Pregnant women in treatment for opioid use disorder: Material hardships and psychosocial factors
| Autor: | Michelle Trevino-Talbot, Ruth Rose-Jacobs, Howard Cabral, Martha Vibbert, Christine Lloyd-Travaglini |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Population Vulnerability 030508 substance abuse Medicine (miscellaneous) Intimate Partner Violence Prenatal care Toxicology 3rd trimester Food Supply Cohort Studies Stress Disorders Post-Traumatic 03 medical and health sciences Young Adult 0302 clinical medicine Pregnancy Medicine Humans 030212 general & internal medicine Prospective cohort study education Psychiatry education.field_of_study business.industry Depression Opioid use disorder medicine.disease Opioid-Related Disorders Food insecurity Pregnancy Complications Psychiatry and Mental health Clinical Psychology Ill-Housed Persons Mental Health Recovery Housing Female 0305 other medical science business Psychosocial |
| Zdroj: | Addictive behaviors. 98 |
| ISSN: | 1873-6327 |
| Popis: | Background While pregnant women in treatment for opioid use disorder (OUD) face considerable challenges, common material hardships– food insecurity and housing instability, known to negatively impact maternal-child health, have been inadequately researched within this population. This study describes food/housing hardships and evaluates associations with key psychosocial factors. Methods A single-site prospective study, 100 3rd trimester women receiving prenatal care and medication-assisted treatment for OUD were interviewed, including screening for food/housing hardships, depressive symptoms, intimate partner vulnerability; and self-reported post-traumatic stress disorder (PTSD) history. We developed a three-level categorization combining food/housing screening outcomes: 1) “both insecure”; 2) “either secure”; and 3) “both secure”. Bivariate analyses and linear path analyses evaluated associations among psychosocial variables using “both secure” as the referent group. Results Of 100 women, 56% reported food insecurity; 61% housing instability; 42% “both insecure”; 33% “either insecure”; 25% “both secure”. In unadjusted food/housing groups “either insecure” and “both insecure” reported significantly greater depressive symptoms; “both insecure” additionally reported significantly greater intimate partner vulnerability. Path analyses adjusted for PTSD and compared with “both secure” (adjusted mean = 6.2): “either insecure” had greater depressive symptom scores (adjusted means = 9.8, p = .01) while “both insecure” had greater depressive scores (adjusted means 10.5, p = .002). In addition, “both insecure” had a clinically important 5.7 point greater intimate partner vulnerability score. There were no significant interactions between food/housing and PTSD. Conclusions Even in women receiving prenatal care and treatment for OUD, food/housing material hardships and associated psychosocial factors are of major concern, requiring screening and remediation. |
| Databáze: | OpenAIRE |
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