Governing parental opioid use: a relational ethnography

为什么我们需要这项研究？受父母吸毒影响的儿童和家庭包括社会上一些最弱势的家庭。例如，父母往往有严重的健康和社会问题，生活贫困，他们的孩子经常最终进入照料系统。父母和家庭经常被污蔑和排斥在主流社会之外，并不总是得到适当的治疗和家庭支持。这些问题可能会代代相传。因此，改善他们的生活是卫生和社会护理服务以及政府的一个重要目标。许多国家(包括英国、澳大利亚、美国和加拿大)都建立了与受父母吸毒影响的家庭合作的方法。然而，这些政策和做法有很大的差异。对于它们在实践中如何运作(在不同机构内部和在不同机构之间)以及它们如何影响儿童和家庭，人们知之甚少。有必要从家庭的角度看整个系统是如何运作的。我们的研究旨在通过采访、观察父母和家庭以及医疗和社会护理服务提供者来更多地了解该系统是如何运行的，从而研究如何在实践中管理父母的药物使用。这项研究将涉及哪些方面？首先，我们将建立两个名为学习联盟的小组：一个在苏格兰，一个在英格兰。学习联盟是一群在某一特定主题上拥有知识和经验的人，例如父母吸毒。学习联盟将包括服务使用者、政策制定者和负责为吸毒父母及其家人管理公共服务的人。学习联盟将在项目的各个方面帮助研究团队，包括规划研究本身，评论我们的发现，并就在实践和政策上可以做些什么提出建议，以回应这些发现。第二，我们将聘请研究人员与30个有吸毒母亲和/或父亲并同意参与的家庭进行交流，其中15个在苏格兰，15个在英格兰。研究人员将在大约一段时间内找出他们的日常生活是什么样子。12-21个月。经允许，我们还将进行采访(约90)与家人、孩子、朋友和家庭的其他同事一起，试图更清楚地了解他们与机构和更广泛的社区的联系。第三，研究人员还将花费时间在12项服务(约各3个月)和面试人员(约100)为吸毒的父母提供照顾的人。研究人员将记录他们在服务中的所见所闻，了解吸毒父母是如何得到治疗和处理的。这些服务将包括一系列不同领域的NHS、社会工作和第三部门机构。最后，我们将审查和审查有关吸毒父母的治疗和管理的政策，以比较不同机构和国家(苏格兰/英格兰)的政策差异，以及不同政策对吸毒父母及其家人的管理和治疗有何影响。谁将受益？我们的研究结果将以不同的方式帮助一系列人和机构。它将在未来使吸毒父母及其家庭受益，因为它将有助于展示实践和政策如何更好地满足他们的需求。它将使社会更广泛地受益，因为它将使人们更好地了解父母及其家人的日常生活。它还将使专业人员、服务机构和政策制定者对现有做法和政策如何可能或可能不会造福于他们寻求帮助的人产生新的理解。它将通过展示如何为家庭改善政策和做法而使国际社会受益，它还可以帮助学术界开发新的干预措施，帮助吸毒的父母及其家人。

WHY DO WE NEED THIS STUDY?Children and families affected by parental drug use include some of the most disadvantaged families in society. For example, parents often have severe health and social problems, live in poverty, and their children frequently end up in the care system. Parents and families are often stigmatised and excluded from mainstream society and do not always receive the right kind of treatment and family support. These problems can be repeated from one generation to the next. Improving their lives is therefore a key goal for health and social care services as well as for government.Many countries (including the UK, Australia, USA and Canada) have established ways of working with families affected by parental drug use. However, there is wide variation in these policies and practices. There is little knowledge of how they operate in practice (within and across different agencies) and how they impact on children and families. There is a need to look at how the whole system works from a family perspective.Our study aims to do this by looking at how parental drug use is managed in practice by interviewing, observing and spending time with parents and families as well as health and social care service providers to understand more about how the system works.WHAT WILL THE STUDY INVOLVE?First, we will set up two groups called Learning Alliances: one in Scotland and one in England. A Learning Alliance is a group of people who have knowledge and experience in a particular topic, such as parental drug use. The Learning Alliances will include service users, policymakers and those in charge of managing public services for parents who use drugs and their families. The Learning Alliance will help the research team in all aspects of the project, including planning the research itself, commenting on our findings, and making suggestions about what can be done, in practice and policy, to respond to the findings.Second, we will employ researchers to spend time with 30 families who have a drug-using mother and/or father, and who agree to take part, 15 in Scotland and 15 in England. The researchers will find out what life is like for them day-to-day over a period of approx. 12-21 months. We will also, with permission, conduct interviews (approx. 90) with family members, children, friends, and other associates of the families to try to get a clearer understanding of their connections with agencies and their wider communities.Third, the researchers will also spend time in 12 services (approx. 3 months each) and interview staff (approx. 100) who provide care to parents who use drugs. Researchers will take notes about what they see and hear in the services about how drug-using parents are treated and dealt with. The services will include NHS, social work and third sector agencies in a range of different areas.Lastly, we will review and examine policies about the treatment and management of parents who use drugs to compare how polices differ in different agencies and countries (Scotland/England) and what effects the different policies have on how parents who use drugs and their families are managed and treated.WHO WILL BENEFIT?Our study findings will help a range of people and agencies in different ways.It will benefit parents who use drugs and their families in the future because it will help to show how practices and policies might better meet their needs. It will benefit society more widely as it will provide a better understanding of the everyday lives of parents and their families.It will also benefit professionals, services and policymakers by offering new understandings about how existing practices and policies may or may not be benefiting the people they seek to help.It will benefit the international community by showing how policies and practices could be improved for families and it could help academics develop new interventions to help parents who use drugs and their families.