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医学生对阿片类药物的认知:揭示其复杂性与影响

Perception of opioids among medical students: unveiling the complexities and implications.

作者信息

Borgemenke Samuel, Durstock Nicholas, DeShetler Lori, Matus Coral, Beverly Elizabeth A

机构信息

Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA.

Department of Medical Education, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA.

出版信息

J Osteopath Med. 2024 Jan 31;124(5):195-203. doi: 10.1515/jom-2023-0176. eCollection 2024 May 1.

Abstract

CONTEXT

From 2000 to 2019, drug overdoses, combined intentional and unintentional, were the number one cause of death for Americans under 50 years old,with the number of overdoses increasing every year. Between 2012 and 2018, approximately 85 % of all opioid users obtained their opioids through prescriptions from healthcare providers, predominantly physicians. Increased education about the severity of this issue may increase the likelihood of physicians integrating alternative forms of care such as cognitive behavioral approaches, nonopioid therapies, and nonpharmacologic therapies into treatment plans for chronic pain.

OBJECTIVES

This study investigates medical students' beliefs, experiences, and perceived impact of opioids at Ohio University Heritage College of Osteopathic Medicine (OU-HCOM) and University of Toledo College of Medicine and Life Sciences (UT).

METHODS

A total of 377 students from OU-HCOM (years 1-4, n=312) and UT (years 1-2, n=65) were surveyed on their beliefs, experiences, and perceived impact of opioids. Multiple t tests were conducted to compare the difference in perceived severity and stigma between participants who were impacted by the epidemic and those who were not. A Kendall rank test was performed to analyze the relationship between the county drug overdose rate and perceived severity for medical students. p <0.05 defined statistical significance for all statistical tests performed in this study.

RESULTS

In comparing medical students' personal experiences with the opioid crisis, it was found that many more participants had experiences with an affected classmate or patient (4.1; 95 % CI, 4.0-4.2), as opposed to direct experiences within their family or group of friends (1.9; 95 % CI, 1.8-2.0). However, this group of participants who directly experienced the opioid crisis were found to be more likely to view the crisis as more severe in Ohio's adult population than those without that direct experience (p=0.03, α=0.05). The difference in experience and severity outlook did not make one group of medical students more likely to hold a stigma toward those struggling with opioid addiction (p=0.3, α=0.05). The study did not find a significant relationship between the county drug overdose rate and the perceived severity among medical students (R=0.05, p=0.6, α=0.05).

CONCLUSIONS

This study gave an insight into the beliefs, experiences, and perceived impact of opioids within a group of 377 medical students. It was shown that differences in background can lead to differences in perception of the crisis. Knowing these differences can lead to beneficial changes in education and curriculum design in medical education.

摘要

背景

2000年至2019年期间,药物过量(包括故意和非故意的)是50岁以下美国人的首要死因,且药物过量的人数逐年增加。2012年至2018年期间,所有阿片类药物使用者中约85%是通过医疗保健提供者(主要是医生)开具的处方获得阿片类药物的。加强对这一问题严重性的教育,可能会增加医生将认知行为疗法、非阿片类疗法和非药物疗法等替代护理形式纳入慢性疼痛治疗计划的可能性。

目的

本研究调查了俄亥俄大学传统整骨医学院(OU-HCOM)和托莱多大学医学院及生命科学学院(UT)的医学生对阿片类药物的看法、经历和感知影响。

方法

对来自OU-HCOM(1至4年级,n = 312)和UT(1至2年级,n = 65)的377名学生进行了关于他们对阿片类药物的看法、经历和感知影响的调查。进行了多次t检验,以比较受疫情影响的参与者和未受影响的参与者在感知严重性和耻辱感方面的差异。进行了肯德尔等级检验,以分析县药物过量率与医学生感知严重性之间的关系。p<0.05定义为本研究中所有统计检验的统计学显著性。

结果

在比较医学生个人与阿片类药物危机的经历时发现,更多的参与者有受影响的同学或患者的经历(4.1;95%CI,4.0 - 4.2),而不是在其家庭或朋友圈内的直接经历(1.9;95%CI,(1.8 - 2.0))。然而,发现这组直接经历阿片类药物危机的参与者比没有这种直接经历的参与者更有可能认为俄亥俄州成年人口中的危机更为严重(p = 0.03,α = 0.05)。经历和严重程度看法上的差异并没有使一组医学生更有可能对与阿片类药物成瘾作斗争的人持有耻辱感(p = 0.3,α = 0.05)。该研究未发现县药物过量率与医学生感知严重性之间存在显著关系(R = 0.05,p = 0.6,α = 0.05)。

结论

本研究深入了解了377名医学生对阿片类药物的看法、经历和感知影响。结果表明,背景差异可能导致对危机的认知差异。了解这些差异可以在医学教育的教育和课程设计中带来有益的改变。

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