Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
Subst Abus. 2022;43(1):1163-1171. doi: 10.1080/08897077.2022.2074593.
Health care professionals (HCPs) play an important role in opioid misuse and opioid use disorder (OUD) screening/identification, mitigation, and referral to treatment. This study compared attitudes, self-efficacy, and practices related to opioid risk assessment and mitigation among pregnancy and non-pregnancy HCPs in rural communities. We conducted a secondary analysis of cross-sectional, self-report survey data of HCPs in two rural counties in southern Utah. Pregnancy HCPs were identified by a question asking whether they provide care to pregnant patients. HCPs' attitudes toward their patients with opioid misuse/OUD were measured using the Survey of Attitudes and Perceptions questionnaire. Self-efficacy and practices related to opioid risk assessment and mitigation were captured with questions asking about assessment and screening of opioid use, advisement to change opioid use behavior, and referral to treatment for OUD. We used linear regression analyses to estimate associations between HCPs' attitudes toward patients with opioid misuse/OUD and their self-efficacy and use of opioid risk assessment and mitigation practices. This sample included a total of 132 HCPs, including 82 pregnancy HCPs and 50 non-pregnancy HCPs. Attitudes domains were similar among pregnancy and non-pregnancy HCPs. Among pregnancy HCPs, role adequacy ( = .48, 95% CI = .16-.80), role legitimacy ( = .72, 95% CI = .21-1.22), motivation ( = .68, 95% CI = .14-1.21), and positive task-specific self-esteem ( = 1.52, 95% CI = .70-2.35) were positively associated with more frequent use of opioid risk assessment and mitigation practices, while attitudes were not associated with these practices among non-pregnancy HCPs. Training initiatives that lead to improved HCP attitudes could improve opioid care management among rural pregnancy HCPs. More research is needed to determine approaches to increase the use of opioid risk assessment and mitigation practices among rural non-pregnancy HCPs.
医疗保健专业人员（HCPs）在阿片类药物滥用和阿片类药物使用障碍（OUD）的筛查/识别、缓解和转介治疗方面发挥着重要作用。本研究比较了农村社区中怀孕和非怀孕 HCPs 与阿片类药物风险评估和缓解相关的态度、自我效能感和实践。我们对犹他州南部两个农村县的 HCPs 进行了横断面、自我报告调查数据的二次分析。通过询问他们是否为孕妇提供护理来确定怀孕 HCPs。使用问卷调查 HCPs 对阿片类药物滥用/ OUD 患者的态度。使用询问阿片类药物使用评估和筛查、改变阿片类药物使用行为的建议以及 OUD 治疗转介的问题来捕获与阿片类药物风险评估和缓解相关的自我效能感和实践。我们使用线性回归分析来估计 HCPs 对阿片类药物滥用/ OUD 患者的态度与其自我效能感和阿片类药物风险评估和缓解实践的使用之间的关联。该样本共包括 132 名 HCPs，包括 82 名怀孕 HCPs 和 50 名非怀孕 HCPs。怀孕和非怀孕 HCPs 的态度领域相似。在怀孕 HCPs 中，角色充分性（=.48，95%CI = .16-.80）、角色合法性（=.72，95%CI = .21-1.22）、动机（=.68，95%CI = .14-1.21）和积极的任务特定自尊（= 1.52，95%CI = .70-2.35）与更频繁地使用阿片类药物风险评估和缓解实践呈正相关，而态度与非怀孕 HCPs 中的这些实践无关。导致 HCP 态度改善的培训计划可以改善农村怀孕 HCPs 的阿片类药物护理管理。需要更多的研究来确定增加农村非怀孕 HCPs 使用阿片类药物风险评估和缓解实践的方法。
