Factors influencing medical students’ attitudes towards substance use during pregnancy

Abstract

Background People with substance use disorder, and pregnant women especially, are subject to a lot of stigmas, which can prevent optimal accessibility and quality of care. In this survey, we investigated attitudes of final year medical students regarding substance use during pregnancy and identified the factors that influence these attitudes. Method This cross-sectional study was conducted in 2019 and 2020 in Belgium using the short version of the “Substance Abuse Attitude Survey” questionnaire. We focused on two items regarding punishment of substance use during pregnancy. We analysed the concordance between these two, their correlation with other items (e.g. stereotyping, morality, forced withdrawal, low treatment optimism) and the association between respondents’ opinion on punishment and their sociodemographic data. Results The response rate was 65.2% (370/567 online and face-to face questionnaires). 19.2% of respondents were in favour of punishment for alcohol use (n = 353) and 15.1% for drug use (n = 356) during pregnancy. The agreement analysis between the two items showed that 14.3% of students were in favour of punishing both pregnant women who use drugs and those using alcohol. Respondents tended to be more in favour of punishment if they were male students, older, their mothers’ had a lower education level or had no personal or family history of substance use. Attitudes appeared to be more punitive among students with limited contact with people with substance use disorder (i.e. none or limited to hospital). Students intending to specialise in internal medicine were more in favour of punishment of women whereas none of those intending to specialise in psychiatry were in favour. Conclusion Our study shows that about 20% of surveyed medical students favoured punishing substance-using pregnant women. Awareness and training work seems to be necessary to ensure adequate care and support for this already vulnerable population.

Exploratory Factor Analysis of a French Adapted Version of the Substance Abuse Attitude Survey Among Medical Students in Belgium

“…The fact of never having used substances on one's own also seemed to encourage these stereotypes. All these elements are in line with the literature [17,27,28].…”

“…As for the results of the factor scores, we can see that the characteristics of the subjects with higher scores for stereotype and moralism are similar to those who were in favor of punishing substance use during pregnancy (alcohol/drugs) in our previous study [17], these 2 items being the most « weighted » in this first factor.…”

“…In order to characterise our population and to better understand the factors favoring the students' representations, we included several socio-demographic data (sex, age, origin); data related to the personal and professional background linked to substance use; data related to the type of professional orientation (choice of specialty); as well as data related to the perception of their own health (we wanted to evaluate whether this influenced the way in which addicts are perceived). This questionnaire, which was called "bSAAS" by our research team, has already been used in a previous study to evaluate the attitudes of medical students towards substance use in pregnancy and showed a good internal consistency (Cronbach's alpha = 0.77) [17].…”

Matters arising: methodological issues on evaluating agreement between medical students’ attitudes towards drugs/alcohol use during pregnancy by Cohen’s kappa analysis

“… The data has been cited from the article published by Richelle et al [ 1 ] and undergone modification. k c : Cohen’s kappa, k lw : linear weighted kappa, k qw : quadratic weighted kappa …”

“…We read with interest the article entitled: “Factors influencing medical students’ attitudes towards substance use during pregnancy” which was published in BMC Medical Education on 2 May 2022 [ 1 ]. The authors investigated the attitudes of final-year medical students regarding substance use during pregnancy and identified the factors that influence these attitudes.…”