信任在物质使用障碍患者中推荐给成瘾咨询服务的医院医生：混合方法研究。

Trust in Hospital Physicians Among Patients With Substance Use Disorder Referred to an Addiction Consult Service: A Mixed-methods Study.

机构信息

Department of Biomedical Engineering, School of Medicine, Oregon Health and Science University, Portland, OR (CK), MD/PhD Program, School of Medicine, Oregon Health and Science University, Portland, OR (CK), Department of Sociology, University of Washington, Seattle, WA (DC), Department of Medicine, Oregon Health and Science University, Portland, OR (AP, CN, HE), School of Social Work, Portland State University, Portland, OR (CN).

出版信息

J Addict Med. 2022;16(1):41-48. doi: 10.1097/ADM.0000000000000819.

DOI:10.1097/ADM.0000000000000819

PMID:33577229

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8349928/

Abstract

BACKGROUND

Trust is essential in patient-physician relationships. Hospitalized patients with substance use disorders (SUDs) often experience stigma and trauma in the hospital, which can impede trust. Little research has explored the role of hospital-based addictions care in creating trusting relationships with patients with SUDs. This study describes how trust in physicians changed among hospitalized people with SUDs who were seen by an interprofessional addiction medicine service.

METHODS

We analyzed data from hospitalized patients with SUD seen by an addiction consult service from 2015 to 2018. Participants completed surveys at baseline and 30 to 90 days after hospital discharge. Follow-up assessments included open-ended questions exploring participant experiences with hospitalization and the addiction consult service. We measured provider trust using the Wake Forest Trust scale. We modeled trust trajectories using discrete mixture modeling, and sampled qualitative interviews from those trust trajectories.

RESULTS

Of 328 participants with SUD who had prior hospitalizations but had not previously been seen by an addiction consult service, 196 (59.8%) had both baseline and follow-up trust scores. We identified 3 groups of patients: Persistent-Low Trust, Increasing Trust, and Persistent-High Trust and 4 qualitative themes around in-hospital trust: humanizing care, demonstrating addiction expertise, reliability, and granting agency.

CONCLUSIONS

Most participants retained or increased to high trust levels after hospitalization with an addiction consult service. Addiction consult services can create environments where healthcare providers build trust with, and humanize care for, hospitalized patients with SUD, and can also mitigate power struggles that hospitalized patients with SUD frequently experience.

摘要

背景

信任是医患关系的基础。患有物质使用障碍（SUD）的住院患者在医院经常经历耻辱和创伤，这可能会阻碍信任的建立。很少有研究探讨基于医院的成瘾治疗在与患有 SUD 的患者建立信任关系方面的作用。本研究描述了在接受跨专业成瘾医学服务的患有 SUD 的住院患者中，医生信任度是如何变化的。

方法

我们分析了 2015 年至 2018 年期间接受成瘾咨询服务的患有 SUD 的住院患者的数据。参与者在基线和出院后 30 至 90 天完成了调查。随访评估包括探索参与者住院和成瘾咨询服务体验的开放性问题。我们使用维克森林信任量表来衡量提供者信任度。我们使用离散混合模型来模拟信任轨迹，并从这些信任轨迹中抽取定性访谈。