From the Pritzker School of Medicine, University of Chicago, Chicago, IL (MY); Division of Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (KJB); and Section of Geriatrics and Palliative Medicine, Department of Medicine, University of Chicago, Chicago, IL (SL).
J Addict Med. 2023;17(2):155-162. doi: 10.1097/ADM.0000000000001061. Epub 2022 Aug 30.
Over the past decade, the numbers of older adults with opioid and substance use disorders (OUD/SUD) have increased. As this population enters nursing homes (NHs) in increasing numbers, it is crucial to consider their capacity to manage issues related to OUD/SUD. This study aimed to examine current NH protocols for care coordination of residents with OUD/SUD as well as facility-related barriers to providing care to this vulnerable population within the NH.
Twenty-four semistructured interviews were conducted with NH staff including directors of nursing, administrators, nurses, and physicians in July 2020. Staff were recruited from 11 different post-acute care and long-term care facilities located in urban and suburban communities of Chicago. Interviews were conducted virtually (via teleconference platform or by telephone) and subsequently coded using ATLAS.ti 8 (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany) using constant comparative method.
Qualitative analyses identified 3 themes around NH barriers to care for residents with SUD/OUD: (1) staff preparedness, (2) staff perceptions of addiction, and (3) overall lack of resources. Results revealed a strong need for the development of consistent policies, as well as standardized, educational interventions for NH staff that target SUD/OUD management in this vulnerable population.
The evaluation and impact of persons with SUD/OUD entering NHs are an important topic that requires further study. More resources and staff training are necessary to ensure that residents with SUD/OUD have access to appropriate care within these settings.
在过去的十年中，患有阿片类药物和物质使用障碍（OUD/SUD）的老年人数量有所增加。随着这一人群越来越多地进入养老院（NHs），必须考虑他们管理与 OUD/SUD 相关问题的能力。本研究旨在检查 NH 目前用于协调患有 OUD/SUD 的居民的护理的协议，以及 NH 内为这一弱势群体提供护理的设施相关障碍。
2020 年 7 月，对包括护理主任、管理人员、护士和医生在内的 NH 工作人员进行了 24 次半结构化访谈。工作人员来自芝加哥市区和郊区的 11 个不同的康复和长期护理设施招募。访谈通过虚拟方式（通过电话会议平台或电话）进行，并使用 ATLAS.ti 8（ATLAS.ti Scientific Software Development GmbH，柏林，德国）进行恒定性比较方法进行编码。
定性分析确定了 NH 为 SUD/OUD 居民提供护理的障碍有 3 个主题：（1）员工准备情况，（2）员工对成瘾的看法，（3）资源总体匮乏。结果表明，迫切需要制定一致的政策，以及针对 NH 工作人员的标准化教育干预措施，以针对这一弱势群体的 SUD/OUD 管理。
评估和影响患有 SUD/OUD 的人进入 NH 是一个重要的话题，需要进一步研究。需要更多的资源和员工培训，以确保患有 SUD/OUD 的居民在这些环境中能够获得适当的护理。
