J Obstet Gynecol Neonatal Nurs. 2024 Sep;53(5):485-490. doi: 10.1016/j.jogn.2024.04.006. Epub 2024 May 22.
To describe the unique challenges faced by rural pregnant women with intersecting substance use disorder (SUD) and unmet social needs.
Secondary qualitative data analysis with an analytic expansion approach.
Hospital system in northern New England.
Four rural women with food insecurity who were in recovery for SUD (three were pregnant and one had given birth in the past 15 weeks).
In the primary qualitative descriptive study, we interviewed 14 women about their experience of food insecurity during the perinatal period, including facilitators and barriers to being screened and accessing referrals for food insecurity and other social needs during prenatal care. This secondary analysis centered on the perspectives of four participants who reflected specifically on receiving material and mental health support through the integration of prenatal care and SUD treatment.
Rural women with SUD who experience social needs during pregnancy have difficulty accessing appropriate prenatal care and maintaining treatment engagement due to intersecting factors (e.g., food and housing insecurity and transportation) and psychological (e.g., mental health challenges, social isolation, and stigma) factors. Participants emphasized the importance of integrating social support within prenatal and substance use care to promote physical and mental health and engagement in SUD treatment.
In line with The Joint Commission's 2022 policy recommendations for universal social determinants of health screening, we support one-stop clinical and social care for pregnant women who face intersecting barriers to health, such as SUD and unmet social needs. Nurses can play an important role in care coordination for people with complex medical and social determinants of health screening needs. This approach is especially relevant to rural areas, where food, housing, and transportation insecurity rates are greater than nonrural areas.
描述患有重叠物质使用障碍（SUD）和未满足的社会需求的农村孕妇所面临的独特挑战。
具有分析扩展方法的二次定性数据分析。
新英格兰北部的医院系统。
四名患有食物不安全的农村妇女，她们有 SUD 康复经历（其中三人怀孕，一人在过去 15 周内生过孩子）。
在初步定性描述性研究中，我们采访了 14 名妇女，了解她们在围产期期间经历食物不安全的情况，包括在产前护理期间进行筛查和获得食物不安全和其他社会需求转介的促进因素和障碍。本次二次分析集中在四名参与者的观点上，他们具体反映了通过整合产前护理和 SUD 治疗来获得物质和心理健康支持的情况。
患有 SUD 的农村孕妇在怀孕期间面临社会需求，由于交叉因素（例如食物和住房不安全以及交通）和心理因素（例如心理健康挑战、社会孤立和耻辱感），难以获得适当的产前护理并保持治疗参与。参与者强调在产前和物质使用护理中整合社会支持以促进身心健康和参与 SUD 治疗的重要性。
与 2022 年联合委员会关于普遍社会决定健康筛查的政策建议一致，我们支持为面临健康交叉障碍（如 SUD 和未满足的社会需求）的孕妇提供一站式临床和社会护理。护士可以在具有复杂医疗和社会决定健康筛查需求的患者的护理协调中发挥重要作用。这种方法尤其适用于食物、住房和交通不安全率高于非农村地区的农村地区。
