提供者耻辱的减少与乌克兰初级保健中心接受甲的人群中改善的质量健康指标有关
Eteri Machavariani1, Daniel J Bromberg2, Kostyantyn Dumchev3
1Yale School of Medicine, Department of Medicine, Section of Infectious Diseases, New Haven, CT, United States; Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, United States.
The International journal on drug policy
|December 20, 2024
概括
将美沙纳入初级保健减少了提供者耻辱,改善了患者健康结果. 这种方法提高了注射毒品的人获得基本服务的机会.
科学领域:
- 公共卫生 公共卫生
- 成 药物 药物 药物 药物
- 医疗保健实施方案的实施
背景情况:
- 注射毒品的人面临着严重的健康差异,通常由提供者耻辱加剧,影响他们获得护理.
- 像甲这样的阿片类激素治疗改善了注射药物的人的结果,但医疗保健利用仍然是一个挑战.
- 乌克兰将甲纳纳入初级保健中心 (PCC) 提供了一个独特的环境来研究提供者耻辱及其影响.
研究的目的:
- 评估将甲纳纳入初级保健对提供者对注射毒品的人的耻辱影响.
- 检查乌克兰减少提供者耻辱和患者健康结果之间的关联.
- 评估远程教育在缓解PCC内部提供者耻辱的有效性.
主要方法:
- 一项实施试验的子分析,涉及在PCC中接受美沙的患者与专业成诊所的患者.
- 在24个月内评估了提供者耻辱,对基于证据的实践的态度和患者质量健康指标 (QHI) 评分.
- 使用线性混合效应模型分析了耻辱的变化及其与患者结果的相关性.
主要成果:
- 提供者对注射毒品的人的恐惧和刻板印象在整合后显著改善.
- 提供者偏见和对基于证据的实践的态度的改善与患者初级保健QHI得分的增加相关.
- 减少刻板印象和对甲维持的偏好与患者专科护理QHI得分的显著增加有关.
结论:
- 在远程教育的支持下,将甲纳纳入PCC,有效地减少了提供者的耻辱,包括恐惧和刻板印象.
- 较低的提供者耻辱与改善患者获得初级和专业医疗保健服务有关.
- 这种整合模式有可能加强注射毒品的人的预防护理和查.
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