Jahan Nusrath, Gade Neerav, Zhen-Duan Jenny, Fukuda Marie, Estrada Rodolfo, Alegría Margarita
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Tufts University School of Medicine, Boston, MA, USA.
Addict Res Theory. 2024;32(4):291-298. doi: 10.1080/16066359.2023.2265300. Epub 2023 Oct 8.
While positive impacts of recovery capital and social capital in facilitating substance use disorder (SUD) recovery is increasingly documented, research has shown that low-income and marginalized individuals have lower social capital and may rely on different networks. A more comprehensive approach is needed to understand the social capital of low-income individuals with SUD and how these relationships impact their treatment and recovery.
Qualitative data were gathered through semi-structured interviews and analyzed employing thematic analysis. Participants included individuals with SUD (n=10), clinicians (n=12), and policy leaders (n=13).
Three themes emerged: 1) Patients' positive and negative interpersonal relationships with friends and family influenced decisions to seek treatment; 2) strong patient-provider relationships, often defined by the quality of SUD providers and treatment settings, were perceived as crucial for staying in treatment; and 3) justice involvement facilitated treatment access yet deteriorated treatment engagement. Themes emphasized social and structural factors that inhibit patients from fostering support and treatment engagement.
Our study underscores the importance of interpersonal relationships in SUD treatment-seeking and recovery and the need for positive interactions across the care continuum within broader social networks. Opportunities for positive interpersonal relationships include increasing access to language-concordant treatment; provider training to enhance cultural humility and patient-provider relationships; and mechanisms that improve interpersonal relationships between patients, parole officers, and other justice system members. Accentuating the role of interpersonal relationships and expanding social support interventions can pave the way for structural changes that improve recovery by harnessing different types of social capital.
虽然越来越多的文献记载了康复资本和社会资本在促进物质使用障碍(SUD)康复方面的积极影响,但研究表明,低收入和边缘化个体的社会资本较低,可能依赖不同的社交网络。需要一种更全面的方法来理解患有物质使用障碍的低收入个体的社会资本,以及这些关系如何影响他们的治疗和康复。
通过半结构化访谈收集定性数据,并采用主题分析法进行分析。参与者包括患有物质使用障碍的个体(n = 10)、临床医生(n = 12)和政策领导人(n = 13)。
出现了三个主题:1)患者与朋友和家人的积极和消极人际关系影响了寻求治疗的决定;2)强大的患者-提供者关系,通常由物质使用障碍提供者的质量和治疗环境来定义,被认为对坚持治疗至关重要;3)司法介入有助于获得治疗,但会降低治疗参与度。这些主题强调了抑制患者获得支持和参与治疗的社会和结构因素。
我们的研究强调了人际关系在物质使用障碍寻求治疗和康复中的重要性,以及在更广泛的社交网络中整个护理连续过程中积极互动的必要性。积极人际关系的机会包括增加获得语言匹配治疗的机会;提供培训以增强文化谦逊和患者-提供者关系;以及改善患者、假释官和其他司法系统成员之间人际关系的机制。强调人际关系的作用并扩大社会支持干预措施可以为通过利用不同类型的社会资本改善康复的结构变革铺平道路。