探索酒精和其他药物使用对肯塔基州老年非裔美国成年人艾滋病毒护理的影响：一项建构主义扎根理论研究

Exploring the Impacts of Alcohol and Other Drug Use on HIV Care Among Older African American Adults in Kentucky: A Constructivist Grounded Theory Study.

作者信息

Harris Lesley M, Silverstein Sydney M, Crawford Timothy N, Kerr Jelani C, Ball Diana

机构信息

Lesley M. Harris, PhD, MSW, is an Associate Professor, University of Louisville, Kent School of Social Work, Louisville, Kentucky, USA. Sydney M. Silverstein, PhD, is an Assistant Professor, Wright State University, Boonshoft School of Medicine, Department of Population and Public Health Sciences, Center for Interventions, Treatment, and Addictions Research, Kettering, Ohio, USA. Timothy N. Crawford, PhD, MPH, is an Assistant Professor, Wright State University, Boonshoft School of Medicine, Department of Population and Public Health Sciences, Kettering, Ohio, USA. Jelani C. Kerr, PhD, MPH, is an Associate Professor, University of Louisville, School of Public Health and Information Sciences, Louisville, Kentucky, USA. Diana Ball, MSW, is a PhD Candidate, University of Louisville, Kent School of Social Work, Louisville, Kentucky, USA.

出版信息

J Assoc Nurses AIDS Care. 2022;33(3):333-347. doi: 10.1097/JNC.0000000000000319. Epub 2021 Dec 14.

DOI:10.1097/JNC.0000000000000319

PMID:34907970

Abstract

This grounded theory study examined the use of alcohol and other drugs (AOD) on the management of HIV disease among 27 older African Americans (≥50 years). Interview transcripts were analyzed using constructivist grounded theory analytic techniques. Participants reported facing (a) environmental impacts of AOD use and (b) discrimination from the health care system. The analysis revealed six phases of AOD use, occurring at various stages of the HIV care continuum: (a) linking AOD use as the cause of HIV diagnosis, (b) having AOD use facilitate denial of HIV, (c) experiencing problematic use as a barrier to care engagement, (d) "testing the waters," (e) relying on AIDS service organizations and medical providers, and (f) changing or maintaining patterns of AOD use to maintain engagement with care. Recommendations include assessing a patient's AOD use in relationship to the care continuum to evaluate patients' experiences and barriers within systems of care.

摘要

这项扎根理论研究调查了27名年龄较大的非裔美国人（≥50岁）在艾滋病毒疾病管理中使用酒精和其他药物（AOD）的情况。使用建构主义扎根理论分析技术对访谈记录进行了分析。参与者报告称面临（a）使用AOD的环境影响和（b）来自医疗保健系统的歧视。分析揭示了AOD使用的六个阶段，发生在艾滋病毒护理连续统一体的不同阶段：（a）将AOD使用与艾滋病毒诊断的原因联系起来，（b）让AOD使用助长对艾滋病毒的否认，（c）经历有问题的使用作为护理参与的障碍，（d）“试探”，（e）依赖艾滋病服务组织和医疗服务提供者，以及（f）改变或维持AOD使用模式以保持对护理的参与。建议包括评估患者在护理连续统一体中的AOD使用情况，以评估患者在护理系统中的经历和障碍。