Data_Sheet_1_Perceptions of stigma among people with lived experience of methamphetamine use within the hospital setting: qualitative point-in-time interviews and thematic analyses of experiences.PDF

ObjectivesAs part of a larger mixed-methods study into harm reduction in the hospital setting and people with lived experience of methamphetamine use, stigma was found to be a prominent issue. The aim of this secondary analysis was to investigate the issue of stigma.DesignParticipants completed a one-time qualitative interview component to assess their experiences in the hospital setting.SettingThe study setting included secondary and tertiary care in Southwestern Ontario, Canada. Participants who had received care from these settings were also recruited from an overdose prevention site, a primary healthcare center, a national mental health organization, an affordable housing agency, and six homeless-serving agencies between October 2020 and April 2021.ParticipantsA total of 104 individuals completed the qualitative component of a mixed-methods interview. Sixty-seven participants identified as male, thirty-six identified as female, and one identified as non-binary. Inclusion criteria included past or current use of methamphetamine, having received services from a hospital, and being able to communicate in English.MethodsOpen-ended questions regarding experiences in the hospital setting were asked in relation to the lived experience of methamphetamine. A secondary analysis was conducted post-hoc using a thematic ethnographic approach due to prominent perceptions of stigma.ResultsThree themes were identified. The first theme identified that substance use was perceived as a moral and personal choice; the second theme pertained to social stigmas such as income, housing and substance use, and consequences such as being shunned or feeling less worthy than the general patient population; and the third theme highlighted health consequences such as inadequate treatment or pain management.ConclusionThis study revealed that stigma can have consequences that extend beyond the therapeutic relationship and into the healthcare of the individual. Additional training and education for healthcare providers represents a key intervention to ensure care is non-stigmatizing and patient-centered, as well as changing hospital culture.

本研究旨在对医院环境中药物滥用者的减害干预措施进行多方法研究，并聚焦于其生活经验。研究发现，歧视问题尤为突出。本次二次分析的目标在于探究歧视问题。研究对象完成了定性访谈的一次性组成部分，以评估他们在医院环境中的体验。研究场所包括加拿大西南安大略省的二级和三级医疗机构。这些机构接受过治疗的参与者也被招募自一个过量预防场所、一个初级医疗保健中心、一个国家心理健康组织、一个住房代理机构以及六个为无家可归者提供服务的机构，招募时间介于2020年10月至2021年4月之间。共104名个体完成了混合方法访谈的定性部分。其中，67名参与者自认为是男性，36名认为是女性，1名认为是非二元性别。纳入标准包括过去或现在使用甲基苯丙胺、曾接受过医院服务以及能够用英语进行沟通。研究方法包括对医院环境中的体验进行开放式提问，并基于歧视的显著感知，采用主题民族志方法进行事后二次分析。研究结果确定了三个主题。第一个主题指出，物质使用被视为一种道德和个人选择；第二个主题涉及社会歧视，如收入、住房和物质使用，以及后果，如被排斥或感到不如普通患者群体；第三个主题突出了健康后果，如治疗不足或疼痛管理不当。结论表明，歧视的后果不仅限于治疗关系，还扩展到个人的医疗保健。为医疗保健提供者提供额外的培训和教育活动是关键干预措施，以确保护理非歧视性和以患者为中心，以及改变医院文化。