Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, Pennsylvania, USA.
Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania, USA.
Health Soc Care Community. 2022 Nov;30(6):e4605-e4616. doi: 10.1111/hsc.13864. Epub 2022 Jun 14.
Syringe services programmes face operational challenges to provide life-sustaining services to people who use substances and those who have substance use disorders. COVID-19 has disrupted operations at these programmes and is a threat to people with substance use disorder because of severe poverty, de-prioritisation of COVID-19 safety and high prevalence of comorbidities. This phenomenological qualitative study describes 16 in-depth interviews with staff of one of the largest syringe services programme in North America-Prevention Point Philadelphia, located in the Kensington neighbourhood of Philadelphia, Pennsylvania. Interviews were conducted from December 2020 to February 2021, audio-recorded, transcribed and coded to develop a thematic framework. Participants were mostly white (71.4%) and female (68.8%) with a median age of 31.5. Three main and four sub-themes related to the impact of COVID-19 on the syringe services programme were identified: (1) COVID-19 altered services provision (sub-theme: select service changes should be retained); (2) unclear or absent COVID-19 response guidance which compromised mitigation (sub-themes: COVID-19 messaging was difficult to translate to practice, learn-as-we-go); and (3) staff and clients experienced elevated mental anguish during the pandemic (sub-theme: already limited resources were further strained). COVID-19 presented complex challenges to an organisation normally strained in pre-pandemic times. A staff culture of resourcefulness and resiliency aided the syringe services programme to balance client needs and staff safety. However, staff experienced a serious psychological impact, largely attributable to being unable to find reprieve from the stressors of COVID-19 and the difficulties associated with navigating and acting-on contradictory public health messaging. Staff also shared a belief that the relaxing of some pre-pandemic barriers allowed staff to link clients more readily with services. Syringe services programmes should embrace the potential for lasting changes to health services delivery brought about by wide-scale changes in service provisions because of COVID-19.
美加最大的美沙酮维持治疗（MMT）项目之一：费城预防点（Prevention Point Philadelphia），位于宾夕法尼亚州费城肯辛顿社区，其员工接受了 16 次深入访谈。访谈于 2020 年 12 月至 2021 年 2 月进行，全程录音，转写并进行编码以形成主题框架。参与者多数为白人（71.4%）和女性（68.8%），平均年龄 31.5 岁。访谈揭示了 COVID-19 对 MMT 项目的 3 个主要影响和 4 个次要影响：（1）新冠改变了服务模式（子主题：一些服务调整应保留）；（2）缺乏或不清楚的新冠应对指南，影响了缓解措施的实施（子主题：将新冠相关信息转化为实践操作十分困难，只能边做边学）；（3）疫情期间员工和患者承受了更多心理压力（子主题：本就有限的资源更加紧张）。在大流行时期，组织面临着复杂的挑战。该 MMT 项目的员工具有创造力和适应力的文化，这有助于平衡客户需求和员工安全。然而，员工承受了严重的心理压力，这主要归因于无法缓解新冠带来的压力，以及难以应对相互矛盾的公共卫生信息。员工还表示，一些疫情前的障碍已经放宽，这使得员工更容易将患者与服务联系起来。MMT 项目应该接受由于新冠大流行而广泛改变服务提供模式带来的医疗服务提供的持久变化。
