Comprehensive Treatment for Pregnant and Parenting Women with Substance Use Disorders and Their Children: The UNC Horizons Story.
Comprehensive Treatment for Pregnant and Parenting Women with Substance Use Disorders and Their Children: The UNC Horizons Story.
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对患有药物滥用障碍的孕妇和育儿妇女及其孩子的综合治疗：北卡罗来纳大学地平线故事。
DOI：
10.1007/s10995-023-03870-7
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发表时间：
2024
影响因子：
2.3
通讯作者：
Thorp,John
中科院分区：
文献类型：
--
作者：
Jones,HendréeE;Andringa,Kim;Carroll,Senga;Johnson,Elisabeth;Horton,Evette;O'Grady,Kevin;Stanford,Deborah;Renz,Connie;Thorp,John
目的描述北卡罗来纳州地平线项目，一个以妇女为中心的综合性项目，针对患有药物使用障碍的孕妇和育儿妇女，及其患者群体是如何随着时间的推移而变化的，并总结在地平线上接受治疗的妇女所生婴儿的基本新生儿结局。研究了患者特征和婴儿结局，并与北卡罗来纳州的标准数据进行了比较。研究结果的亮点包括：将阿片类药物作为主要使用物质的女性比例从1995-1996年的0%上升到2016-17年的62%，而可卡因的比例从66%下降到12%。静脉注射药物使用史从1994-1995年的7%上升到2016-2017年的41%。报告有监禁史的妇女人数从早年的10%-20%上升到2007年至2008年的40%-50%。报告想要伤害自己的女性比例从2004-2005年的20%上升到2016-2017年的40%。多年来，自我报告的自杀未遂历史保持在32%。虽然多年来儿童遭受身体虐待的报告保持在38%，但性虐待和家庭暴力的报告呈上升趋势。Horizons与北卡罗来纳州在患者早产的可能性[χ2(13) = 20.6，p= .082]或患者生下低出生体重儿的可能性[χ2(13) = 14.7，p= .333]方面没有不同。结论实践打破妇女和儿童的成瘾循环必须专注于帮助有药物使用问题的女性培养一种希望，即她们的生活可以改善，以及一种安全感和养育感。
ObjectivesTo describe how the UNC Horizons program, a comprehensive women-centered program for pregnant and parenting women with substance use disorders, and its patient population have changed over time and summarize basic neonatal outcomes for infants born to women in treatment at Horizons.MethodsYearly Annual Reports from fiscal years of 1994 to 2017 were abstracted. Patient characteristics and infant outcomes compared to normative North Carolina data were examined.ResultsHighlights of findings include: The percentage of women for whom opioids were the primary substance of use increased from 0% in 1995–1996 to 62% in 2016–17, while cocaine decreased from 66 to 12%. Intravenous substance use history increased from 7% in 1994–1995 to 41% in 2016–2017. The number of women reporting a history of incarceration rose from 10–20% in the early years to 40%-50% beginning in 2007–2008. The proportion of women reporting a desire to hurt themselves rose from 20% in 2004–2005 to 40% in 2016–2017. Self-reported suicide attempt history remained consistent at 32% across years. While reporting of childhood physical abuse remained at 38% across years, reporting of sexual abuse and domestic violence trended upward. Horizons did not differ from North Carolina in the likelihood of patients giving birth prematurely [χ2(13) = 20.6,p= .082], or the likelihood of a patient giving birth to a low birthweight infant [χ2(13) = 14.7,p= .333].Conclusions for PracticeBreaking the cycle of addiction for women and children must focus on helping women with substance use problems develop a sense of hope that their lives can improve, and a sense of feeling safe and nurtured.