Introduction
Women experiencing substance use disorders (SUD) have often reported challenges in their relationships with health care providers during the perinatal period that served as a barrier to care. Establishing trust is an important aspect in forming positive relationships. The purpose of this study was to identify provider characteristics associated with the development of trust when caring for women experiencing SUD during the perinatal period.
Methods
A systematic search was conducted using the databases of CINAHL, APA PsychINFO, and PubMed along with a manual search of Google Scholar between the years of 2000‐2021. Studies were included if they were (1) original qualitative research; (2) published in English; (3) peer reviewed; (4) from the perspective of women experiencing SUD; (5) included descriptions of positive health care interactions between women experiencing SUD in the perinatal period and their health care providers; and (6) conducted in the United States or Canada. The studies were assessed for quality and validity using 10 criteria from the Joanne Briggs Institute critical appraisal checklist for qualitative research.
Results
Findings from 21 qualitative studies were synthesized using a thematic synthesis approach and revealed 3 overarching themes that included 7 descriptive subthemes which identified provider characteristics associated with trust. The 7 descriptive subthemes included: developing rapport with women, demonstrating caring behaviors, including women in care, understanding women's SUD treatment efforts, reassuring women, delivering competent care, and educating women.
Discussion
Participants’ accounts of trusting interactions with health care providers occurred when providers viewed women approvingly, affirmed their treatment efforts and maternal abilities, and delivered competent care that was knowledgeable of issues associated with SUD. The findings suggest the importance of confronting implicit biases, integrated care, and fostering a stigma‐free and trauma‐informed working environment.
Pregnant women with substance use disorder (SUD) can face varying degrees of negative interactions with healthcare providers, including judgment of the individual’s value and involvement in their infant’s care. This research explored potential stigma and attitudes among medical providers within a maternal/fetal healthcare setting towards women with maternal SUD. An electronic survey was administered to 117 health care providers, including social workers, who work with pregnant women in an urban, Midwest, healthcare facility. Attitudes and stigma differed significantly based on the health care providers’ discipline. Healthcare providers who viewed SUD as a disease had a more positive perception of mothers with SUD. By building professional awareness, creating policy change, increasing education, and continuing research regarding maternal SUD, social workers have an opportunity to develop responsive support programs for healthcare workers and promote overall change within the healthcare setting.
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