Patient experiences with a transitional, low-threshold clinic for the treatment of substance use disorder: A qualitative study of a bridge clinic
Patient experiences with a transitional, low-threshold clinic for the treatment of substance use disorder: A qualitative study of a bridge clinic
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DOI：
10.1016/j.jsat.2019.09.003
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发表时间：
2019-12-01
影响因子：
3.9
通讯作者：
Wakeman, Sarah E.
中科院分区：
文献类型：
--
作者：
Snow, Rachel L.;Simon, Rachel E.;Wakeman, Sarah E.
背景资料：少数患有物质使用障碍（SUD）的患者接受治疗，这表明需要对SUD患者的护理进行创新。过渡和低阈值模式的护理SUD是用来解决这个治疗差距，但有有限的证据表明，他们的有效性或病人的观点，这些models.Methods：患者参加了半结构化访谈（N = 29），探讨他们的经验，过渡，低阈值，桥诊所治疗SUD。为了达到不同年龄，性别，住房状况，SUD类型，住院时间和临床患者状态的患者人群，研究人员采用了最大变异抽样。访谈一直进行到没有新的中心概念出现为止。代码的开发和分配使用的归纳以及混合的归纳演绎approach.Results：患者确定的灵活性和可访问性的服务，富有同情心的方式的供应商和工作人员，使用同行的恢复，并强调减少伤害的模型的积极特征。患者挣扎过渡出clinic.Conclusion：患者报告的过渡，低阈值诊所SUD的积极经验，比较有利的其他程序。患者保持清醒更加一致，并增加了坚持治疗的动力。患者几乎普遍赞赏灵活和以减少伤害为导向的治疗模式。未来的定量研究需要进一步研究低阈值计划对治疗结果的影响，包括持续的物质使用，治疗保留和过量死亡率，与传统的治疗计划相比。
Background: A minority of patients with substance use disorder (SUD) receives treatment, indicating the need for innovation in care for individuals with SUD. Transitional and low threshold models of care for SUD are utilized to address this treatment gap, but there is limited evidence about their effectiveness or patient perspectives on these models.Methods: Patients participated in semi-structured interviews (N = 29) which explored their experience in a transitional, low threshold, Bridge clinic for the treatment of SUD. In order to reach a diverse patient population across age, gender, housing status, type of SUD, length of stay, and patient status in the clinic, researchers employed maximum variation sampling. Interviews were conducted until no new central concepts emerged. Codes were developed and assigned using an inductive as well as a mixed inductive-deductive approach.Results: Patients identified flexibility and accessibility of services, compassionate approach of providers and staff, use of peers in recovery, and the emphasis on harm reduction as positive features of the model. Patients struggled with transitioning out of the clinic.Conclusion: Patients reported positive experiences in a transitional, low threshold clinic for SUD, comparing it favorably to other programs. Patients maintained sobriety more consistently and increasing motivation to adhere to treatment. Patients almost universally appreciated the flexible and harm reduction-oriented model of treatment. Future quantitative research is needed to further examine the effects of low threshold programs on treatment outcomes, including ongoing substance use, treatment retention and overdose mortality, as compared to traditional treatment programs.