PDF(Pubmed)
Abstract：
To assess the extent of Coronavirus-related disruption to health and social care treatment and social interactions among people with lived or living experience of substance use in Scotland, and explore potential reasons for variations in disruption.
Cross sectional mixed methods interview, incorporating a social network \'egonet interview\' approach asking about whether participants had interactions with a range of substance use, health, social care or third sector organisations, or informal social interactions.
Five Alcohol and Drug Partnership Areas in Scotland.
57 (42% women) participants were involved in the study, on average 42 years old.
Five-point Likert scale reporting whether interactions with a range of services and people had gotten much better, better, no different (or no change), worse, or much worse since COVID19 and lockdown. Ratings were nested within participants (Individuals provided multiple ratings) and some ratings were also nested within treatment service (services received multiple ratings). The nested structure was accounted for using cross classified ordinal logistic multilevel models.
While the overall average suggested only a slight negative change in interactions (mean rating 2.93), there were substantial variations according to type of interaction, and between individuals. Reported change was more often negative for mental health services (Adjusted OR = 0.93 95% CI 0.17,0.90), and positive for pharmacies (3.03 95% CI 1.36, 5.93). The models found between-participant variation of around 10%, and negligible between-service variation of around 1% in ratings. Ratings didn\'t vary by individual age or gender but there was variation between areas.
Substance use treatment service adaptations due to COVID19 lockdown led to both positive and negative service user experiences. Social network methods provide an effective way to describe complex system-wide interaction patterns, and to measure variations at the individual, service, and area level.
Cross sectional mixed methods interview, incorporating a social network \'egonet interview\' approach asking about whether participants had interactions with a range of substance use, health, social care or third sector organisations, or informal social interactions.
Five Alcohol and Drug Partnership Areas in Scotland.
57 (42% women) participants were involved in the study, on average 42 years old.
Five-point Likert scale reporting whether interactions with a range of services and people had gotten much better, better, no different (or no change), worse, or much worse since COVID19 and lockdown. Ratings were nested within participants (Individuals provided multiple ratings) and some ratings were also nested within treatment service (services received multiple ratings). The nested structure was accounted for using cross classified ordinal logistic multilevel models.
While the overall average suggested only a slight negative change in interactions (mean rating 2.93), there were substantial variations according to type of interaction, and between individuals. Reported change was more often negative for mental health services (Adjusted OR = 0.93 95% CI 0.17,0.90), and positive for pharmacies (3.03 95% CI 1.36, 5.93). The models found between-participant variation of around 10%, and negligible between-service variation of around 1% in ratings. Ratings didn\'t vary by individual age or gender but there was variation between areas.
Substance use treatment service adaptations due to COVID19 lockdown led to both positive and negative service user experiences. Social network methods provide an effective way to describe complex system-wide interaction patterns, and to measure variations at the individual, service, and area level.
摘要：
目的：评估与冠状病毒相关的破坏健康和社会护理治疗的程度，以及在苏格兰有使用药物的生活或生活经验的人之间的社会互动，并探索中断变化的潜在原因。
方法：横断面混合方法访谈，纳入社交网络\“egonet访谈\”方法，询问参与者是否与一系列物质使用有互动，健康,社会关怀或第三部门组织，或非正式的社会互动。
方法：苏格兰的五个酒精和毒品合作领域。
方法：57名（42%为女性）参与者参与了这项研究，平均年龄42岁。
方法：五点李克特量表报告与一系列服务和人员的互动是否变得更好，更好,没有不同（或没有变化），更糟,或者自COVID19和封锁以来更糟。评级嵌套在参与者内(个人提供多个评级),并且一些评级也嵌套在治疗服务内(服务获得多个评级)。嵌套结构使用交叉分类序数逻辑多水平模型进行解释。
结果：虽然总体平均值表明相互作用仅有轻微的负变化（平均评分为2.93），根据相互作用的类型有很大的差异，和个人之间。报告的变化对精神卫生服务更常见的是负面的(调整后的OR=0.9395%CI0.17,0.90)，药房呈阳性（3.0395%CI1.36，5.93）。模型发现参与者之间的差异约为10%，和微不足道的服务之间的变化，大约1%的评级。评级没有因个人年龄或性别而异，但地区之间存在差异。
结论：由于COVID19封锁而导致的物质使用治疗服务适应导致了积极和消极的服务用户体验。社会网络方法为描述复杂的全系统交互模式提供了一种有效的方法,并测量个体的变化，服务,和区域水平。
方法：横断面混合方法访谈，纳入社交网络\“egonet访谈\”方法，询问参与者是否与一系列物质使用有互动，健康,社会关怀或第三部门组织，或非正式的社会互动。
方法：苏格兰的五个酒精和毒品合作领域。
方法：57名（42%为女性）参与者参与了这项研究，平均年龄42岁。
方法：五点李克特量表报告与一系列服务和人员的互动是否变得更好，更好,没有不同（或没有变化），更糟,或者自COVID19和封锁以来更糟。评级嵌套在参与者内(个人提供多个评级),并且一些评级也嵌套在治疗服务内(服务获得多个评级)。嵌套结构使用交叉分类序数逻辑多水平模型进行解释。
结果：虽然总体平均值表明相互作用仅有轻微的负变化（平均评分为2.93），根据相互作用的类型有很大的差异，和个人之间。报告的变化对精神卫生服务更常见的是负面的(调整后的OR=0.9395%CI0.17,0.90)，药房呈阳性（3.0395%CI1.36，5.93）。模型发现参与者之间的差异约为10%，和微不足道的服务之间的变化，大约1%的评级。评级没有因个人年龄或性别而异，但地区之间存在差异。
结论：由于COVID19封锁而导致的物质使用治疗服务适应导致了积极和消极的服务用户体验。社会网络方法为描述复杂的全系统交互模式提供了一种有效的方法,并测量个体的变化，服务,和区域水平。
