Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review

Werder, Karen; Curtis, Alexa Colgrove; Reynolds, Stephanie; Satterfield, Jason M.

doi:10.1177/10783903211050121

Cited by 30 publications

(33 citation statements)

References 47 publications

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“…In the context of AOD nursing, this is an important finding. Although the Australian registered nurses' standards of practice mandate collaborative care and respectful communication (Nursing and Midwifery Board 2016), research indicates that PWUD are often excluded from decisions about their care (Goodhew et al 2019), and experience disrespectful language (Werder et al 2022). Our co-evaluation shows that co-produced nursing curricula may support healthcare trainees to prioritize respectful collaboration and communication when working with PWUD.…”

Section: Discussionmentioning

confidence: 86%

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Learning that cannot come from a book: An evaluation of an undergraduate alcohol and other drugs subject co‐produced with experts by experience

Goodhew

River

Samuel³

et al. 2022

Int J Mental Health Nurs

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Alcohol and other drugs (AOD) use is a significant public health issue and is associated with high mortality and morbidity rates. Despite this, people who use drugs are often reluctant to seek care due to the lack of trauma‐informed treatment and harm reduction treatment options, as well as experiences of stigma and discrimination in health services. Arguably, AOD education that is co‐produced with people who use alcohol and drugs can enhance future health professionals' ability to practice in ways that support the needs of this population. This paper reports on a qualitative co‐evaluation of a co‐produced undergraduate nursing AOD subject. The AOD subject was co‐planned, co‐designed, co‐delivered, and co‐evaluated with experts by experience, who have a lived experience of substance dependence and work as advocates and peer workers. Following the delivery of the subject in 2021 and 2022, focus groups were undertaken with 12 nursing students. Focus group data indicate that the co‐produced subject supported participants to understand and appreciate how stigma impacts on nursing care and how to recognize and undertake ‘good’ nursing care that was oriented to the needs of service users. Student participants noted that being co‐taught by people who use drugs was particularly powerful for shifting their nursing perspectives on AOD use and nursing care and took learning beyond what could be understood from a book. Findings indicate that co‐produced AOD education can shift nursing students' perceptions of AOD use by providing access to tacit knowledge and embodied equitable and collaborative relationships with people who use drugs.

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Section: Discussionmentioning

confidence: 86%

“…2019), and experience disrespectful language (Werder et al . 2022). Our co‐evaluation shows that co‐produced nursing curricula may support healthcare trainees to prioritize respectful collaboration and communication when working with PWUD.…”

Section: Discussionmentioning

confidence: 99%

Learning that cannot come from a book: An evaluation of an undergraduate alcohol and other drugs subject co‐produced with experts by experience

Goodhew

River

Samuel³

et al. 2022

Int J Mental Health Nurs

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“…Most importantly, care professionals should question the words and expressions they use to refer to care-experienced youth, their past, and their future. Language propagates stereotypes and prejudice to the point that it can affect the quality of care offered by professionals (Ashford et al, 2019) and thus youth's engagement in treatment and recovery (Werder et al, 2022). Advocates and organizations such as The Adolescent and Children's Trust (TACT) 3 have therefore worked with young people in care to suggest better, less stigmatizing, ways of referring to care-experienced youth and their stories.…”

Section: Discussionmentioning

confidence: 99%

The Many Faces of the “Foster Care Youth” Label: How Young Women Manage the Stigma of Out-of-Home Placement

Turcotte

Lanctôt²

2023

IJCYFS

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A number of studies have found that adolescents in foster care expect and perceive stigma related to their “foster care youth” status. Yet, little is known about how this perceived stigma manifests, as well as how youth manage it. The current study therefore aimed to explore how young women with a history in foster care integrate these experiences into their life stories. The focus is on discursive manifestations of stigma in participants’ narratives about placement in foster care, their own perceptions of care-experienced girls and women, as well as how they self-present. Special attention is also given to the ways in which youth try to reduce, deflect, or eliminate stigma. The present study draws on semi-structured interviews conducted with a sample of 20 young women with a history in foster care. Our findings suggest that participants do anticipate and perceive public stigma in relation to their history in foster care. The results also highlight the various strategies used by participants to resist self-stigmatization. The main strategy used was to distance themselves from their “foster care youth” status, insisting that they should never have been placed in foster care and that they are not faring badly as adults, unlike typical care-experienced youth.

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“…In the context of SUD, the hidden curriculum may convey stigma and depersonalization of patients, while the learning environment presents a hierarchical, power-driven system that discourages disagreement from learners and creates an environment ripe for medical errors. [47][48][49][50] Whenever patients are seen as less than human or believed to have moral failures, their needs are likely to go unrecognized and unaddressed. When learners fear retribution for speaking up about what they observe, they are less likely to report physician mistakes and adverse outcomes.…”

Section: The Learning Environmentmentioning

confidence: 99%

Commentary Article: Transforming an Educational Ecosystem for Substance use Disorders: A Multi-Modal Model for Continuous Curricular Improvement and Institutional Change

et al. 2022

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Health professions curricula are created to prepare learners to effectively address health issues affecting individ uals and their communities. Ideally, curricula emphasize the predominant biopsychosocial influences impacting the health of diverse populations. However, despite decades of investment and advances in educational research and design, we have failed to create a health professional workforce capable of equitably meeting the health care needs of the public. Particular communities, geographic regions, and patients with stigmatized diagnoses continue to be underserved, and the potential contributions of multidisciplinary health professionals and advanced practice providers continue to be unrealized within a predominantly physician-centric health care model. Genuine educational transformation requires multidimensional, iterative strategies used to meaningfully evolve traditional classroom curricula, break from the implicit and “hidden” curricula, and enrich the educational ecosystem in which all operate. This manuscript elaborates the construct and process of “educational ecosystem transformation” as a tool for the evolution of the educational ecosystem and its situated curriculum that will eventually drive the enrichment of the healthcare workforce. Drawing from traditional models of curriculum development, recent work on transforming the hidden curriculum, the clinical learning environment, and change management strategies, this new approach uses a health equity and structural competence lens to interrogate and deconstruct a learning system in order to identify opportunities to change, strengthen, and deepen a learner's experience around a specific topic. This process requires an in-depth, multidimensional assessment followed by the identification of key change targets and a stepwise, iterative plan for improvement and transformation. The topic area of substance use disorders (SUD) is used to illustrate how this complex process might be employed to improve the quality of care, realize and amplify the contributions of the entire healthcare team, stimulate interest in addiction medicine as a career, and reduce the stigma and disparities patients with SUDs often experience.

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Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review

Cited by 30 publications

References 47 publications

Learning that cannot come from a book: An evaluation of an undergraduate alcohol and other drugs subject co‐produced with experts by experience

Learning that cannot come from a book: An evaluation of an undergraduate alcohol and other drugs subject co‐produced with experts by experience

The Many Faces of the “Foster Care Youth” Label: How Young Women Manage the Stigma of Out-of-Home Placement

Commentary Article: Transforming an Educational Ecosystem for Substance use Disorders: A Multi-Modal Model for Continuous Curricular Improvement and Institutional Change

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