PDF(Pubmed)
Abstract：
Scholars worldwide have defined the COVID-19 pandemic as a mass-disabling event of our time. The situation is grave for families experiencing financial hurdles while caring for young adults in recovery from addiction problems.
Using semi-structured interviews with 30 purposively selected family caregivers (FCGs) of young adults with substance use disorders (SUDs) in Lusaka, Zambia, this study reveals several factors influencing forgone healthcare for this medically vulnerable group.
Financial challenges and huge out-of-pocket bills; caregivers\' perceived far-fetched recovery of the young adult; the cost of medication and transportation; the young adult\'s little perceived need for healthcare service use, their runaway and treatment elusive tendencies; caregiver concerns about contracting the virus, and the stigma associated with it; and a fragmented child and adolescent mental health system influenced forgone healthcare. The young adults were often unavailable for days and months, posing challenges to the continuity of care. Despite caregivers\' acknowledgment of the availability of healthcare professionals, young adults with problematic substance use had limited access to SUD recovery services, resulting in adverse health outcomes. Results also show that most family caregivers encountered challenges in accessing and purchasing psychotropic medications, which were difficult to find during the lockdowns. Some family caregivers lost their sources of income by being laid off from work due to the pandemic and skipping work to attend to caregiving responsibilities. Most of those in self-employment had to close their business and stay home to look after their youth. Several caregivers kept their youth at home because they failed to access private residential SUD recovery services. Family caregivers mostly relied on outpatient public health services, alternative medicine from traditional healers, and faith-based healing, all of which some young adults rarely accessed because of their problematic behaviors of escaping healthcare.
These identifiable risk factors, and their detrimental consequences highlight the need for interventions to improve healthcare access for this vulnerable population. Supporting FCGs of addicted young adults is crucial in ensuring the well-being of both the caregivers and care recipients. Further research is warranted to explore potential solutions, such as peer support programs, policy changes, and education initiatives for carers and recipients in the (post) pandemic era.
Using semi-structured interviews with 30 purposively selected family caregivers (FCGs) of young adults with substance use disorders (SUDs) in Lusaka, Zambia, this study reveals several factors influencing forgone healthcare for this medically vulnerable group.
Financial challenges and huge out-of-pocket bills; caregivers\' perceived far-fetched recovery of the young adult; the cost of medication and transportation; the young adult\'s little perceived need for healthcare service use, their runaway and treatment elusive tendencies; caregiver concerns about contracting the virus, and the stigma associated with it; and a fragmented child and adolescent mental health system influenced forgone healthcare. The young adults were often unavailable for days and months, posing challenges to the continuity of care. Despite caregivers\' acknowledgment of the availability of healthcare professionals, young adults with problematic substance use had limited access to SUD recovery services, resulting in adverse health outcomes. Results also show that most family caregivers encountered challenges in accessing and purchasing psychotropic medications, which were difficult to find during the lockdowns. Some family caregivers lost their sources of income by being laid off from work due to the pandemic and skipping work to attend to caregiving responsibilities. Most of those in self-employment had to close their business and stay home to look after their youth. Several caregivers kept their youth at home because they failed to access private residential SUD recovery services. Family caregivers mostly relied on outpatient public health services, alternative medicine from traditional healers, and faith-based healing, all of which some young adults rarely accessed because of their problematic behaviors of escaping healthcare.
These identifiable risk factors, and their detrimental consequences highlight the need for interventions to improve healthcare access for this vulnerable population. Supporting FCGs of addicted young adults is crucial in ensuring the well-being of both the caregivers and care recipients. Further research is warranted to explore potential solutions, such as peer support programs, policy changes, and education initiatives for carers and recipients in the (post) pandemic era.
摘要：
■全世界的学者都将COVID-19大流行定义为我们这个时代的大规模致残事件。对于在照顾年轻人从成瘾问题中康复的同时经历财务障碍的家庭来说，情况是严峻的。
■对卢萨卡有物质使用障碍（SUDs）的30名有意选择的家庭照顾者（FCG）进行半结构化访谈，赞比亚，这项研究揭示了影响这一医学弱势群体放弃医疗保健的几个因素。
■财务挑战和巨额自付费用；看护者认为年轻人的康复牵强；药物和交通费用；年轻人对医疗服务使用的需求很少，他们失控和治疗难以捉摸的倾向；护理人员对感染病毒的担忧，以及与之相关的污名；支离破碎的儿童和青少年心理健康系统影响了放弃的医疗保健。年轻人经常几天甚至几个月不在，对护理的连续性构成挑战。尽管护理人员承认医疗保健专业人员的可用性，有问题物质使用的年轻人获得SUD恢复服务的机会有限，导致不良的健康结果。结果还显示，大多数家庭护理人员在获取和购买精神药物方面遇到了挑战，在封锁期间很难找到。一些家庭照顾者因流行病而被解雇，并跳槽承担照顾责任，从而失去了收入来源。大多数自营职业的人不得不关闭他们的生意，留在家里照顾他们的年轻人。几名护理人员将年轻人留在家中，因为他们无法获得私人住宅SUD恢复服务。家庭照顾者大多依赖门诊公共卫生服务,传统治疗师的替代医学，和基于信仰的治疗，所有这些都是一些年轻人很少接触到的，因为他们逃避医疗保健的问题行为。
■这些可识别的风险因素，其有害后果突出表明，需要采取干预措施来改善这一弱势群体的医疗保健。支持上瘾的年轻人的FCG对于确保护理人员和护理接受者的福祉至关重要。需要进一步的研究来探索潜在的解决方案，例如同行支持计划，政策变化,以及(后)大流行时代照顾者和接受者的教育举措。
■对卢萨卡有物质使用障碍（SUDs）的30名有意选择的家庭照顾者（FCG）进行半结构化访谈，赞比亚，这项研究揭示了影响这一医学弱势群体放弃医疗保健的几个因素。
■财务挑战和巨额自付费用；看护者认为年轻人的康复牵强；药物和交通费用；年轻人对医疗服务使用的需求很少，他们失控和治疗难以捉摸的倾向；护理人员对感染病毒的担忧，以及与之相关的污名；支离破碎的儿童和青少年心理健康系统影响了放弃的医疗保健。年轻人经常几天甚至几个月不在，对护理的连续性构成挑战。尽管护理人员承认医疗保健专业人员的可用性，有问题物质使用的年轻人获得SUD恢复服务的机会有限，导致不良的健康结果。结果还显示，大多数家庭护理人员在获取和购买精神药物方面遇到了挑战，在封锁期间很难找到。一些家庭照顾者因流行病而被解雇，并跳槽承担照顾责任，从而失去了收入来源。大多数自营职业的人不得不关闭他们的生意，留在家里照顾他们的年轻人。几名护理人员将年轻人留在家中，因为他们无法获得私人住宅SUD恢复服务。家庭照顾者大多依赖门诊公共卫生服务,传统治疗师的替代医学，和基于信仰的治疗，所有这些都是一些年轻人很少接触到的，因为他们逃避医疗保健的问题行为。
■这些可识别的风险因素，其有害后果突出表明，需要采取干预措施来改善这一弱势群体的医疗保健。支持上瘾的年轻人的FCG对于确保护理人员和护理接受者的福祉至关重要。需要进一步的研究来探索潜在的解决方案，例如同行支持计划，政策变化,以及(后)大流行时代照顾者和接受者的教育举措。
