Konflikte zwischen Personen mit Opioidabhängigkeit und Fachpersonen im Akutspital
Eine qualitative Dokumentenanalyse
Abstract
Zusammenfassung:Hintergrund: Opioidabhängigkeit ist eine chronisch verlaufende Krankheit mit schweren gesundheitlichen und sozialen Folgen. Betroffene leiden oft unter chronischen Infektionskrankheiten, deren Folgen Behandlungen im Akutspital erfordern. Im Spitalalltag kommt es zwischen Patient_innen mit Opioidabhängigkeit und Fachpersonen häufig zu Konflikten. Fragestellung/Ziel: Diese Studie exploriert, in welchen Situationen und aus welchen Gründen Konflikte entstehen. Methoden: Einträge von Fachpersonen in die Patientendokumentationen wurden qualitativ in Anlehnung an die Thematische Analyse untersucht. Ergebnisse: Einträge von 177 Fällen wurden analysiert und drei Themenbereiche identifiziert. In „Unterschiedliche Prioritäten im Kontext Akutspital“ zeigte sich, dass Patient_innen und Behandlungsteams oftmals divergente Ansichten hatten, was während einer Hospitalisation wichtig ist. „Sich selbst medizieren“ gab Hinweise, dass Patient_innen unter Symptomen litten, die unzureichend behandelt waren und sich daher selbst medizierten. Dem Grundbedürfnis, „als Mensch wahrgenommen zu werden“, wurde im Akutspital nicht immer entsprochen. Schlussfolgerung: Unsere Ergebnisse zeigen Ursachen und Arten von Konflikten. Divergente Wertvorstellungen, die Minderbehandlung suchtspezifischer Symptome und von Schmerzen sowie lückenhaftes Fachwissen der Fachpersonen scheinen ebenso ursächlich zu sein wie die fehlende Umsetzung der Schadensminderung.
Abstract:Background: Opioid dependency is a chronic disease with severe health and social consequences. Patients often suffer from chronic infectious diseases, the consequences of which require treatment in an acute care hospital. On hospital wards, conflicts between patients with opioid dependency and professionals can be observed frequently. Aim: This study explores in which situations and for which reasons conflicts arise. Methods: Entries of professionals in patient charts were analysed qualitatively according to the Thematic Analysis. Results: Entries of 177 cases were analysed and three themes were identified. “Different priorities in the context of an acute hospital” showed that patients and professional teams often had divergent views on what is important during hospitalisation. “Self-medicating” provided evidence that patients suffered from symptoms that were inadequately treated and therefore self-medicated. The basic need “to be perceived as a human being” was not always met in the acute care hospital. Conclusions: Our results show causes and types of conflicts. Divergent values, under-treatment of addiction-specific symptoms and pain, and incomplete expertise among professionals appear to be causal, as does the lack of implementation of harm reduction.
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