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首页> 外文期刊>Substance abuse: official publication of the Association for Medical Education and Research in Substance Abuse >A qualitative analysis of family involvement in prescribed opioid medication monitoring among individuals who have experienced opioid overdoses
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A qualitative analysis of family involvement in prescribed opioid medication monitoring among individuals who have experienced opioid overdoses

机译：对阿片类药物过量服用者的家庭参与处方阿片类药物监测的定性分析

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Background: Little is known about the role, extent, or effects of family member involvement in monitoring and managing opioid analgesics. Knowing when or how family members monitor prescribed opioid medication taking, whether it is acceptable to patients, or how family relationships may be affected by monitoring, are not well documented. Methods: The study was conducted at Kaiser Permanente Northwest, an integrated health plan in Oregon and Washington. Semistructured in-depth interviews (N = 87) assessed circumstances surrounding overdose events among individuals who either experienced an opioid-related overdose or were family members of patients who died as a result of such an overdose. A subset of participants (n = 20) described family members' roles in monitoring opioid medications before or after overdoses. Interviews were transcribed verbatim and coded using Atlas.ti. We used a modified grounded theory approach to categorize emergent data and to identify common themes. Results: When family members played roles in monitoring and managing opioid medications, clinicians were often unaware of their involvement. Patients and family members reported better outcomes when the patient, caregiver, and clinician developed a shared treatment plan. Negative outcomes included relationship stress, particularly when patients and caregivers had differing perspectives about what constituted effective pain management versus misuse and abuse. Conclusions: When families are concerned about opioid medications, coordination between clinicians, patients, and family carers appears to clarify roles and foster better outcomes. Increased stress and worse outcomes were reported when clinicians were not actively involved and when they did not attend to carers' concerns.
机译：背景：关于家庭成员参与监测和管理阿片类镇痛药的作用，程度或影响知之甚少。关于家庭成员何时或如何监控处方阿片类药物的服用情况，患者是否可以接受或通过监控可能如何影响家庭关系，尚无充分记载。方法：该研究在俄勒冈州和华盛顿州的一项综合卫生计划-西北凯撒永久医院进行。半结构化深度访谈（N = 87）评估了服用阿片类药物相关过量或因过量服用而死亡的患者家庭成员的过量事件的情况。一部分参与者（n = 20）描述了家庭成员在服药过量之前或之后监测阿片类药物的作用。采访被逐字记录，并使用Atlas.ti进行编码。我们使用改良的扎根理论方法对紧急数据进行分类并确定常见主题。结果：当家庭成员在监视和管理阿片类药物方面发挥作用时，临床医生通常不知道他们的参与。当患者，护理人员和临床医生制定了共享的治疗计划时，患者及其家人报告了更好的结果。负面结果包括人际关系压力，特别是当患者和护理人员对于有效的疼痛管理与滥用和滥用构成什么有不同看法时。结论：当家庭关注阿片类药物时，临床医生，患者和家庭护理人员之间的协调似乎可以澄清角色并促进更好的结果。据报道，当临床医生没有积极参与并且没有照顾护理人员时，他们的压力就会增加，结果会恶化。

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