Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.
Res Nurs Health. 2021 Aug;44(4):664-671. doi: 10.1002/nur.22140. Epub 2021 May 16.
Canada is currently in the midst of an overdose crisis. With new and innovative approaches desperately needed, injectable opioid agonist treatment (iOAT) should be considered as an integral treatment option to prevent even more fatalities. These programs provide injectable diacetylmorphine or hydromorphone to clients with severe opioid use disorders. Currently, they remain an under-executed and under-studied treatment modality. To better understand why this may be, we performed an evolutionary concept analysis as described by Rodgers. The attributes, antecedents, consequences, and surrogate terms of iOAT were unpacked and explored. Further, four themes were identified within the literature: (1) physical and mental health, (2) illicit drug use, (3) criminal behavior, and (4) ethical considerations. Recommendations surrounding the need for additional studies that focus on the perspectives of people who use opioids (PWUO), the necessity of nursing advocacy in iOAT, and the consideration of a changing illicit drug supply were explored. Further, theoretical analysis coupled with direct input from PWUO was discussed as a necessity to move forward with iOAT.
加拿大目前正处于阿片类药物过量危机之中。由于迫切需要新的创新方法，注射用阿片类激动剂治疗（iOAT）应该被视为一种完整的治疗选择，以防止更多的死亡。这些方案为有严重阿片类药物使用障碍的患者提供注射用二乙酰吗啡或氢吗啡酮。目前，它们仍然是一种执行不力和研究不足的治疗方式。为了更好地理解其中的原因，我们按照罗杰斯的描述进行了进化概念分析。对 iOAT 的属性、前因、后果和替代术语进行了剖析和探讨。此外，在文献中还确定了四个主题：（1）身心健康，（2）非法药物使用，（3）犯罪行为，（4）伦理考虑。探讨了围绕需要进行更多研究的建议，这些研究应侧重于使用阿片类药物的人的观点、在 iOAT 中护理倡导的必要性，以及考虑不断变化的非法毒品供应的问题。此外，还讨论了理论分析与使用阿片类药物者的直接投入相结合的必要性，以推进 iOAT 的发展。
