Age-based preferences for risk communication in the fentanyl era: 'A lot of people keep seeing other people die and that's not enough for them'.
Age-based preferences for risk communication in the fentanyl era: 'A lot of people keep seeing other people die and that's not enough for them'.
复制标题
DOI：
10.1111/add.15305
复制
发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Bagley SM
中科院分区：
文献类型：
--
作者：
Gunn CM;Maschke A;Harris M;Schoenberger SF;Sampath S;Walley AY;Bagley SM
探索使用芬太尼的人和医疗保健提供者如何参与并应对过量风险沟通互动，以及这些参与和反应如何因年龄而异。一项单点定性深入访谈研究。美国马萨诸塞州波士顿。该样本包括21人（10名女性，11名男性），他们年龄在18-25岁或35岁以上，讲英语，并报告去年非法使用芬太尼，以及10名直接与临床和社区环境中使用芬太尼（PWUF）的人合作的医疗保健提供者。在所有访谈中，都使用了由风险沟通框架指导的开放式、灵活的访谈问题。用于主题分析的代码包括与风险沟通框架相关的演绎代码和来自访谈内容的归纳、紧急代码。我们确定了对芬太尼过量的看法存在潜在的年龄差异，包括年轻参与者似乎对芬太尼的致命性表现出更多的免疫力，而老年人似乎对芬太尼表达了更强烈的厌恶，因为它增加了致命过量的风险，较短的影响和长期健康后果的可能性。供应商认为更大的挑战中继风险信息年轻PWUF，并认为他们是不太开放的风险沟通。所有参与者都更喜欢减少压缩机危害的沟通，并认为社区卫生工作者和同行提供的最有效。PWUF和提供者确定了限制同情伤害减少的结构性障碍，包括可用治疗与首选方案和临床结构的不一致，这阻碍了风险沟通信息的传递。在非法使用芬太尼的人中，芬太尼相关的风险沟通经验和偏好可能因年龄而异，但一些基本要素，包括富有同情心，建立信任的方法，似乎是整个年龄范围的首选。临床环境中的结构性障碍，如提供者的处方权力和不经常的接触，可能会阻碍提供者提供富有同情心的减少伤害沟通的能力。
To explore how people who use fentanyl and health-care providers engaged in and responded to overdose risk communication interactions, and how these engagements and responses might vary by age. A single-site qualitative in-depth interview study. Boston, MA, United States. The sample included 21 people (10 women, 11 men) who were either 18–25 or 35+, English-speaking, and reported illicit fentanyl use in the last year and 10 health-care providers who worked directly with people who use fentanyl (PWUF) in clinical and community settings. Open-ended, flexible interview questions guided by a risk communication framework were used in all interviews. Codes used for thematic analysis included deductive codes related to the risk communication framework and inductive, emergent codes from interview content. We identified potential age-based differences in perceptions of fentanyl overdose, including that younger participants appeared to display more perceptions of an immunity to fentanyl’s lethality, while older people seemed to express a stronger aversion to fentanyl due to its heightened risk of fatal overdose, shorter effects and potential for long-term health consequences. Providers perceived greater challenges relaying risk information to young PWUF and believed them to be less open to risk communication. Compassionate harm reduction communication was preferred by all participants and perceived to be delivered most effectively by community health workers and peers. PWUF and providers identified structural barriers that limited compassionate harm reduction, including misalignment of available treatment with preferred options and clinical structures that impeded the delivery of risk communication messages. Among people who engage in illicit fentanyl use, fentanyl-related risk communication experiences and preferences may vary by age, but some foundational elements including compassionate, trust-building approaches seem to be preferred across the age spectrum. Structural barriers in the clinical setting such as provider-prescribing power and infrequent encounters may impede the providers’ ability to provide compassionate harm reduction communication.
登录
查看更多内容
影响因子：
3.7
作者：
Coffin PO;Santos GM;Matheson T;Behar E;Rowe C;Rubin T;Silvis J;Vittinghoff E
通讯作者：
Vittinghoff E
影响因子：
4.2
作者：
Cedarbaum, Emily R.;Banta-Green, Caleb J.
通讯作者：
Banta-Green, Caleb J.
海洛因，处方阿片类药物和非法芬太尼过量的纳洛酮：挑战和创新对动态流行作出反应。
DOI：
10.1016/j.drugpo.2017.06.005
发表时间：
2017-08
期刊：
The International journal on drug policy
影响因子：
--
作者：
Fairbairn N;Coffin PO;Walley AY
通讯作者：
Walley AY
影响因子：
33.9
作者：
Armenian, Patil;Whitman, Jeffrey D.;Lynch, Kara L.
通讯作者：
Lynch, Kara L.
影响因子：
3.8
作者：
Eccleston, P;Werneke, U;MacFaul, R
通讯作者：
MacFaul, R