Elizabeth Charron1, Rachel M Mayo2, Smith F Heavner-Sullivan3, Kacey Y Eichelberger4, Lori Dickes5, Khoa D Truong2, Lior Rennert2. 1. Department of Public Health Sciences, 503 Edwards Hall, Clemson University, Clemson, SC 29634, USA; Program of Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA) Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, 295 Chipeta Way Salt Lake City, UT 84132, USA. Electronic address: betsy.charron@utah.edu. 2. Department of Public Health Sciences, 503 Edwards Hall, Clemson University, Clemson, SC 29634, USA. 3. Department of Public Health Sciences, 503 Edwards Hall, Clemson University, Clemson, SC 29634, USA; Prisma Health Upstate, 701 Grove Road, Greenville, SC 29605, USA. 4. Prisma Health Upstate, 701 Grove Road, Greenville, SC 29605, USA. 5. Department of Parks, Recreation and Tourism Management, 263 Lehotsky Hall, Clemson University, Clemson, SC 29634, USA.
Abstract
OBJECTIVE: To explore health care providers' communication practices during contraceptive counseling for women with substance use disorders (SUDs). STUDY DESIGN: In 2019, we conducted semi-structured phone interviews with a purposive sample of medical doctors and advanced practice nurses (n = 24). A two-member team analyzed these interviews for themes using deductive and inductive techniques and ATLAS.ti to manage the data. RESULTS: Providers discussed that developing strong interpersonal relationships and trust is critically important to provide effective contraceptive counseling to women with SUDs. Providers reported exchanging information with patients by asking open-ended questions, tailoring discussions to patients' responses, and being direct but not judgmental. To facilitate contraceptive decision-making, providers described eliciting patients' preferences for contraceptive methods while simultaneously using their own clinical judgment and professional experience to identify which methods would be most effective and appropriate for their patients. Most often these were long-acting reversible contraceptive methods, and providers emphasized the benefits of these methods for women with SUDs. CONCLUSION: Providers used a variety of communication strategies, some of which were grounded in the principles of patient-centered care and others that were directive, to discuss contraception with women with SUDs. IMPLICATIONS: Because of past and ongoing stigma and discrimination by health care professionals and the general public, women with SUDs may be distrustful of contraceptive providers. Patient-centered contraceptive counseling may be an effective approach to increase trust and improve relationships and communication between women with SUDs and their providers. Additional research with women with SUDs is needed to understand women's experiences with and preferences for patient-provider communication during contraceptive counseling.
OBJECTIVE: To explore health care providers' communication practices during contraceptive counseling for women with substance use disorders (SUDs). STUDY DESIGN: In 2019, we conducted semi-structured phone interviews with a purposive sample of medical doctors and advanced practice nurses (n = 24). A two-member team analyzed these interviews for themes using deductive and inductive techniques and ATLAS.ti to manage the data. RESULTS: Providers discussed that developing strong interpersonal relationships and trust is critically important to provide effective contraceptive counseling to women with SUDs. Providers reported exchanging information with patients by asking open-ended questions, tailoring discussions to patients' responses, and being direct but not judgmental. To facilitate contraceptive decision-making, providers described eliciting patients' preferences for contraceptive methods while simultaneously using their own clinical judgment and professional experience to identify which methods would be most effective and appropriate for their patients. Most often these were long-acting reversible contraceptive methods, and providers emphasized the benefits of these methods for women with SUDs. CONCLUSION: Providers used a variety of communication strategies, some of which were grounded in the principles of patient-centered care and others that were directive, to discuss contraception with women with SUDs. IMPLICATIONS: Because of past and ongoing stigma and discrimination by health care professionals and the general public, women with SUDs may be distrustful of contraceptive providers. Patient-centered contraceptive counseling may be an effective approach to increase trust and improve relationships and communication between women with SUDs and their providers. Additional research with women with SUDs is needed to understand women's experiences with and preferences for patient-provider communication during contraceptive counseling.
Authors: Ximena A Levander; Canyon A Foot; Sara L Magnusson; Ryan R Cook; Jerel M Ezell; Judith Feinberg; Vivian F Go; Kathryn E Lancaster; Elizabeth Salisbury-Afshar; Gordon S Smith; Ryan P Westergaard; April M Young; Judith I Tsui; P Todd Korthuis Journal: J Gen Intern Med Date: 2022-06-15 Impact factor: 6.473
Authors: Orli K Florsheim; Dallas Augustine; Megan M Van Ligten; Heike Thiel de Bocanegra; Rachel Perry Journal: J Addict Med Date: 2021 Nov-Dec 01 Impact factor: 3.702
Authors: Britton Gibson; Emily Hoff; Alissa Haas; Zoe M Adams; Carolina R Price; Dawn Goddard-Eckrich; Sangini S Sheth; Anindita Dasgupta; Jaimie P Meyer Journal: Womens Health (Lond) Date: 2022 Jan-Dec