Unité de Recherche en Soins Primaires ULB, Faculty of Medicine, Université libre de Bruxelles, Route de Lennik 808 CP 612, Brussels, 1070, Belgium.
Departement de Médecine Générale, Faculty of Medicine, Université libre de Bruxelles, Route de Lennik 808 CP 612, Brussels, 1070, Belgium.
BMC Prim Care. 2024 Aug 14;25(1):303. doi: 10.1186/s12875-024-02493-3.
People who use illicit drugs cumulate medical and psychosocial vulnerabilities, justifying a rounded health approach. Both caregivers and patients can form barriers to accessing care, leading to inadequate care. This study aimed to identify the needs and expectations of such patients in general practice.
Qualitative research was conducted using semi-structured interviews with 23 people with illicit substance use disorder in Brussels in 2020. Multicentric recruitment was conducted to obtain a heterogeneous mix of sociodemographic profiles and care trajectories. Thematic analysis was performed using RQDA package software.
Participants highlighted several vulnerabilities. These include the presence of significant self-stigmatization and guilt, sometimes to the extent of self-dehumanization, even after years of care, and overdoses masking suicide attempts and early memory disorders. Multiple substance use, smoking in almost all participants, and misuse of benzodiazepines were also noted. The majority of participants expressed the need for an open-minded, non-stigmatizing and empathic GP with a holistic approach that could guide them throughout their life course. The competencies of the GPs in the field of addiction seemed secondary to the participants. Knowledge and good collaboration with the mental health network were assets.
Participants expressed the need for GPs with good interpersonal skills, including a non-stigmatizing attitude. The care coordinator role of the GP was highlighted as a key element, as it was a holistic approach focusing on global health (including the social determinants of health) and not only on substance use disorders.
使用非法药物的人会累积医疗和心理社会脆弱性，这证明需要全面的健康方法。护理人员和患者本身都可能成为获得护理的障碍，导致护理不足。本研究旨在确定一般实践中此类患者的需求和期望。
2020 年在布鲁塞尔对 23 名患有非法药物使用障碍的人进行了定性研究，采用半结构化访谈。采用多中心招募的方法，获得了不同社会人口学特征和护理轨迹的混合人群。使用 RQDA 软件包进行主题分析。
参与者强调了几个脆弱性。这些脆弱性包括存在严重的自我污名化和内疚感，有时甚至到了自我非人化的程度，即使在经过多年的治疗后也是如此，而且过量用药掩盖了自杀企图和早期记忆障碍。还注意到多种物质使用、几乎所有参与者都吸烟以及苯二氮䓬类药物的滥用。大多数参与者表示需要一位心胸开阔、不污名化、富有同理心的全科医生，以整体的方法为他们的整个生命历程提供指导。参与者认为全科医生在成瘾领域的能力相对次要。了解并与精神卫生网络良好合作是资产。
参与者表示需要具有良好人际交往能力的全科医生，包括不歧视的态度。全科医生的护理协调员角色被强调为一个关键要素，因为它是一种整体方法，侧重于整体健康（包括健康的社会决定因素），而不仅仅是药物使用障碍。
