促进安全、支持与希望：对2023年华盛顿州西雅图市为吸毒女性设计医疗服务的多利益相关者观点的定性研究
Fostering Safety, Support, and Hope: A Qualitative Study of Multistakeholder Perspectives on Designing Health Care Services for Women Who Use Drugs in Seattle, Washington, 2023.
作者信息
Austin Elizabeth J, Stewart Jenell, Violette Lauren R, Glick Sara N, Dhanireddy Shireesha, Williams Emily C, Corcorran Maria A
机构信息
Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA.
Division of Infectious Diseases, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.
出版信息
Womens Health Rep (New Rochelle). 2025 Aug 27;6(1):782-790. doi: 10.1177/26884844251372851. eCollection 2025.
BACKGROUND
Women who use drugs (WWUD) experience increasingly worse outcomes from drug use as compared to men. Additionally, transactional sex, unstable housing, and unmet needs may further complicate their ability to get needed health care. To inform the design of gender-based, mobile health services, we sought perspectives on health care service delivery from WWUD and health care and harm reduction professionals (HHRPs) in Seattle, WA.
MATERIALS AND METHODS
In 2023, we conducted qualitative interviews with WWUD (n = 16) and HHRPs (n = 5) in the Seattle, Washington area. Interviews focused on experiences receiving health care services, barriers and facilitators to accessing care, and preferences for health care service delivery. Interviews were audio recorded, transcribed, and double coded. Final learnings were reviewed with the study's community advisory boards.
RESULTS
All WWUD participants identified as cisgender women, 12 (75%) identified as White, and 11 (69%) had unstable housing. Analysis identified four themes that characterized perspectives of WWUD and HHRP on health care service delivery needs, embodied by: safety, stigma, hope, and resiliency. Participants described that lack of safety and unmet basic needs made it challenging for WWUD to ever feel healthy (theme 1), and that WWUD felt stigmatized by mainstream health care services in intersectional ways (theme 2). However, participants shared that these burdens were lessened when health care teams created space for hope in care delivery interactions (theme 3) and built resiliency by reducing barriers and complementing care with structural supports (theme 4).
DISCUSSION
In this small qualitative sample, WWUD experienced a myriad of intersecting challenges that perpetuated marginalization and health disparities. This population may benefit from interventions rooted in intersectional and trauma-informed approaches.
背景
与男性相比，吸毒女性（WWUD）因吸毒而面临的后果日益恶化。此外，交易性行为、住房不稳定和未满足的需求可能会使她们获得所需医疗保健的能力更加复杂。为了为基于性别的移动健康服务设计提供信息，我们在华盛顿州西雅图市征求了吸毒女性以及医疗保健和减少伤害专业人员（HHRPs）对医疗服务提供的看法。
材料与方法
2023年，我们对华盛顿州西雅图地区的吸毒女性（n = 16）和医疗保健和减少伤害专业人员（n = 5）进行了定性访谈。访谈重点关注接受医疗保健服务的经历、获得护理的障碍和促进因素以及对医疗服务提供的偏好。访谈进行了录音、转录和双重编码。最终的研究结果与该研究的社区咨询委员会进行了审查。
结果
所有吸毒女性参与者均为顺性别女性，12人（75%）为白人，11人（69%）住房不稳定。分析确定了四个主题，这些主题体现了吸毒女性和医疗保健和减少伤害专业人员对医疗服务提供需求的看法，即：安全、耻辱感、希望和恢复力。参与者表示，缺乏安全保障和未满足的基本需求使吸毒女性难以感到健康（主题1），并且吸毒女性在多个方面受到主流医疗服务的污名化（主题2）。然而，参与者分享说，当医疗团队在护理互动中创造希望的空间（主题3）并通过减少障碍和用结构性支持补充护理来增强恢复力时（主题4），这些负担就会减轻。
讨论
在这个小型定性样本中，吸毒女性经历了无数相互交织的挑战，这些挑战使她们持续处于边缘化和健康差距之中。这一人群可能会从基于交叉性和创伤知情方法的干预措施中受益。
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