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Hur patienter med opioidberoende upplever omvårdnaden vid LARO-behandling: En allmän litteraturöversikt
Blekinge Institute of Technology.
Blekinge Institute of Technology.
2023 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Bakgrund: Personer med opioidberoende är till sin omfattning mer än 26 miljoner människor världen över. Läkemedelsassisterad rehabilitering av opioidberoende (LARO) i kombination med omvårdnad och psykosocial behandling är en effektiv behandlingsmetod vid opioidberoende. Målen med LARO-behandling är utöver att minska dödligheten att personer med opioidberoende ska få ökad psykisk och fysisk hälsa samt få ett socialt fungerande liv. Klinisk erfarenhet visar dock att det finns svårigheter med att kvarhålla personer i LARO-behandling, vilket ofta leder till att personer i stället avlider. Sjuksköterskan har ett ansvar att ge omvårdnad på ett personcentrerat tillvägagångssätt i samband med behandling och kunskap som en sjuksköterska besitter kan hjälpa till att förbättra vårdresultaten i en LARO-behandling.

Syfte: Syftet med studien var att belysa hur vuxna patienter med opioidberoende upplever omvårdnad vid LARO-behandling (läkemedelsassisterad rehabilitering vid opioidberoende).

Metod: En allmän litteraturöversikt genomfördes där resultatet baserades på nio vetenskapliga artiklar med kvalitativ ansats som inhämtats genom systematiska sökningar i databaserna PubMed och CHINAL. Data analyserades i enlighet med Fribergs analys bestående av fem steg.

Resultat: Analysen resulterade i tre huvudkategorier med sex tillhörande subkategorier. Huvudkategorierna var: Sjuksköterskan villkorar LARO-behandlingen, Vårdrelationen med sjuksköterskan och Utmaningar i tillgängligheten. Subkategorierna var: Begränsad delaktighet, Stigmatisering, Vikten av en god relation, Brister med informationen, Begränsad tillgänglighet och Avsaknaden av omvårdnadsutbud.

Slutsats: Patienter med opioidberoende upplevde LARO-behandlingen som villkorad. Patienter upplevde bristande delaktighet gällande omvårdnaden. Upplevelse av stigmatisering kopplat till omvårdnaden framkom även. Patienter upplevde att de misstänkliggjordes efter flertalet år i behandling. Brister avseende tillgänglighet kopplat till LARO-behandlingen identifierades. Relationen till sjuksköterskan upplevdes vara en viktig del i behandlingen. Relationen skulle bidra till att bygga förtroende, reducera stigma och upplevas accepterande. Rådgivande samtal tillsammans med medicinering ansågs vara den viktigaste aspekten i behandlingen.

Abstract [en]

Background: People with substance use disorder are to its extent more than 26 million people worldwide. LARO treatment (drug-assisted rehabilitation in opioid dependence) for people with substance use disorder in combination with other nursing care and psychosocial treatment is an effective treatment for people with substance use disorder. The goals of LARO treatment are for people with opioid dependence to have increased mental and physical health, have a socially functioning life and a reduced mortality. However, clinical experience shows that there are difficulties in retaining people in LARO treatment, which often leads to people dying instead. The nurse has a responsibility to provide nursing in a person-centered approach. Knowledge that a nurse possesses can help improve care outcomes in a LARO treatment.

Aim: The purpose of the study was to highlight how adult patients with opioid dependence experience nursing care during LARO treatment.

Method: A literature review was conducted where the results were based on nine scientific articles with qualitative approaches obtained through systematic searches in the databases PubMed and CINAHL. The data was analyzed in accordance with Friberg's analysis that consists of five steps.

Results: The analysis led to three main categories with six associated subcategories. The main categories were following: The nurse conditions the treatment, The care relationship and Accessibility challenges. The associated categories were: Limited participation, Stigma, The imprtance of a good relationship, Deficiencies with the information, Limited availability and Lack of nursing services.

Conclusion: Patients with opioid dependence experienced LARO treatment as conditional and experienced a lack of participation. Experiences of stigma linked to nursing emerged. Deficiencies regarding accessibility linked to the LARO treatment were identified. The relationship with the nurse was perceived to be an important part of the treatment. The relationship would help build trust, reduce stigma, and be perceived as accepting. Counseling along with medication was considered the most important aspect of treatment.

Place, publisher, year, edition, pages
2023. , p. 53
Keywords [en]
availability, experiences, maintenance treatment, nurse's role, opioid dependence, participation, relationship, stigma.
Keywords [sv]
delaktighet, LARO-behandling, opioidberoende, relation, sjuksköterskans roll, stigma, tillgänglighet, upplevelser
National Category
Nursing
Identifiers
URN: urn:nbn:se:bth-24910OAI: oai:DiVA.org:bth-24910DiVA, id: diva2:1772196
Subject / course
OM2538 Master's Thesis in Nursing Science focusing on Psychiatric care 15,0 hp
Educational program
OMAPV Specialist Nursing Programme in Mental Health Care, 60,0 hp
Supervisors
Examiners
Available from: 2023-06-21 Created: 2023-06-21 Last updated: 2023-06-21Bibliographically approved

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