“戒酒等于摆脱丙型肝炎”：一项探索住院成年人物质使用障碍和丙型肝炎相互作用的定性研究。
"Sobriety equals getting rid of hepatitis C": A qualitative study exploring the interplay of substance use disorder and hepatitis C among hospitalized adults.
机构信息
School of Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States.
Department of Medicine, Division of General Internal Medicine, Section of Addiction Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States.
出版信息
J Subst Abuse Treat. 2021 Aug;127:108337. doi: 10.1016/j.jsat.2021.108337. Epub 2021 Feb 25.
BACKGROUND
People who use drugs (PWUD) commonly experience complex illness, psychosocial stressors, housing insecurity, and stigma, which may play key roles in their struggles with addiction. In a study of hospitalized PWUD with hepatitis C virus infection (HCV), participants described treating HCV as "part of recovery." These findings led us to explore how hospitalization and acute illness altered patients' perceptions of substance use disorder (SUD) and HCV.
METHODS
Researchers audio recorded in-depth semi-structured individual interviews of 27 hospitalized adults with SUD and HCV seen by an addiction consult service (ACS) at an urban academic medical center between June and November 2019. Research staff transcribed interviews and dual coded them deductively and inductively at the semantic level. Researchers used a matrix visualization to discern relationships among codes and conducted a thematic analysis.
RESULTS
Many participants believed addictions treatment should precede an HCV cure for varying reasons. Some wanted to avoid reinfection; others believed "getting clean" afforded the mental clarity to address health issues, including HCV. Patients newly engaged in SUD treatment described HCV treatment as a "step towards recovery" and could serve as motivation to continue SUD treatment. Participants believed HCV cure could facilitate sobriety by "mentally putting drugs in the past" and was a future-oriented action toward "better health." Many participants described the compounded stigma of having HCV infection and SUD by multiple groups, including friends/family who do not use drugs, other drug users, and health care workers.
CONCLUSION
Hospitalized adults with SUD and HCV believed addictions engagement should precede HCV treatment and HCV cure could play an important role in their "recovery" journey. Discussing HCV treatment during hospitalization may be an opportunity to support engagement in SUD treatment and targets an untreated patient population critical for achieving HCV elimination.
背景
吸毒者（PWUD）通常患有复杂的疾病、心理社会压力、住房不安全和污名化，这些因素可能在他们的成瘾斗争中起着关键作用。在一项对患有丙型肝炎病毒感染（HCV）的住院吸毒者的研究中，参与者将治疗 HCV 描述为“康复的一部分”。这些发现促使我们探讨住院和急性疾病如何改变患者对物质使用障碍（SUD）和 HCV 的看法。
方法
研究人员对 2019 年 6 月至 11 月期间在城市学术医疗中心的成瘾咨询服务（ACS）就诊的 27 名患有 SUD 和 HCV 的住院成年人进行了深入的半结构化个人访谈，并对访谈进行了录音。研究人员将访谈转录，并在语义层面上进行了演绎和归纳双重编码。研究人员使用矩阵可视化来辨别代码之间的关系，并进行了主题分析。
结果
许多参与者认为，出于各种原因，成瘾治疗应该先于 HCV 治疗。一些人希望避免再次感染；另一些人则认为“戒毒”可以提供精神上的清晰，从而解决包括 HCV 在内的健康问题。新开始接受 SUD 治疗的患者将 HCV 治疗描述为“康复之路”，并可以作为继续 SUD 治疗的动力。参与者认为 HCV 治愈可以通过“从心理上将毒品抛在过去”来促进戒酒，并将其作为“更好的健康”的面向未来的行动。许多参与者描述了 HCV 感染和 SUD 受到来自多个群体的双重污名化，包括不吸毒的朋友/家人、其他吸毒者和医疗保健工作者。
结论
患有 SUD 和 HCV 的住院成年人认为，应该先进行成瘾治疗，而 HCV 治疗可以在他们的“康复”之旅中发挥重要作用。在住院期间讨论 HCV 治疗可能是支持 SUD 治疗参与的机会，并针对一个对于实现 HCV 消除至关重要的未治疗患者群体。
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