Alcohol and other substance use disorder recovery during pregnancy among patients with posttraumatic stress disorder symptoms: A qualitative study.
Alcohol and other substance use disorder recovery during pregnancy among patients with posttraumatic stress disorder symptoms: A qualitative study.
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DOI：
10.1016/j.dadr.2021.100013
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Leeman LM
中科院分区：
文献类型：
--
作者：
Henry MC;Sanjuan PM;Stone LC;Cairo GF;Lohr-Valdez A;Leeman LM
接受SUD治疗的孕妇有很高的创伤后应激障碍发生率。政策，经济，物理和社会环境影响产前药物使用。产前SUD的治疗必须解决社会和结构性障碍。创伤和SUD知情的护理培训是必要的产前SUD保健提供者。大约5%的妇女在接受药物使用障碍（SUD）治疗时怀孕，患有SUD的孕妇通常属于边缘化群体，这些群体经历着与产前药物使用相关的社会，经济和卫生保健障碍。接受SUD治疗的孕妇有很高的创伤和创伤后应激障碍（PTSD）发生率。本研究旨在（1）检查有PTSD症状的妊娠个体在SUD治疗中的生活经历，（2）了解系统性或背景性障碍对追求产前禁欲的作用。我们借鉴了深入的半结构化访谈，以探讨SUD，心理创伤/PTSD的经验，社会资源，并在产前SUD治疗与PTSD症状的患者之间的生活经验之间的关系。我们的样本是怀孕的患者（N = 13）与以前的DSM-5标准A创伤和目前的创伤后应激障碍症状参加了一个综合计划，整合产前护理，物质使用咨询，阿片类药物使用障碍和病例管理在三个网站附属于新墨西哥州的城市学术医疗中心。通过专题分析，确定了影响酒精和药物用途：（a）缺乏获得资源的途径或能力，（B）使用药物来科普负面影响，（c）社会耻辱，（d）人际关系。尽管接受了高质量的综合产前和SUD护理，这些在SUD治疗中有PTSD症状的怀孕患者在怀孕期间仍然经历了大量的社会和结构障碍，以实现禁欲。
Pregnant patients in SUD treatment have high posttraumatic stress disorder rates. Policy, economic, physical, and social environments impact prenatal substance use. Treatment for prenatal SUD must address social and structural barriers. Trauma-and SUD-informed care training is needed for prenatal SUD health providers. About 5% of women are pregnant at substance use disorder (SUD) treatment entry, and pregnant women with SUD often belong to marginalized groups experiencing social, economic, and health care barriers associated with stigma from prenatal substance use. Pregnant women in SUD treatment have high rates of trauma and posttraumatic stress disorder (PTSD). This study sought to (1) examine the lived experiences of pregnant individuals with PTSD symptoms in SUD treatment and (2) understand the roles of systematic or contextual barriers to the pursuit of prenatal abstinence. We draw upon in-depth semi-structured interviews to examine relationships between SUD, psychological trauma/PTSD experience, social resources, and lived experiences among patients in prenatal SUD treatment with PTSD symptoms. Our sample was pregnant patients (N = 13) with prior DSM-5 Criterion A trauma and current PTSD symptoms enrolled in a comprehensive program integrating prenatal care, substance use counseling, medication for opioid use disorder and case management at three sites affiliated with an urban academic medical center in New Mexico. Using thematic analysis, four main themes identified structural forces influencing alcohol and drug use: (a) lack of access or ability to obtain resources, (b) substance use to cope with negative affect, (c) social stigma, and (d) interpersonal relationships. Despite receiving high-quality integrated prenatal and SUD care, these pregnant patients with PTSD symptoms in SUD treatment still experienced substantial social and structural hurdles to achieving abstinence during pregnancy.
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影响因子：
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