2):e042865. doi: 10.1136/bmjopen-2020-042865.

Abstract

OBJECTIVE

To understand the most significant aspects of care experienced by people in opioid substitution treatment (OST) in primary care settings.

DESIGN

Semistructured individual interviews were conducted, following the critical incidents technique. Interview transcripts were analysed following a thematic analysis approach.

PARTICIPANTS

Adults aged 18 years or older, receiving OST in UK-based primary care services.

RESULTS

Twenty-four people in OST were interviewed between January and March 2019. Participants reported several aspects which were significant for their treatment, when engaging with the primary care service. These were grouped into 10 major themes: (1) humanised care; (2) individual bond/connection with the professional; (3) professionals' experience and knowledge; (4) having holistic care; (5) familiarity; (6) professionals' commitment and availability to help; (7) anonymity; (8) location; (9) collaborative teamwork; and (10) flexibility and changes around the treatment plan.

CONCLUSIONS

This study included first-hand accounts of people who use drugs about what supports them in their recovery journey. The key lessons learnt from our findings indicate that people who use drugs value receiving treatment in humanised and destigmatised environments. We also learnt that a good relationship with primary care professionals supports their recovery journey, and that treatment plans should be flexible, tailor-made and collaboratively designed with patients.

摘要

目的

了解在初级保健机构接受阿片类药物替代治疗(OST)的患者所体验到的护理中最重要的方面。

设计

采用关键事件技术进行半结构化个人访谈。访谈记录采用主题分析方法进行分析。

参与者

年龄在18岁及以上、在英国初级保健服务机构接受OST治疗的成年人。

结果

2019年1月至3月期间,对24名接受OST治疗的患者进行了访谈。参与者报告了在与初级保健服务机构接触时,对其治疗具有重要意义的几个方面。这些方面被归纳为10个主要主题:(1)人性化护理;(2)与专业人员的个人联系/纽带;(3)专业人员的经验和知识;(4)获得全面护理;(5)熟悉感;(6)专业人员提供帮助的承诺和可及性;(7)匿名性;(8)地点;(9)团队协作;(10)治疗计划的灵活性和变更。

结论

本研究纳入了吸毒者关于在康复过程中得到何种支持的第一手叙述。从我们的研究结果中吸取的关键经验教训表明,吸毒者重视在人性化且无歧视的环境中接受治疗。我们还了解到,与初级保健专业人员建立良好关系有助于他们的康复进程,并且治疗计划应该灵活、量身定制并与患者共同设计。

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