What aspects of their child's primary care do mothers value? A qualitative analysis of perspectives of women in treatment for opioid use disorder

Abstract

Background: Preventive paediatric healthcare is essential for infant and child health. Current research, however, suggests that the delivery of routine well child care (WCC) for children affected by maternal opioid use disorder (OUD) could be improved. How mothers perceive interactions with healthcare providers may help identify ways to modify the experience of WCC, which could ultimately improve healthcare utilization, patient satisfaction and clinical outcomes. The objective of this qualitative study was to assess perceptions of WCC among mothers in treatment for OUD. Methods: Four focus group sessions of 4-8 participants each (N = 22) were conducted. All study participants were receiving comprehensive behavioural and physical health support and care plus pharmacotherapy for OUD from a single outpatient treatment centre. Focus groups were semi-structured, with a standardized set of open-ended questions and follow-up prompts to engage participants in a fluid discussion. Participants were asked to identify and discuss important aspects of their youngest child's WCC and what they liked and disliked about their child's WCC. Grounded theory analysis was used to identify themes. Results: Several aspects of WCC were identified as important to the mothers. Main themes identified included (1) mother-provider relationship, (2) communication with healthcare team and (3) support for mother's OUD treatment. Participants discussed their desire to be heard and understood and wanted the entire healthcare team and clinic staff to see them as mothers first and foremost, not merely as individuals with OUD. Conclusion: Future attempts to refine care may consider healthcare models that highlight open communication and personalized care and offer strong support and ongoing encouragement for the mother's OUD treatment and recovery process.

Stigma Experienced by Perinatal Women with Opioid Dependency in the United States: A Qualitative Meta-Synthesis

“…After application of inclusion and exclusion criteria to these articles' abstracts, this total was reduced to 26 articles. After a full-text assessment for eligibility was completed, 18 articles [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] were included (See Figure 1 for PRISMA diagram 20 ).…”

“…All studies explored the experiences of women with perinatal OUD during various points in the perinatal period (i.e., the prenatal, labor and delivery, and postpartum periods). [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Four studies explored infant care-related experiences in the postpartum period. 25,32,37,39…”

“…Communicating and sharing knowledge was noted to be important to perinatal women with OUD. 25,40,41 Women expressed a desire to partake in respectful, reciprocal communication with the goal of effective sharing of caring, accurate information and concern for the woman as a human being. 25,40,41 Importance was also placed on the development of a trusting relationship with nurses/healthcare providers, which was influenced by effective communication and shared knowledge.…”

“…25,40,41 Women expressed a desire to partake in respectful, reciprocal communication with the goal of effective sharing of caring, accurate information and concern for the woman as a human being. 25,40,41 Importance was also placed on the development of a trusting relationship with nurses/healthcare providers, which was influenced by effective communication and shared knowledge. The presence of a trust relationship promoted perceived better care, resulting in perinatal women with OUD feeling respected and empowered which increased trust in maternal abilities.…”

Health Status and Preventive Health Services Among Reproductive-Aged Women in Treatment for Opioid Use Disorder

“…Having an established provider would allow for personalized care and enhance continuity of care, two aspects of clinical care that are valued by women in treatment for OUD. 33 …”