Antenatal care of women who use opioids: a qualitative study of practitioners' perceptions of strengths and challenges of current service provision in Scotland.
Antenatal care of women who use opioids: a qualitative study of practitioners' perceptions of strengths and challenges of current service provision in Scotland.
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DOI：
10.1186/s12884-024-06265-w
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发表时间：
2024-01-23
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
--
作者：
世界各地怀孕期间使用阿片类药物的妇女人数日益增加，这使人们对这一群体获得产前护理的机会和质量感到关切。苏格兰的阿片类药物使用率特别高，相应地，涉及使用阿片类药物的妇女的怀孕率也很高。本研究的目的是调查不同模式的产前护理妇女在怀孕期间使用阿片类药物在三个苏格兰卫生局地区，并探讨多学科从业者的优势和挑战的看法与妇女谁使用阿片类药物通过这些专业服务。13个半结构化的采访进行了卫生和社会保健工作者提供产前和产后护理的妇女谁使用药物在三个苏格兰卫生局地区的经验：国民保健服务大格拉斯哥和克莱德，国民保健服务洛锡安和国民保健服务泰赛德。访谈数据采用框架分析法进行分析。框架分析分五个阶段进行：熟悉、确定专题框架、编制索引、制图、绘图和解释。每个地区都为使用药物的妇女提供专门的产前途径。途径各不相同，有些途径由专业助产士组成，另一些途径由多学科团队组成（如助产士、心理健康护士、社会工作者和产科医生）。卫生局各地区的专家服务转诊标准各不相同。这些专业化的途径提供了几个关键优势：一名助产士的护理连续性和强大的患者-医生关系;预约，支持和扫描的数量增加;以及具有药物使用工作经验的高度专业化的医疗保健专业人员。尽管如此，这些途径仍存在一些局限性：缺乏对母亲的额外心理支持;一些工作人员没有技能与使用药物的患者的复杂性接触;以及患者参与的问题。在这三个地区，似乎有高质量的多学科产前服务的妇女在怀孕期间使用阿片类药物。然而，转诊标准各不相同，有些服务似乎比其他服务更全面。需要进一步研究使用阿片类药物的妇女对产前护理的促进者和障碍以及苏格兰农村地区的看法。在线版本包含补充材料，可通过10.1186/s12884-024-06265-w获得。
The increasing rise of women using opioids during pregnancy across the world has warranted concern over the access and quality of antenatal care received by this group. Scotland has particularly high levels of opioid use, and correspondingly, pregnancies involving women who use opioids. The purpose of this study was to investigate the different models of antenatal care for women using opioids during pregnancy in three Scottish Health Board Areas, and to explore multi-disciplinary practitioners’ perceptions of the strengths and challenges of working with women who use opioids through these specialist services. Thirteen semi-structured interviews were conducted with health and social care workers who had experience of providing antenatal and postnatal care to women who use drugs across three Scottish Health Board Areas: NHS Greater Glasgow and Clyde, NHS Lothian, and NHS Tayside. Framework Analysis was used to analyse interview data. The five stages of framework analysis were undertaken: familiarisation, identifying the thematic framework, indexing, charting, and mapping and interpretation. Each area had a specialist antenatal pathway for women who used substances. Pathways varied, with some consisting of specialist midwives, and others comprising a multidisciplinary team (e.g. midwife, mental health nurse, social workers, and an obstetrician). Referral criteria for the specialist service differed between health board areas. These specialised pathways presented several key strengths: continuity of care with one midwife and a strong patient-practitioner relationship; increased number of appointments, support and scans; and highly specialised healthcare professionals with experience of working with substance use. In spite of this, there were a number of limitations to these pathways: a lack of additional psychological support for the mother; some staff not having the skills to engage with the complexity of patients who use substances; and problems with patient engagement. Across the three areas, there appears to be high-quality multi-disciplinary antenatal services for women who use opioids during pregnancy. However, referral criteria vary and some services appear more comprehensive than others. Further research is needed into the perceptions of women who use opioids on facilitators and barriers to antenatal care, and provision in rural regions of Scotland. The online version contains supplementary material available at 10.1186/s12884-024-06265-w.
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影响因子：
0.7
作者：
Renbarger, Kalyn M.;Moorman, Margaret;Draucker, Claire
通讯作者：
Draucker, Claire
影响因子：
11.4
作者：
ROWLEY, MJ;HENSLEY, MJ;WLODARCZYK, JH
通讯作者：
WLODARCZYK, JH
影响因子：
4.2
作者：
Frazer, Zane;McConnell, Krystle;Jansson, Lauren M.
通讯作者：
Jansson, Lauren M.
DOI：
10.1016/j.drugpo.2013.04.004
发表时间：
2013-11-01
期刊：
The International journal on drug policy
影响因子：
--
作者：
Chandler, Amy;Whittaker, Anne;Mathews, Gillian
通讯作者：
Mathews, Gillian
影响因子：
3.8
作者：
Martin, Caroline J. Hollins;MacArthur, Juliet;McInnes, Rhona J.
通讯作者：
McInnes, Rhona J.