Impacts of COVID-19 on residential treatment programs for substance use disorder.
Impacts of COVID-19 on residential treatment programs for substance use disorder.
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DOI：
10.1016/j.jsat.2020.108255
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发表时间：
2021-04
影响因子：
3.9
通讯作者：
Guydish JR
中科院分区：
文献类型：
--
作者：
Pagano A;Hosakote S;Kapiteni K;Straus ER;Wong J;Guydish JR
COVID-19大流行可能对住宅物质使用障碍（SUD）治疗设施带来特殊挑战，这些设施可能缺乏基础设施和支持，无法在维持现场治疗服务的同时实施感染控制方案。然而，有关COVID-19大流行如何影响住宅SUD治疗计划的情况知之甚少。研究小组对加州20个住宅SUD治疗项目的17名负责人进行了半结构化访谈。研究人员随后按主题分析定性访谈数据，并使用ATLAS.ti软件对其进行编码。专题分析确定了六大主题：方案层面的影响，工作人员的影响，客户的影响，使用远程保健，方案的需求，和积极的影响。“方案一级的影响”是客户普查减少导致收入减少，以及执行感染控制措施的资源不足。“员工影响”包括裁员、休假以及身体和情绪疲劳加剧。“客户影响”是治疗启动延迟;治疗期间接受的服务减少;保留率降低;以及重返社区的经济和心理障碍。“使用远程保健”包括与远程保健访问有关的技术和人际关系挑战。“方案需要”是个人防护设备、刺激资金、危险津贴和一致的公共卫生指导。大流行应对措施的“积极影响”包括更加重视卫生和健康、扩大远程保健、改善业务以及正式承认SUD治疗为基本卫生保健服务。研究结果强调了与COVID相关的对住宅SUD治疗计划生存的威胁; SUD治疗工作人员的保留;以及客户的SUD治疗结果。这些发现还确定了改善SUD服务交付的机会，并为COVID-19大流行期间和之后的住宅SUD治疗设施提供了支持途径。
The COVID-19 pandemic may present special challenges for residential substance use disorder (SUD) treatment facilities, which may lack infrastructure and support to implement infection control protocols while maintaining on-site treatment services. However, little is known about how residential SUD treatment programs are impacted by the COVID-19 pandemic. The research team conducted semi-structured interviews with 17 directors of 20 residential SUD treatment programs across California during the state's shelter-in-place order. The researchers then analyzed qualitative interview data thematically and coded them using ATLAS.ti software. Thematic analyses identified six major themes: program-level impacts, staff impacts, client impacts, use of telehealth, program needs, and positive effects. “Program-level impacts” were decreased revenue from diminished client censuses and insufficient resources to implement infection control measures. “Staff impacts” included layoffs, furloughs, and increased physical and emotional fatigue. “Client impacts” were delayed treatment initiation; receipt of fewer services while in treatment; lower retention; and economic and psychosocial barriers to community re-entry. “Use of telehealth” included technical and interpersonal challenges associated with telehealth visits. “Program needs” were personal protective equipment (PPE), stimulus funding, hazard pay, and consistent public health guidance. “Positive effects” of the pandemic response included increased attention to hygiene and health, telehealth expansion, operational improvements, and official recognition of SUD treatment as an essential health care service. Study findings highlight COVID-related threats to the survival of residential SUD treatment programs; retention of the SUD treatment workforce; and clients' SUD treatment outcomes. These findings also identify opportunities to improve SUD service delivery and suggest avenues of support for residential SUD treatment facilities during and after the COVID-19 pandemic.
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