在患有阿片类药物使用障碍的孕妇患者中,提供者-患者关系和创伤
Molly Doernberg1, Kathryn Gilstad-Hayden2, Kimberly A Yonkers3
1Yale School of Medicine, New Haven, Connecticut, USA.
The American journal on addictions
|April 30, 2024
概括
患有阿片类药物使用障碍和可能的PTSD的孕妇患者报告说,提供者与患者之间的关系较弱,影响了沟通和赋权. 这凸显了这一弱势群体在产前环境中需要创伤信息化的护理.
科学领域:
- 产科和妇科 产科和妇科
- 精神病学是一个精神病学.
- 成 药物 药物 药物 药物
背景情况:
- 提供者与患者之间的关系对医疗保健结果至关重要,特别是在弱势群体中.
- 孕妇的阿片类药物使用障碍 (OUD) 带来了独特的挑战.
- 创伤史可以显著影响患者的体验和与医疗保健提供者的关系.
研究的目的:
- 根据她们的中度至重度创伤史,比较OUD孕妇患者之间的提供者-患者关系.
- 调查可能的创伤后应激障碍 (PTSD) 与该人群中提供者-患者联盟的质量之间的关联.
主要方法:
- 对119名患有OUD的孕妇患者的探索性数据分析,来自支持模型的成相关治疗试验.
- 使用DSM-5的PTSD检查清单 (得分≥31) 评估可能的PTSD.
- 在怀孕26 ± 4周使用金联盟量表 (KAS) 评估提供者-患者关系.
- 多变量回归分析以检查KAS分数和可能的PTSD之间的关联.
主要成果:
- 与没有可能的PTSD (N=88,61.4 ± 2.8) 相比,可能患有PTSD的孕妇参与者 (N=31) 的KAS平均得分较低 (59.6 ± 3.7).
- 经过调整后的分析显示,可能患有PTSD的参与者在授权和沟通子表中的总KAS分数和分数显著较低 (分别为p=.04和p=.02).
- 在各组之间的协作和整合子表中没有发现显著差异.
结论:
- 一个可能的PTSD诊断与较差的提供者-患者关系有关,特别是在沟通和赋权方面,在OUD的孕妇患者中.
- 这一发现强调了在OUD患者的产前护理中解决创伤的重要性.
- 将创伤相关的实践纳入产科护理可能会改善治疗结盟,改善这一弱势群体的健康结果.
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