"It's been an Experience, a Life Learning Experience": A Qualitative Study of Hospitalized Patients with Substance Use Disorders
"It's been an Experience, a Life Learning Experience": A Qualitative Study of Hospitalized Patients with Substance Use Disorders
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DOI：
10.1007/s11606-016-3919-4
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发表时间：
2017-03-01
影响因子：
5.7
通讯作者：
Englander, Honora
中科院分区：
文献类型：
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作者：
Velez, Christine M.;Nicolaidis, Christina;Englander, Honora
患有物质使用障碍（SUD）的人慢性病和再入院的比率很高，但很少有人接受成瘾治疗。 Hospitalization may be a reachable moment for initiating and coordinating addiction care, but little is known about motivation for change in the inpatient setting.To explore the experiences of hospitalized adults with SUD and to better understand patient and system level factors impacting readiness for change.We performed a qualitative study using individual interviews.该研究嵌套在更大的混合方法需求评估中。在城市学术医疗中心的内科或外科单位入住的住院成人，在 AUDIT-C 或单项药物使用筛查中报告了高风险酒精或药物使用情况。我们在语义层面使用归纳方法进行了主题分析。32 名患者参与。 The mean age was 43 years; 75% 是男性，68% 是白人。参与者报告了中度至高风险的酒精（39%）、安非他明（46%）和阿片类药物（65%）的使用。新兴主题突出了住院治疗对患者、提供者和卫生系统层面的影响。许多患者的住院经历是一次警钟，死亡是改变的动力，而住院则扰乱了药物的使用。然而，许多参与者表达了对社会混乱、创伤、无家可归和慢性疼痛的复杂叙述。参与者重视了解 SUD 和治疗选择重要性的提供者。患者的经验表明，医院环境中的同伴、获得药物辅助治疗以及出院后协调护理的重要性。这项研究支持住院治疗提供了启动和协调成瘾护理的机会，并提供了对患者、提供者和卫生系统因素的见解，这些因素可以利用这一时刻的可达性。
Individuals with substance use disorders (SUD) have high rates of chronic illness and readmission, yet few are engaged in addiction treatment. Hospitalization may be a reachable moment for initiating and coordinating addiction care, but little is known about motivation for change in the inpatient setting.To explore the experiences of hospitalized adults with SUD and to better understand patient and system level factors impacting readiness for change.We performed a qualitative study using individual interviews. The study was nested within a larger mixed-methods needs assessment.Hospitalized adults admitted to medical or surgical units at an urban academic medical center who reported high-risk alcohol or drug use on AUDIT-C or single-item drug use screener.We conducted a thematic analysis, using an inductive approach at a semantic level.Thirty-two patients participated. The mean age was 43 years; 75% were men, and 68% identified as white. Participants reported moderate to high-risk alcohol (39%), amphetamine (46%), and opioid (65%) use. Emergent themes highlight the influence of hospitalization at the patient, provider, and health system levels. Many patients experienced hospitalization as a wake-up call, where mortality was motivation for change and hospitalization disrupted substance use. However, many participants voiced complex narratives of social chaos, trauma, homelessness, and chronic pain. Participants valued providers who understood SUD and the importance of treatment choice. Patient experience suggests the importance of peers in the hospital setting, access to medication-assisted treatment, and coordinated care post-discharge.This study supports that hospitalization offers an opportunity to initiate and coordinate addiction care, and provides insights into patient, provider, and health system factors which can leverage the reachability of this moment.