A life-course theory exploration of opioid-related maternal mortality in the United States.
A life-course theory exploration of opioid-related maternal mortality in the United States.
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DOI：
10.1111/add.15054
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Recto P
中科院分区：
文献类型：
--
作者：
Cleveland LM;McGlothen-Bell K;Scott LA;Recto P
2007 年至 2016 年间，美国因药物过量导致的妊娠相关死亡率增加了一倍多。本研究探讨了孕产妇阿片类药物相关发病率和死亡率的情况，使用生命历程理论作为敏化框架来研究每个参与者的生命历程如何导致其药物使用、复发、恢复或过量。采用半结构化、深入的面对面访谈和焦点小组的混合方法研究。美国德克萨斯州。对重新使用阿片类药物或经历过“险些”过量服用的妇女以及因阿片类药物过量在产妇期间死亡的妇女的家人进行了访谈（n = 99）。社会人口统计调查问卷记录了参与者的种族、年龄、婚姻状况、医疗和心理健康史以及就业状况。压力生活事件筛查问卷修订版 (SLESQ-R) 评估了一生中遭受创伤的情况。妇女报告了因他杀或自杀而遭受虐待和失去亲人的历史。参与者表示，有限的社会支持、与伴侣的人际冲突以及未得到解决的精神疾病使康复变得更具挑战性。此外，通过儿童福利系统失去孩子被认为是一种惩罚，并使他们面临更大的复发和吸毒过量的风险。美国德克萨斯州采用生命历程理论方法来检查孕产妇阿片类药物相关发病率和死亡率，揭示了面临阿片类药物使用复发和过量风险的妇女的复杂需求以及先前创伤经历的重要作用。
Between 2007 and 2016, pregnancy‐associated mortality resulting from overdose more than doubled in the United States. This study explored the circumstances surrounding maternal opioid‐related morbidity and mortality, using the life‐course theory as a sensitizing framework to examine how each participant's life‐course contributed to her substance use, relapse, recovery or overdose. A mixed‐methods study using semi‐structured, in‐depth face‐to‐face interviews and focus groups were conducted. Texas, United States. Women who had relapsed into opioid use or experienced a ‘near‐miss’ overdose and family members of women who had died during the maternal period due to opioid overdose were interviewed (n = 99). A socio‐demographic questionnaire captured participants’ ethnicity, age, marital status, medical and mental health history and employment status. The Stressful Life Events Screening Questionnaire—revised (SLESQ‐R) assessed life‐time exposure to trauma. Women reported histories of abuse and loss of a loved one through homicide or suicide. Participants indicated that limited social support, interpersonal conflict with their partner and unaddressed mental illness made recovery more challenging. Additionally, losing their children through the child welfare system was described as punitive and placed them at greater risk for relapse and overdose. A life‐course theory approach to examining maternal opioid‐related morbidity and mortality in Texas, United States reveals the complex needs of women at risk for opioid use relapse and overdose and the significant role of previous traumatic experiences.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
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作者：
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