背景:提供者制定的污名化是与医疗保健系统接触的物质使用障碍(SUD)患者的障碍,它已被证明会导致更糟糕的医疗保健结果。这迫切需要减少污名化的干预措施,例如基于教育和接触的方法。之前已经研究了跨专业教育(IPE)在减少研究生健康学生对阿片类药物的污名化态度方面的积极作用,我们通过研究以下四个健康学科的态度来为现有文献做出贡献-整骨医学,助理医师(PA)研究和公共卫生,药房,以及针对阿片类药物使用障碍(OUD)的单次半天IPE事件后的护理。
目的:我们旨在通过在IPE事件之前和之后使用适应版本的酒精和酒精问题感知问卷(AAPPQ)评估态度来确定态度是否会受到IPE事件的影响。
方法:前面提到的四个健康学科共有647名学生参加了IPE活动。使用未配对t检验比较前/后组间的态度,并产生了一个总结性的“所有态度”分数,更高的分数与对OUD个体的态度改善有关。控制程序类型进行线性回归,性别,和以前的OUD曝光(个人,专业,和教育)。
结果:我们发现,对于整个健康研究生队列,总结态度前/后得分平均提高了2.81个单位(SD0.87,p=0.001,CI1.09-4.52)(56.9vs.66.6,p<0.0001),对于所有态度分量表(角色充分性,角色合法性,角色支持,任务特定的自尊,和工作满意度)。来自PA项目的学生的态度得分明显高于其他项目,学位类型在态度得分上存在差异,态度得分平均下降1.89个单位(SE0.38,p<0.0001,CI-2.64至-1.16)。我们发现,以前接触过OUD的学生比没有接触过OUD的学生有更高的IPE事件前分数,知道某人受到SUD的影响是态度得分增加的重要预测因素,平均3.82个单位(SE0.27,p<0.0001,CI3.49-4.16)。然而,以前没有接触过OUD的学生在事件后的态度分数与以前通过教育接触过OUD的学生相同,个人经历,或训练。
结论:我们的研究结果表明,IPE干预和小组讨论可能会改善医疗保健学员对OUD患者的态度,这与先前的研究一致,该研究表明教育和接触在减少污名方面的有益效果。学位类型和了解受SUD影响的人也是态度得分的重要预测因素。IPE活动通过鼓励不同卫生专业人员在培训的早期阶段进行合作,有助于针对公共卫生问题,和临床前的教育努力可以影响治疗态度。
BACKGROUND: Provider-enacted stigma is a barrier for people with substance use disorder (SUD) who interface with the healthcare system, and it has been shown to lead to worse healthcare outcomes. This has given urgency to the need for stigma reduction interventions such as education- and contact-based approaches. The positive effect of interprofessional education (IPE) in reducing graduate health students\' stigmatizing attitudes on opioids has been examined before, and we contribute to the existing literature by examining the attitudes across the following four health disciplines-osteopathic medicine, physician assistant (PA) studies and public health, pharmacy, and nursing-following a single half-day IPE event focused on opioid use disorder (OUD).
OBJECTIVE: We aimed to determine whether attitudes could be affected by the IPE event by assessing attitudes utilizing an adapted version of the Alcohol and Alcohol Problems Perceptions Questionnaire (AAPPQ) before and after the IPE event.
METHODS: A total of 647 students across the four previously mentioned health disciplines participated in the IPE event. Attitudes were compared between the pre/post groups utilizing unpaired t tests, and a summative \"all-attitudes\" score was generated, with higher scores being associated with improved attitudes toward individuals with an OUD. Linear regression was performed controlling for program type, gender, and previous OUD exposure (personal, professional, and education).
RESULTS: We found that the pre/post summative attitudes scores improved an average of 2.81 units (SD 0.87, p=0.001, CI 1.09-4.52) for the entire cohort of graduate health students (56.9 vs. 66.6, p<0.0001) and for all attitudinal subscales (role adequacy, role legitimacy, role support, task-specific self-esteem, and work satisfaction). Students from PA programs had significantly higher attitude scores than other programs, and there were differences in degree type on attitude scores, with an average decrease of 1.89 units in attitude scores (SE 0.38, p<0.0001, CI -2.64 to -1.16). We found that students with previous exposure to OUD had higher pre-IPE event scores than those without, and knowing someone impacted by an SUD was a significant predictor of increased attitude scores, by an average of 3.82 units (SE 0.27, p<0.0001, CI 3.49-4.16). However, students without previous exposure to OUD had equal attitude scores post event to those who had previous exposure to OUD through education, personal experience, or training.
CONCLUSIONS: Our findings suggest that an IPE intervention and panel discussion may improve attitudes toward people with OUD in healthcare trainees, which is consistent with previous research that shows the beneficial effect of education and contact in reducing stigma. Degree type and knowing someone who has been impacted by an SUD are also significant predictors of attitude scores. IPE events are useful in targeting a public health issue by encouraging collaboration between different health professionals at early stages of their training, and preclinical educational efforts can affect therapeutic attitudes.