A grounded theory approach to the care experience of patients with intravenous drug use/abuse-related endocarditis

Colwill, Jennifer P.; Sherman, Minerva; Siedlecki, Sandra L.; Burchill, Christian N.; Siegmund, Lee Anne

doi:10.1016/j.apnr.2020.151390

Cited by 3 publications

(9 citation statements)

References 22 publications

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“…Four studies 60,61,67,69 included analyses of how delays in care due to negative experiences in health care settings had a disproportionate impact by race or gender. Assessing hospital care experiences in Vancouver (Canada), McNeil and colleagues 67 described, “Many participants of Aboriginal ancestry further expressed that institutionalized racism reinforced the view among hospital staff that they were ‘drug-seeking’”.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Only one study specifically explored insufficient health insurance as a barrier to care. 69 In other studies, authors explained that insurance is a barrier to health care for some PWID but their study participants had access to public health insurance (universally in Canada 67 , and Medicaid in USA 63,64 ).…”

Section: "Mainly Because How I Have Been Treated At the Hospitals Whi...mentioning

confidence: 95%

“…65,66 Health care policies and practices In 13 studies, authors analysed why PWID delay or avoid medical care for injecting-related infections (often until infections had progressed and spread). Contributing factors were prior experiences of stigmatizing or discriminatory care (in 12 studies 53,54,60,61,64,[67][68][69][70][71][72][73] ) and of untreated pain and withdrawal (in six studies 53,61,63,64,71,72 ). In several studies, PWID described both: "I'm not trying to get drugs.…”

Section: Unsafe Spacesmentioning

confidence: 99%

“…Three studies included descriptions of how PWID who were mothers were discouraged from accessing care for injecting-related infections, including feelings of shame at disclosing substance use as a mother, 60 and fear of child apprehension if their substance use was reported by health professionals. 61,69 In four studies, 63,67,70,74 PWID described leaving hospital prematurely, before completing treatment for injecting-related infections. Explanations included leaving hospital in response to discrimination 67,74 and because restrictions on their movements in hospital triggered post-traumatic stress.…”

Section: "Mainly Because How I Have Been Treated At the Hospitals Whi...mentioning

confidence: 99%

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Social and structural determinants of injection drug use-associated bacterial and fungal infections: a qualitative systematic review and thematic synthesis

Brothers

Bonn²,

Lewer

et al. 2022

Preprint

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Background: Injection drug use-associated bacterial and fungal infections are increasingly common, and social contexts shape individuals' injecting practices and treatment experiences. We sought to synthesize qualitative studies of social-structural factors influencing incidence and treatment of injecting-related infections. Methods: We searched PubMed, EMBASE, Scopus, CINAHL, and PsycINFO from January 1, 2000, to February 18, 2021. Informed by Rhodes' "risk environment" framework, we performed thematic synthesis in three stages: (1) line-by-line coding; (2) organizing codes into descriptive themes, reflecting interpretations of study authors; (3) consolidating descriptive themes into conceptual categories to identify higher-order analytic themes. Results: We screened 4,841 abstracts and included 26 qualitative studies on experiences of injecting-related bacterial and fungal infections. We identified six descriptive themes organized into two analytic themes. The first analytic theme, social production of risk, considered macro-environmental influences. Four descriptive themes highlighted pathways through which this occurs: (1) unregulated drug supply, leading to poor drug quality and solubility; (2) unsafe spaces, influenced by policing practices and insecure housing; (3) health care policies and practices, leading to negative experiences that discourage access to care; and (4) harm reduction programs, including structural barriers to effective service provision. The second analytic theme, practices of care among people who inject drugs, addresses protective strategies that people who inject drugs employ within infection risk environments. Associated descriptive themes were: (5) mutual care, including assisted-injecting and sharing sterile equipment; and (6) self-care, including vein health and self-treatment. Within constraining risk environments, some protective strategies for bacterial infections precipitated other health risks (e.g., HIV transmission). Conclusions: Injecting-related bacterial and fungal infections are shaped by modifiable social-structural factors, including unregulated drug quality, criminalization, insufficient housing, limited harm reduction services, and harmful health care practices. Enabling environment interventions that address these factors could further empower people who inject drugs to protect themselves and their community.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: "Mainly Because How I Have Been Treated At the Hospitals Whi...mentioning

confidence: 95%

Section: Unsafe Spacesmentioning

confidence: 99%

Section: "Mainly Because How I Have Been Treated At the Hospitals Whi...mentioning

confidence: 99%

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Social and structural determinants of injection drug use-associated bacterial and fungal infections: a qualitative systematic review and thematic synthesis

Brothers

Bonn²,

Lewer

et al. 2022

Preprint

View full text Add to dashboard Cite

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Infective Endocarditis in Patients Addicted to Injected Opioid Drugs

Javorski,

Rosinski,

Shah

et al. 2024

Journal of the American College of Cardiology

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Social and structural determinants of injection drug use‐associated bacterial and fungal infections: A qualitative systematic review and thematic synthesis

Brothers

Bonn²,

Lewer

et al. 2023

Addiction

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Background and aimsInjection drug use‐associated bacterial and fungal infections are increasingly common, and social contexts shape individuals’ injecting practices and treatment experiences. We sought to synthesize qualitative studies of social–structural factors influencing incidence and treatment of injecting‐related infections.MethodsWe searched PubMed, EMBASE, Scopus, CINAHL and PsycINFO from 1 January 2000 to 18 February 2021. Informed by Rhodes’ ‘risk environment’ framework, we performed thematic synthesis in three stages: (1) line‐by‐line coding; (2) organizing codes into descriptive themes, reflecting interpretations of study authors; and (3) consolidating descriptive themes into conceptual categories to identify higher‐order analytical themes.ResultsWe screened 4841 abstracts and included 26 qualitative studies on experiences of injecting‐related bacterial and fungal infections. We identified six descriptive themes organized into two analytical themes. The first analytical theme, social production of risk, considered macro‐environmental influences. Four descriptive themes highlighted pathways through which this occurs: (1) unregulated drug supply, leading to poor drug quality and solubility; (2) unsafe spaces, influenced by policing practices and insecure housing; (3) health‐care policies and practices, leading to negative experiences that discourage access to care; and (4) restrictions on harm reduction programmes, including structural barriers to effective service provision. The second analytical theme, practices of care among people who use drugs, addressed protective strategies that people employ within infection risk environments. Associated descriptive themes were: (5) mutual care, including assisted‐injecting and sharing sterile equipment; and (6) self‐care, including vein health and self‐treatment. Within constraining risk environments, some protective strategies for bacterial infections precipitated other health risks (e.g. HIV transmission).ConclusionsInjecting‐related bacterial and fungal infections are shaped by modifiable social–structural factors, including poor quality unregulated drugs, criminalization and policing enforcement, insufficient housing, limited harm reduction services and harmful health‐care practices. People who inject drugs navigate these barriers while attempting to protect themselves and their community.

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A grounded theory approach to the care experience of patients with intravenous drug use/abuse-related endocarditis

Cited by 3 publications

References 22 publications

Social and structural determinants of injection drug use-associated bacterial and fungal infections: a qualitative systematic review and thematic synthesis

Social and structural determinants of injection drug use-associated bacterial and fungal infections: a qualitative systematic review and thematic synthesis

Infective Endocarditis in Patients Addicted to Injected Opioid Drugs

Social and structural determinants of injection drug use‐associated bacterial and fungal infections: A qualitative systematic review and thematic synthesis

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