词语很重要：个人选择阿片类药物使用障碍药物的医疗记录中的污名化语言

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-08-09 DOI:10.1016/j.drugalcdep.2025.112831

Matthew Perez , Elise N. Marino , Curtis Bone , Tara Karns-Wright , Jennifer S. Potter

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引用次数: 0

摘要

背景：在医疗环境中，人们一直在努力减少污名化语言的使用；然而，它在卫生记录文件中的流行率仍然很高。本研究检查了在两种情况下，基于办公室的阿片类药物治疗和阿片类药物治疗计划中，临床医生对阿片类药物使用障碍选择药物的医疗记录中的耻辱感和患者自我耻辱感语言。方法：在这项回顾性队列研究中，数据是从德克萨斯州一个为公共资助患者服务的分布式提供者网络的健康记录中提取的。纳入了2020年12月至2021年11月期间因阿片类药物使用障碍寻求药物治疗的患者。使用自然语言处理算法来审查健康记录中的开放文本字段，我们在国家药物滥用研究所的“词语问题”工具中确定了污名化语言的流行。结果共纳入1391例患者，其中白人63.8%，西班牙裔27.5%，女性40.5%，年龄40.8岁[SD=10.3]。在分析的6099份笔记中，81.1% （n = 4944）包含污名化语言，7.1% （n = 430）包含自我污名化语言。在多变量模型中，污名化语言与年龄、种族、农村、教育、收入、阿片类药物使用和治疗环境有关。自我污名化语言与治疗环境有关。结论：研究结果表明，患者的社会人口统计学背景影响临床医生使用的污名化语言，而治疗环境影响提供者和自我污名化语言。需要进一步的研究来探索污名化语言的差异是否导致了不同阿片类药物治疗环境下的不同治疗结果。

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Words matter: Stigmatizing language in medical records of individuals electing medication for opioid use disorder

Background

There has been a concerted effort to minimize the use of stigmatizing language in healthcare settings; however, its prevalence in health record documentation remains high. This study examined clinicians’ stigmatizing and patients’ self-stigmatizing language in medical records for patients electing medication for opioid use disorder in two settings, office-based opioid treatment and opioid treatment programs.

Methods

In this retrospective cohort study, data were extracted from health records for a distributed provider network serving publicly funded patients in Texas. Patients seeking medication treatment for opioid use disorder between December 2020 and November 2021 were included. Using a natural language processing algorithm to review open text fields in the health records, we identified the prevalence of stigmatizing language identified in the National Institute on Drug Abuse’s “Words Matter” tool.

Results

The analytic sample included 1391 patients (63.8 % White, 27.5 % Hispanic, 40.5 % female, M_age= 40.8 years [SD=10.3]). Of the 6099 notes analyzed, 81.1 % (n = 4944) contained stigmatizing language and 7.1 % (n = 430) contained self-stigmatizing language. In multivariate models, stigmatizing language was associated with age, race, rurality, education, income, opioid use, and treatment setting. Self-stigmatizing language was associated with treatment setting.

Conclusions

Findings suggest that a patient’s sociodemographic background influences the stigmatizing language their clinicians use while treatment setting influences both provider and self-stigmatizing language. Additional research is needed to explore whether differences in stigmatizing language contributes to differential treatment outcomes seen in different opioid treatment settings.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.