“病人,创伤幸存者,甜心,还是麻烦制造者?”:全科医生和药剂师对阿片类药物替代治疗的客户描述的话语分析。

IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE
Lena De Bonte, Liesbet Goubert, Melissa Ceuterick
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引用次数: 0

摘要

尽管阿片类药物替代治疗(OSTs)的有效性得到了高度的科学支持,但依赖这种治疗的个体在医疗保健机构中是高度污名化的人群。以往的研究主要集中在OST患者的体验上,而医疗专业人员对OST的看法在很大程度上尚未得到探索。本研究旨在透过定位理论的视角,探讨药师与全科医师关于OST的话语。为了探讨他们对OST的态度,我们对比利时法兰德斯的30名药剂师和全科医生进行了半结构化访谈,他们分别在药店、社区卫生中心、私人医疗诊所、监狱和药物治疗服务机构工作。本研究的参与者话语建构了四个故事情节来定位自己和OST客户,即生物医学、心理动力学、生物心理社会和道德故事情节。这些故事情节是基于历史解释成瘾模型,它们的使用根据参与者的工作环境而变化。道德化的故事情节以他人、刻板印象和标签为特征,而应用生物心理社会故事情节的参与者以一种去污名化的方式接近客户。最后,参与者使用确定的故事情节来定义客户在OST中的位置,以及他们的相关权利和义务。因此,主要的故事情节塑造了在医疗环境中对OST客户的看法和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
"Patients, Trauma Survivors, Sweethearts, or Troublemakers?": A Discourse Analysis of General Practitioners' and Pharmacists' Accounts of Clients on Opioid Substitution Treatment.

Despite the high level of scientific support for the effectiveness of opioid substitution treatments (OSTs), individuals who rely on this treatment are a highly stigmatized population within healthcare settings. Previous studies mainly focused on the experiences of OST clients, while the perspective of medical professionals regarding OST remains largely unexplored. This study aims to investigate the discourse of pharmacists and general practitioners about OST through the lens of positioning theory. To explore their stance toward OST, semi-structured interviews were conducted with 30 pharmacists and general practitioners working in pharmacies, community health centers, private medical practices, prisons, and drug treatment services in Flanders, Belgium. The participants of this study discursively constructed four storylines to position themselves and OST clients, namely, a biomedical, psychodynamic, biopsychosocial, and moralizing storyline. These storylines are based on historical explanatory addiction models, and their use varies according to the participant's work setting. While the moralizing storyline was characterized by othering, stereotyping, and labeling, participants who applied the biopsychosocial storyline approached clients in a destigmatizing manner. To conclude, participants used the identified storylines to define the position of clients in OST, along with their related rights and duties. The dominant storyline thus shapes the view on and treatment of OST clients in a medical setting.

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来源期刊
CiteScore
6.80
自引率
6.20%
发文量
109
期刊介绍: QUALITATIVE HEALTH RESEARCH is an international, interdisciplinary, refereed journal for the enhancement of health care and to further the development and understanding of qualitative research methods in health care settings. We welcome manuscripts in the following areas: the description and analysis of the illness experience, health and health-seeking behaviors, the experiences of caregivers, the sociocultural organization of health care, health care policy, and related topics. We also seek critical reviews and commentaries addressing conceptual, theoretical, methodological, and ethical issues pertaining to qualitative enquiry.
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