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阿片类药物使用者母亲的情境风险和心理社会特征:一项混合方法研究。

Contextual risk and psychosocial profiles of opioid-using mothers: A mixed-methods study.

机构信息

Department of Child and Family Studies, University of Tennessee Knoxville, Knoxville, TN, USA.

Department of Neonatology, East Tennessee Children's Hospital, Knoxville, TN, USA.

出版信息

Womens Health (Lond). 2021 Jan-Dec;17:17455065211060624. doi: 10.1177/17455065211060624.

Abstract

INTRODUCTION

There is an increase in cases of mothers using opioids during pregnancy in the United States but research investigating mothers' psychosocial environments along with individual variability among this high-risk group of women is scarce.

METHODS

This mixed-methods study aims to examine the complex interplay of contextual risks and experiences of opioid-using mothers. A sample of 50 opioid-using biological mothers of infants diagnosed with neonatal opioid withdrawal syndrome (NOWS) were studied using a set of standardized and open-ended questions, along with medical records extraction.

RESULTS

A high-risk subgroup of 36 mothers was identified using cluster analysis, characterized by a distinct profile of psychosocial risk. Thematic content analysis revealed four themes: (1) barriers to communication and mistrust of health professionals, (2) limitations of access to health care and the amplification of disadvantages related to COVID-19, (3) lifelong consequences of adverse childhood experiences (ACEs), and (4) intimate partner violence and its influence on drug use.

CONCLUSION

Our findings highlight important information toward health services provision for opioid-using women of childbearing age. Efforts to reduce opioid usage in mothers need to consider psychosocial and contextual risks.

摘要

引言

在美国,孕妇使用阿片类药物的案例有所增加,但针对这一高风险孕妇群体的社会心理环境以及个体差异的研究却很少。

方法

本混合方法研究旨在探讨阿片类药物使用母亲的复杂环境风险和经历之间的相互作用。对 50 名被诊断为新生儿阿片戒断综合征(NOWS)的婴儿的阿片类药物使用生物母亲进行了研究,采用了一组标准化和开放式问题以及病历提取。

结果

使用聚类分析确定了一个高危亚组的 36 名母亲,其特征是存在明显的社会心理风险特征。主题内容分析揭示了四个主题:(1)沟通障碍和对卫生专业人员的不信任,(2)医疗保健获取的限制以及与 COVID-19 相关的劣势的放大,(3)童年逆境经历(ACEs)的终身后果,以及(4)亲密伴侣暴力及其对药物使用的影响。

结论

我们的研究结果强调了为育龄期阿片类药物使用妇女提供卫生服务的重要信息。减少母亲使用阿片类药物的努力需要考虑社会心理和环境风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5397/8628311/a24e1b13397f/10.1177_17455065211060624-fig1.jpg

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