Identifying barriers and facilitators for implementing harm reduction strategies for methamphetamine use into hospital settings.
Identifying barriers and facilitators for implementing harm reduction strategies for methamphetamine use into hospital settings.
复制标题
确定障碍和促进者，以实施减少甲基苯丙胺在医院环境中使用损害的策略。
DOI：
10.3389/frhs.2023.1113891
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Scott, Leanne
中科院分区：
文献类型：
--
作者：
Forchuk, Cheryl;Serrato, Jonathan;Scott, Leanne
加拿大医院目前没有提供减少物质使用障碍的伤害战略。以前的研究表明，物质使用可能会继续发生，这可能会导致进一步的并发症，如新的感染。减少伤害的策略可能是解决这个问题的一个办法。该二次分析旨在从医疗保健和服务提供者的角度探讨在医院实施伤害减少的当前障碍和潜在促进因素。主要数据收集自31名医疗保健和服务提供者，他们参加了一系列虚拟焦点小组和一对一访谈，了解他们对减少伤害的看法。所有员工均于2021年2月至2021年12月期间从加拿大西南部安大略的医院招聘。卫生保健和服务专业人员完成了一次个人访谈或虚拟焦点小组使用开放式定性访谈调查。定性数据逐字转录和分析使用民族志专题的方法。根据答复确定了主题和次主题并进行了编码。态度和知识，语用学和安全/减少伤害被确定为核心主题。据报告，存在诸如污名化和不被接受等态度障碍，但教育、开放和社区支持被视为潜在的促进因素。成本、空间、时间和现场物质的可得性被视为务实障碍，但也确定了潜在的促进因素，如组织支持、灵活的减少危害服务和专业团队。政策和责任被认为是一种障碍，也是一种潜在的促进因素。药物的安全性和对治疗的影响被认为是一个障碍和潜在的促进因素，但锐器盒和护理的连续性被认为是潜在的促进因素。尽管在医院环境中实施减少伤害存在障碍，但仍有机会促进变革。正如本研究所确定的那样，存在可行和可实现的解决方案。对工作人员进行减少危害教育被认为是促进减少危害实施的关键临床意义。
Harm reduction strategies for substance use disorder are not currently offered in Canadian hospitals. Previous research has suggested that substance use may continue to occur which can lead to further complications such as new infections. Harm reduction strategies may be a solution to this issue. This secondary analysis aims to explore the current barriers and potential facilitators for implementing harm reduction into the hospital from the perspective of health care and service providers. Primary data was collected from 31 health care and service providers who participated in a series of virtual focus groups and one-to-one interviews regarding their perspectives on harm reduction. All staff were recruited from hospitals in Southwestern Ontario, Canada from February 2021 to December 2021. Health care and service professionals completed a one-time individual interview or a virtual focus group using an open-ended qualitative interview survey. Qualitative data was transcribed verbatim and analyzed using an ethnographic thematic approach. Themes and subthemes were identified and coded based on responses. Attitude and Knowledge, Pragmatics, and Safety/Reduction of Harm were identified as the core themes. Attitudinal barriers such as stigma and lack of acceptance were reported but education, openness and community support were regarded as potential facilitators. Cost, space, time and availability of substances on site were regarded as Pragmatic barriers but potential facilitators such as organizational support, flexible harm reduction services and a specialized team were identified. Policy and liability were perceived as both a barrier and a potential facilitator. Safety and impact of substances on treatment were considered as both a barrier and a potential facilitator but sharps boxes and continuity of care were regarded as potential facilitators. Although barriers in implementing harm reduction in hospital settings exist, there are opportunities to facilitate change. As identified in this study, feasible and achievable solutions are available. Education on harm reduction for staff was considered to be a key clinical implication in facilitating harm reduction implementation.
登录
查看更多内容
影响因子：
3.8
作者：
Brooks, Hannah L.;O'Brien, Daniel C.;Hyshka, Elaine
通讯作者：
Hyshka, Elaine
影响因子：
3.7
作者：
Horner, Gabrielle;Daddona, Jeff;Wurcel, Alysse G.
通讯作者：
Wurcel, Alysse G.
影响因子：
2.1
作者：
Ijioma, Stephen C.;Pontinha, Vasco M.;Carroll, Norman, V
通讯作者：
Carroll, Norman, V
影响因子：
3.6
作者：
Lederer, Katharina;Fouche, Jean-Paul;Uhlmann, Anne
通讯作者：
Uhlmann, Anne
影响因子：
2.7
作者：
James, Jenny
通讯作者：
James, Jenny