Department of Counseling and Family Therapy, Drexel University, Philadelphia, Pennsylvania, USA.
University of Missouri Saint Louis, Missouri Institute of Mental Health, Saint Louis, Missouri, USA.
J Nurs Scholarsh. 2023 May;55(3):730-738. doi: 10.1111/jnu.12803. Epub 2022 Aug 3.
Substance use among pregnant and postpartum women (PPW) is a serious public health concern. The COVID-19 pandemic has exacerbated substance use among the general population including pregnant women, and disrupted operations for substance use treatment centers. Little is known about the outcomes of substance use treatment for PPW before and during the COVID-19 pandemic.
Data from a longitudinal program evaluation were analyzed to examine outcomes among 136 PPW participating in a residential SUD treatment program, and to explore differences in treatment outcomes for women who enrolled in services before versus during the COVID-19 pandemic. Analyses were used to test the significance of change from treatment intake to 6-month post-intake on assessments of substance use, mental health symptoms, and functioning collected to evaluate the Healthy Families Program (HFP), a comprehensive program for PPW located within a gender-specific SUD treatment facility in the United States.
Results indicated that from treatment intake to follow-up assessment, clients self-reported statistically significant improvements in family functioning and daily functioning as well as reduced days of substance use. Notably, the rate of treatment intakes declined during the COVID-19 pandemic. In separate analyses by subgroup, mental health indicators showed improvements only for clients engaged in treatment before the COVID-19 pandemic and not for clients served during the COVID-19 pandemic, but substance use decreased significantly for both pre-pandemic and pandemic enrollees.
Specialized treatment considerations and implications for PPW are discussed, including a need for added emphasis on co-occurring mental health symptoms and family system stress during a pandemic, and the role of nurses in identifying and addressing these concerns. Additionally, potential relapse prevention efforts during COVID-19 for PPW with substance use disorders are examined.
The present research continues to highlight the importance of specialized treatment programming for PPW with SUDs as well as the potential need for additional recovery support mechanisms to be utilized during the COVID-19 pandemic.
孕妇和产后妇女（PPW）的物质使用是一个严重的公共卫生问题。COVID-19 大流行使包括孕妇在内的普通人群的物质使用情况恶化，并扰乱了物质使用治疗中心的运作。在 COVID-19 大流行之前和期间，关于 PPW 的物质使用治疗结果知之甚少。
对一项纵向方案评估的数据进行了分析，以检查 136 名参加住院物质使用障碍治疗计划的 PPW 的结果，并探讨在 COVID-19 大流行之前和期间参加服务的女性在治疗结果方面的差异。分析用于测试从治疗开始到 6 个月后的治疗摄入评估中物质使用、心理健康症状和功能的变化的显著性，这些评估是为了评估位于美国性别特定物质使用障碍治疗设施内的为 PPW 提供的综合计划——健康家庭计划（HFP）而收集的。
结果表明，从治疗开始到随访评估，客户自我报告在家庭功能和日常功能方面有统计学上显著的改善，以及减少了物质使用的天数。值得注意的是，COVID-19 大流行期间治疗摄入量下降。在按亚组进行的单独分析中，心理健康指标仅对在 COVID-19 大流行之前接受治疗的客户有所改善，而对在 COVID-19 大流行期间接受治疗的客户没有改善，但物质使用对大流行前和大流行期间的参与者都显著减少。
讨论了针对 PPW 的专门治疗考虑因素和意义，包括在大流行期间需要更加重视共病心理健康症状和家庭系统压力，以及护士在识别和解决这些问题方面的作用。此外，还研究了 COVID-19 期间患有物质使用障碍的 PPW 的潜在复发预防措施。
本研究继续强调为患有物质使用障碍的 PPW 提供专门治疗计划的重要性，以及在 COVID-19 大流行期间可能需要利用更多的恢复支持机制。
