Published In

Journal of Addiction Medicine

Document Type

Post-Print

Publication Date

2-9-2021

Subjects

Social Work, Substance Related Disorders, Substance abuse -- Treatment

Abstract

Background: Trust is essential in patient-physician relationships. Hospitalized patients with substance use disorders (SUDs) often experience stigma and trauma in the hospital, which can impede trust. Little research has explored the role of hospital-based addictions care in creating trusting relationships with patients with SUDs. This study describes how trust in physicians changed among hospitalized people with SUDs who were seen by an interprofessional addiction medicine service.

Methods: We analyzed data from hospitalized patients with SUD seen by an addiction consult service from 2015 to 2018. Participants completed surveys at baseline and 30 to 90 days after hospital discharge. Follow-up assessments included open-ended questions exploring participant experiences with hospitalization and the addiction consult service. We measured provider trust using the Wake Forest Trust scale. We modeled trust trajectories using discrete mixture modeling, and sampled qualitative interviews from those trust trajectories.

Results: Of 328 participants with SUD who had prior hospitalizations but had not previously been seen by an addiction consult service, 196 (59.8%) had both baseline and follow-up trust scores. We identified 3 groups of patients: Persistent-Low Trust, Increasing Trust, and Persistent-High Trust and 4 qualitative themes around in-hospital trust: humanizing care, demonstrating addiction expertise, reliability, and granting agency.

Conclusions: Most participants retained or increased to high trust levels after hospitalization with an addiction consult service. Addiction consult services can create environments where healthcare providers build trust with, and humanize care for, hospitalized patients with SUD, and can also mitigate power struggles that hospitalized patients with SUD frequently experience.

Rights

© 2021 American Society of Addiction Medicine

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Description

This is the author’s final version of a work that was accepted for publication in the Journal of Addiction Medicine. Changes resulting from the publishing process, such as editing, corrections, formatting, and other quality control mechanisms may not be reflected in this document.

Locate the Document

The final, formatted version of this paper is available at: https://doi.org/10.1097/ADM.0000000000000819

DOI

10.1097/ADM.0000000000000819

Persistent Identifier

https://archives.pdx.edu/ds/psu/35008

Available for download on Wednesday, February 09, 2022

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