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阿片类物质使用障碍治疗中的女性产后和成瘾康复:一项定性研究。

Postpartum and addiction recovery of women in opioid use disorder treatment: A qualitative study.

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.

Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA.

出版信息

Subst Abus. 2022;43(1):389-396. doi: 10.1080/08897077.2021.1944954. Epub 2021 Jul 2.

Abstract

Postpartum is a highly vulnerable time for women with opioid use disorder (OUD). Our primary objective was to identify patient and provider reported aspects of the pregnancy to postpartum transition that impact recovery progress for postpartum women receiving medication for opioid use disorder (MOUD). This qualitative study consisted of semi-structured interviews with postpartum women in OUD treatment ( = 12) and providers ( = 9) at an outpatient addiction clinic. Interviews were transcribed and analyzed using an editing style approach to report themes and quotes. Patients and providers identified different themes that both promote and challenge recovery during the postpartum transition. These comprised of clinical factors, including MOUD, neonatal opioid withdrawal syndrome (NOWS) and pain associated with labor and delivery as well as psychosocial factors, such as role of a support system, mental health aspects of anxiety and depression causing mood changes, stigma and mistrust among healthcare providers and child welfare. Patients receiving MOUD and their providers identified multiple aspects unique to the postpartum transition that substantially strengthen and/or oppose OUD recovery. These aspects impacting recovery include factors specific to the receipt of MOUD treatment and those not specific to MOUD, yet tied to the postpartum state. Overall, these findings provide insight into areas for future research focused on identifying opportunities to promote recovery-oriented care for families affected by OUD.

摘要

产后是患有阿片类药物使用障碍(OUD)的女性高度脆弱的时期。我们的主要目标是确定影响接受阿片类药物使用障碍药物治疗(MOUD)的产后妇女康复进展的与妊娠到产后过渡期相关的患者和提供者报告的方面。这项定性研究包括对在门诊成瘾诊所接受 OUD 治疗的产后妇女( = 12)和提供者( = 9)进行半结构化访谈。使用编辑风格方法对访谈进行转录和分析,以报告主题和引述。患者和提供者确定了在产后过渡期促进和挑战康复的不同主题。这些主题包括临床因素,如 MOUD、新生儿阿片类药物戒断综合征(NOWS)和与分娩相关的疼痛,以及心理社会因素,如支持系统的作用、焦虑和抑郁等心理健康方面导致情绪变化、医疗保健提供者和儿童福利机构之间的耻辱感和不信任。接受 MOUD 的患者及其提供者确定了产后过渡期特有的多个方面,这些方面极大地加强和/或反对 OUD 康复。这些影响康复的因素包括 MOUD 治疗特有的因素和非 MOUD 特有的因素,但与产后状态有关。总的来说,这些发现为未来的研究提供了一些见解,重点是确定促进受 OUD 影响的家庭康复为导向的护理的机会。

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