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有过涉甲基苯丙胺住院治疗经历的个体对医疗护理的需求感知和污名化体验。

Perceived need for care and stigma experiences among individuals with methamphetamine-related admissions to inpatient mental health wards.

机构信息

Department of Psychiatry, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

Department of Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

出版信息

Harm Reduct J. 2023 Aug 2;20(1):104. doi: 10.1186/s12954-023-00827-5.

Abstract

BACKGROUND

There are gaps in our understanding of treatment needs among people who use methamphetamine. We examined the demographics, perceived treatment needs, barriers to accessing care, and stigma experienced by an inpatient sample of people who use methamphetamine.

METHODS

This study surveyed a convenience sample of patients admitted to psychiatry wards with a history of methamphetamine use in Winnipeg, Canada, between May 1 and July 31, 2019. The Perceived Need for Care Questionnaire (PNCQ-9) was used to assess treatment needs and barriers to care, and the Substance Use Stigma Mechanisms Scale (SU-SMS) was used to assess enacted, anticipated, and internalized stigma. Prevalence rates of perceived need, stigma, and demographic variables were determined.

RESULTS

A total of 103 potential participants were identified, with 34 completing the survey. The most common age group was 21-30 years of age (41.2%); an approximate equal number of men and women; and almost all were single and never married (91.1%). Rates of perceived need for care were very high across all treatment types, including 91% identifying a need for medication treatment for their mental health or substance use. Despite the majority receiving care across the seven types of care described in the PNCQ-9, most felt they did not receive enough care. Unmet need for care was therefore high in many categories, including rates of 87% for counselling and skills training. The most common barriers to having needs met were a desire to self-manage substance use, and not receiving care after asking for help. Almost all participants reported experiencing stigma (94%). Stigma from family was endorsed significantly more than stigma from health care providers (p = 0.005).

CONCLUSIONS

The average hospitalized person who uses methamphetamine in this sample is young, single, and has not completed any post-secondary education. High rates of perceived treatment need suggest an awareness of problems with methamphetamine, yet most interventions are perceived as inadequate. People who used methamphetamine felt highly stigmatized, particularly by their family members. Trial registration Registered with the Health Research Ethics Board at the University of Manitoba (Number HS22605 (H2019:072), renewed February 14, 2022).

摘要

背景

我们对使用甲基苯丙胺者的治疗需求了解不足。我们研究了住院的甲基苯丙胺使用者的人口统计学特征、感知到的治疗需求、获得治疗的障碍以及所经历的污名。

方法

本研究于 2019 年 5 月 1 日至 7 月 31 日在加拿大温尼伯的精神病病房调查了有使用甲基苯丙胺史的便利样本患者。使用需要护理感知问卷(PNCQ-9)评估治疗需求和获得治疗的障碍,使用物质使用污名机制量表(SU-SMS)评估被执行、预期和内化的污名。确定了感知需求、污名和人口统计学变量的流行率。

结果

确定了 103 名潜在参与者,其中 34 名完成了调查。最常见的年龄组是 21-30 岁(41.2%);男女人数大致相等;几乎所有人都是单身且未婚(91.1%)。所有治疗类型的治疗需求都非常高,包括 91%的人认为他们需要药物治疗来治疗他们的心理健康或物质使用问题。尽管大多数人在 PNCQ-9 中描述的七种类型的护理中都接受了护理,但大多数人认为他们没有得到足够的护理。在许多类别中,无法满足护理需求的比例很高,包括 87%的人需要咨询和技能培训。满足需求的最大障碍是希望自行管理药物使用,以及在寻求帮助后未得到护理。几乎所有参与者都报告说经历过污名(94%)。来自家人的污名比来自医疗保健提供者的污名更普遍(p=0.005)。

结论

在这个样本中,平均住院使用甲基苯丙胺的人都很年轻,单身,且没有完成任何高等教育。高比例的治疗需求表明对甲基苯丙胺问题有一定认识,但大多数干预措施都被认为是不够的。使用甲基苯丙胺的人感到非常污名化,尤其是来自他们的家人。

试验注册

在马尼托巴大学健康研究伦理委员会注册(编号 HS22605(H2019:072),于 2022 年 2 月 14 日更新)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3323/10399029/e44400272013/12954_2023_827_Fig1_HTML.jpg

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