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探索阿片类药物使用障碍住院患者对沟通与护理的偏好:一项定性描述性研究。

Exploring Preferences for Communication and Care Among Hospitalized Patients With Opioid Use Disorder: A Qualitative Descriptive Study.

作者信息

Davis M Holliday, French Rachel, Crowe Molly, Abrams Matthew, Edwards Grace, Aronowitz Shoshana, Mandell David S, Lowenstein Margaret

机构信息

Center for Addiction Medicine and Policy, University of Pennsylvania, Philadelphia, PA (MHD); Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (MHD); School of Nursing, University of Pennsylvania, Philadelphia, PA (MHD); National Clinician Scholars Program, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA (RF); Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA (RF); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (MC); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (MA); College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA (GE); Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA (SA); School of Nursing, University of Pennsylvania, Philadelphia, PA (SA); Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA (DSM); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DSM); Research Director, Center for Addiction Medicine and Policy, University of Pennsylvania, Philadelphia, PA (ML); Leonard Davis Institute for Health Economics, University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA (ML); and Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (ML).

出版信息

J Addict Med. 2025;19(4):423-429. doi: 10.1097/ADM.0000000000001443. Epub 2025 Feb 3.

Abstract

OBJECTIVE

The aim of the study was to explore hospitalized patient priorities for effective communication and care in opioid use disorder (OUD).

METHODS

In this qualitative descriptive study, we conducted semistructured interviews from April to August 2022 focusing on communication values with inpatient care teams among hospitalized patients with OUD in Philadelphia, PA. Interviews were recorded, transcribed, and analyzed with thematic content analysis.

RESULTS

We identified 3 key themes in the communication and care planning preferences of the 21 patients we interviewed: effectiveness, reciprocity, and empathy. Patients emphasized the need for clear, reliable, and frequent communication from healthcare providers, valuing collaborative dialog, shared decision making, and empathic nonstigmatized interactions that incorporated their prior experiences, full personhood, and current symptoms. Participants reported negative experiences with inconsistent or dismissive communication but appreciated care that incorporated their input and was nonjudgmental, fostering a sense of trust in their healthcare teams.

CONCLUSIONS

Effective, empathic communication, and shared decision making were favored by hospitalized patients with OUD and may be a way to improve treatment for hospitalized patients with OUD. Our findings underscore the need for stigma reduction strategies in clinical education and the expansion of both generalist resources for the treatment of OUD and specialized addiction care services.

摘要

目的

本研究旨在探讨阿片类物质使用障碍(OUD)住院患者对有效沟通与护理的优先需求。

方法

在这项定性描述性研究中,我们于2022年4月至8月对宾夕法尼亚州费城患有OUD的住院患者进行了半结构化访谈,重点关注与住院护理团队的沟通价值观。访谈进行了录音、转录,并采用主题内容分析法进行分析。

结果

我们在采访的21名患者的沟通和护理计划偏好中确定了3个关键主题:有效性、互惠性和同理心。患者强调医疗服务提供者需要进行清晰、可靠且频繁的沟通,重视协作对话、共同决策以及能体现他们既往经历、完整人格和当前症状的共情且无歧视的互动。参与者报告了在沟通不一致或被忽视时的负面经历,但对纳入他们意见且无评判性的护理表示赞赏,这种护理增强了他们对医疗团队的信任感。

结论

有效的共情沟通和共同决策受到患有OUD的住院患者的青睐,可能是改善OUD住院患者治疗的一种方式。我们的研究结果强调了在临床教育中减少歧视策略的必要性,以及扩大OUD治疗的全科资源和专门的成瘾护理服务的必要性。

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