围产期药物滥用者产前护理面临的挑战:对改善护理的新方法进行经验性综合评述。

IF 2.1 4区 医学 Q2 NURSING
Lauren Taylor Narbey CNM, MSN, WHNP-BC, Alice Curtis Cline CNM, MSN
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引用次数: 0

摘要

导言:在美国,围产期药物使用率持续上升,给产前护理工作带来了独特的挑战。使用多种药物、参与医疗保健的时间有限且较晚、并发情绪障碍以及一些社会障碍都有详细记录。本综述旨在总结这些障碍,并提出照顾这一高风险人群的新方法:本研究的纳入标准主要针对过去 5 年中发表的同行评议文章,这些文章明确详述了在美国药物使用环境下提供或接受产前护理的直接影响。研究使用 PubMed 和 Web of Science 查找适用的文章。在找到的 156 篇文章中,有 10 篇相关文章被选中进行最终的实证综合综述,其中包括使用混合方法评估工具 (MMAT) 进行数据评估和主题分析:10 篇综述文章符合纳入标准;其中 3 篇为定性文章,6 篇为定量和非随机文章,1 篇为定量描述性文章。六篇文章符合 MMAT 质量标准,每篇文章都存在明显的局限性。主题包括阿片类药物使用障碍(6 篇)、一般药物使用(3 篇)和烟草使用(1 篇)。主题包括产前护理综合模式、集中护理、资源协调和同伴支持,以及围产期医疗保健专业人员的作用和持续使用药物使用筛查工具:为了满足围产期药物使用患者复杂而迫切的需求,有必要建立一个全面的多学科护理模式,该模式不仅要满足阿片类药物维持治疗或药物戒断的建议,还要满足可及性和人际支持等重要方面的建议。未来的研究应侧重于为这一弱势群体开发、实施和评估新的护理模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Challenges for Antepartum Care of the Individual with Perinatal Substance Use: An Empirical Integrative Review of Novel Approaches to Improve Care

Challenges for Antepartum Care of the Individual with Perinatal Substance Use: An Empirical Integrative Review of Novel Approaches to Improve Care

Introduction

Perinatal substance use continues to rise across the United States presenting unique challenges to providing antepartum care. Polysubstance use, limited and late engagement in health care, co-occurring mood disorders, and several social barriers are well documented. This review seeks to summarize these barriers and present novel approaches to caring for this high-risk population.

Methods

Inclusion criteria for this study focused on peer-reviewed articles that explicitly detailed a direct impact on the provision or receipt of antenatal care in the setting of substance use within the United States that were published in the last 5 years. PubMed and Web of Science were used to find applicable articles. Of the 156 articles found, 10 relevant articles were selected for the final empirical integrative review that entailed data evaluation using the Mixed Methods Appraisal Tool (MMAT) and thematic analysis.

Results

10 review articles met inclusion; 3 were qualitative, 6 were quantitative and nonrandomized, and one was quantitative descriptive. Six articles met MMAT quality criteria, and there were significant limitations in every article. Topics included opioid use disorder (n = 6), general substance use (n = 3), and tobacco use (n = 1). Themes included integrated models of prenatal care, colocated care, resource coordination, and peer support along with the role of the perinatal health care professional and consistent use of a substance use screening tool.

Discussion

A comprehensive and multidisciplinary care model is necessary to meet the complex and urgent needs of individuals with perinatal substance use that not only meets recommendations for opioid maintenance therapy or substance use cessation but the important areas of accessibility and interpersonal support. Future research should focus on the development, implementation, and evaluation of new models of care for this vulnerable population.

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来源期刊
CiteScore
3.60
自引率
7.40%
发文量
103
审稿时长
6-12 weeks
期刊介绍: The Journal of Midwifery & Women''s Health (JMWH) is a bimonthly, peer-reviewed journal dedicated to the publication of original research and review articles that focus on midwifery and women''s health. JMWH provides a forum for interdisciplinary exchange across a broad range of women''s health issues. Manuscripts that address midwifery, women''s health, education, evidence-based practice, public health, policy, and research are welcomed
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