"There's a lot of people who love them, so why call 'em junkies?": clinician and patient perspectives about words used to describe people who use drugs.

IF 3.2 2区 医学 Q1 SUBSTANCE ABUSE
Gayathri Sundaram, Taisuke Sato, Brindet Socrates, Alysse Wurcel
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引用次数: 0

Abstract

Background: There is increasing attention in clinician care to the importance of using person-first language. Clinicians' words can reinforce clinicians' pre-existing stigmas and biases. People who use drugs (PWUD) continue to face stigma from clinicians. Person-first language is a way to reduce stigma and perpetuation of bias.

Methods: Through specific structured in-person interviews, we examined the usage of stigmatizing language in the care of PWUD by surveying key clinicians- such as physicians, nurses, and social workers-and patients who self-identified as PWUD at Tufts Medical Center (Boston, MA) between July 2022-September 2022. Interview guides were created using the Consolidated Framework for Implementation Research (CFIR) 2.0 as a framework. We evaluated perceptions of person-first language and barriers to using person-first language amongst participants. Interviews were coded with Dedoose Software and inductive thematic analysis (ITA) methods were used until all themes were captured; CFIR 2.0 determinants used during interview guide creation were used as preliminary themes and modified as needed.

Results: We interviewed thirty-four people, including eleven PWUD at time of interview. Most clinicians agreed that language is important and matters when talking to patients and during documentation. Almost all patients agreed that language was important to them and impacted their relationship with their provider. However, there were responders that felt that person-first language was unnecessary, ineffective, and overly verbose in the medical setting. Major barriers to using person-first language were unawareness, lack of formal training, and perceived generational differences in appropriate language.

Conclusion: Addressing language usage is a critical opportunity to promote inclusion and reduce bias amongst PWUD. As medical charts become increasingly accessible by patients, the use of language by the clinician becomes increasingly important. To create and maintain equitable systems of care, it is important to meet clinicians where they are at and to work with them to address these issues. This can include targeted educational sessions and resources informing clinicians on preferred language use and curriculum for providers-in-training.

Abstract Image

“有很多人喜欢他们,所以为什么称他们为瘾君子呢?”:临床医生和患者对用于描述吸毒者的词语的看法。
背景:临床医生越来越注意到使用以人为本的语言的重要性。临床医生的话会强化他们已有的偏见和偏见。使用药物的人(PWUD)继续面临来自临床医生的耻辱。以人为本的语言是减少耻辱和偏见的一种方式。方法:在2022年7月至2022年9月期间,我们通过对塔夫茨医疗中心(波士顿,马萨诸塞州)的主要临床医生(如医生、护士和社会工作者)和自我认定为PWUD的患者进行调查,通过具体的结构化面对面访谈,研究了在PWUD护理中污名化语言的使用情况。访谈指南是使用实施研究统一框架(CFIR) 2.0作为框架创建的。我们评估了参与者对“以人为本”语言的认知和使用“以人为本”语言的障碍。使用Dedoose软件对访谈进行编码,并使用归纳主题分析(ITA)方法,直到捕获所有主题;访谈指南制作过程中使用的CFIR 2.0决定因素作为初步主题,并根据需要进行修改。结果:我们访谈了34人,其中11人为PWUD。大多数临床医生都认为,在与患者交谈和记录过程中,语言很重要,也很重要。几乎所有的病人都认为语言对他们很重要,并影响了他们与医生的关系。然而,也有应答者认为,在医疗环境中,以人为本的语言是不必要的、无效的、过于冗长的。使用以人为本的语言的主要障碍是缺乏意识,缺乏正式培训,以及在适当语言方面的代际差异。结论:解决语言使用问题是促进PWUD包容和减少偏见的关键机会。随着病人越来越容易获得医疗图表,临床医生对语言的使用变得越来越重要。为了建立和维持公平的保健系统,重要的是与临床医生在他们所在的地方会面,并与他们合作解决这些问题。这可以包括有针对性的教育会议和资源,告知临床医生首选的语言使用和培训提供者的课程。
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来源期刊
Addiction Science & Clinical Practice
Addiction Science & Clinical Practice Psychology-Clinical Psychology
CiteScore
3.90
自引率
10.80%
发文量
64
审稿时长
28 weeks
期刊介绍: Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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