背景:成瘾性疾病的治疗差距是医疗保健中最大的差距之一。几项研究调查了不同成瘾障碍的治疗障碍,但是很少有研究探索这些障碍是否因物质或行为而异,或者在所有成瘾障碍中是否常见。在瑞典,成瘾护理由医疗保健和社会服务提供,后者很常见,但也不太受欢迎。据我们所知,没有研究探索障碍是否因治疗地点而异。
目的:目的是彻底探索常见的一般和社会服务特定的治疗障碍,不同的障碍,以及如何描述使用酒精有问题的个体之间的障碍,大麻和/或赌博。
方法:进行了混合方法收敛并行设计。对于定量措施,调查包括经过验证的治疗障碍清单以及有关瑞典多供应商领域障碍的问题,是从使用酒精有问题的个体中收集的(n=207),大麻(n=51),和赌博(n=37)。并行,进行了17次来自同一人群的半结构化访谈,并进行了主题分析。此后,比较了定量和定性数据,对比,最后,解释。
结果:定量数据显示,所有群体中最大的普遍障碍是隐私问题和可用性差,从社会服务机构寻求帮助的最大障碍是耻辱,不知道提供了什么,以及对所有群体的后果的恐惧。定性数据导致了五个一般障碍:污名,矛盾心理,可访问性,对后果的恐惧,缺乏关于成瘾及其治疗的知识,以及具体针对社会服务的三个障碍:社会服务声誉,害怕遇到熟人,缺乏知识。这些主题是根据所有群体的数据制定的,但是不同的小组提到了主题的不同方面。
结论:有一些细节和方面可以区分使用酒精有问题的个体之间的一般和特定于社会服务的治疗障碍,大麻,和赌博,但总的来说,他们感知到类似的障碍。
BACKGROUND: The treatment gap for addictive disorders is one of the largest in health care. Several studies have investigated barriers to treatment for different addictive disorders, but very few studies conducted have explored whether the barriers differ depending on substance or behavior or if they are common among all addictive disorders. In Sweden, addiction care is provided both by the healthcare and social services, where the latter is common, but also less popular. To our knowledge, there are no studies exploring whether the barriers are different depending on where the treatment is given.
OBJECTIVE: The aim was to thoroughly explore both which general and social services-specific barriers to treatment that are common, which barriers that differs, and how the barriers are described among individuals with a problematic use of alcohol, cannabis and/or gambling.
METHODS: A mixed method convergent parallel design was conducted. For the quantitative measures, surveys including the validated Barriers to Treatment Inventory as well as questions regarding barriers in the Swedish multi-provider landscape, were collected from individuals with a problematic use of alcohol (n = 207), cannabis (n = 51), and gambling (n = 37). In parallel, 17 semi-structured interviews from the same population were conducted and analyzed with thematic analysis. Thereafter, the quantitative and qualitative data was compared, contrasted, and at last, interpreted.
RESULTS: The quantitative data showed that the largest general barriers in all groups were privacy concern and poor availability, and the largest barriers for seeking help from the social services was stigma, unawareness of what is offered, and fear of consequences for all groups. The qualitative data resulted in five general barriers: stigma, ambivalence, accessibility, fear of consequences, and lack of knowledge about addiction and its\' treatments, and three barriers specifically towards social services: social services reputation, fear of meeting acquaintances, and lack of knowledge. The themes were developed from data from all groups, but different aspects of the themes were mentioned by different groups.
CONCLUSIONS: There are details and aspects that differentiates both the general and social service-specific barriers to treatment between individuals with a problematic use of alcohol, cannabis, and gambling, but in large they perceive similar barriers.