Thomas Jefferson University (VL Short, M Gannon, G Harris, A Kale, DJ Abatemarco, and DJ Hand), Philadelphia, PA.
Thomas Jefferson University (VL Short, M Gannon, G Harris, A Kale, DJ Abatemarco, and DJ Hand), Philadelphia, PA.
Acad Pediatr. 2023 Mar;23(2):425-433. doi: 10.1016/j.acap.2022.07.013. Epub 2022 Jul 22.
Previous research suggests gaps in well-child care (WCC) adherence, quality, and effectiveness for children impacted by parental opioid use disorder (OUD). The objective of this study was to gather in-depth information regarding maternal and clinician-reported factors that enhance ("facilitators") or hinder ("barriers") WCC engagement as well as mothers' experiences during WCC visits.
Thirty mothers who were in treatment for OUD and 13 clinicians working at a pediatric primary care clinic participated in this qualitative study. All participants completed one data collection telephone session which involved a brief questionnaire followed by a semi-structured interview. Thematic analyses of the interview transcripts were conducted using an inductive approach.
Three broad themes were identified as facilitators of WCC by mothers and clinicians, including: 1) continuity in care, 2) addressing material needs, and 3) clinician OUD training and knowledge. Themes identified as barriers to WCC included: 1) stigma toward mothers with OUD, 2) gaps in basic parenting knowledge, 3) competing specialized health care needs, and 4) insufficient time to address all concerns.
WCC programs or clinical pathways designed for families affected by maternal OUD should consider these barriers and facilitators of WCC engagement and affect experiences of WCC for mothers and clinicians.
先前的研究表明,父母患有阿片类药物使用障碍(OUD)的儿童在接受常规儿童保健(WCC)方面存在依从性、质量和效果方面的差距。本研究的目的是收集有关增强(“促进因素”)或阻碍(“障碍”)WCC 参与的产妇和临床医生报告的因素以及母亲在 WCC 就诊期间的体验的深入信息。
30 名正在接受 OUD 治疗的母亲和在儿科初级保健诊所工作的 13 名临床医生参加了这项定性研究。所有参与者都完成了一次数据收集电话会议,其中包括简短的问卷,然后是半结构化访谈。采用归纳法对访谈记录进行主题分析。
母亲和临床医生认为 WCC 的三个广泛主题是促进因素,包括:1)护理的连续性,2)满足物质需求,3)临床医生的 OUD 培训和知识。确定的 WCC 障碍主题包括:1)对患有 OUD 的母亲的污名化,2)基本育儿知识的差距,3)竞争激烈的特殊医疗保健需求,以及 4)没有足够的时间来解决所有问题。
专为受母亲 OUD 影响的家庭设计的 WCC 计划或临床途径应考虑到这些促进和阻碍 WCC 参与的因素,以及 WCC 对母亲和临床医生的体验。