Search

Background and Aims: Long‐acting injectable buprenorphine (LAIB) is a new treatment for opioid use disorder that is generating positive outcomes. Negative effects are typically mild and transient, but can occasionally be serious, resulting in treatment discontinuation/non‐adherence. This paper aims to analyse patients' accounts of how they felt during the first 72 h after initiating LAIB. Methods: Semi‐structured interviews were conducted (June 2021–March 2022) with 26 people (18 males and 8 females) who had started LAIB within the previous 72 h. Participants were recruited from treatment services in England and Wales and were interviewed by telephone using a topic guide. Interviews were audio‐recorded, transcribed and coded. The concepts of embodiment and embodied cognition framed the analyses. Data on participants' substance use, initiation onto LAIB and feelings were tabulated. Next, participants' accounts of how they felt were analysed following the stages of Iterative Categorization. Results: Participants reported complex combinations of changing negative and positive feelings. Bodily experiences included withdrawal symptoms, poor sleep, injection‐site pain/soreness, lethargy and heightened senses inducing nausea ('distressed bodies'), but also enhanced somatic wellbeing, improved sleep, better skin, increased appetite, reduced constipation and heightened senses inducing pleasure ('returning body functions'). Cognitive responses included anxiety, uncertainties and low mood/depression ('the mind in crisis') and improved mood, greater positivity and reduced craving ('feeling psychologically better'). Whereas most negative effects reported are widely recognized, the early benefits of treatment described are less well‐documented and may be an overlooked distinctive feature of LAIB. Conclusions: During the first 72 h after initiating long‐acting injectable buprenorphine, new patients report experiencing a range of interconnected positive and negative short‐term effects. Providing new patients with information about the range and nature of these effects can prepare them for what to expect and help them manage feelings and reduce anxiety. In turn, this may increase medication adherence. [ABSTRACT FROM AUTHOR]

Background Research on staffed housing for people with intellectual disability has identified the challenges in achieving postitive quality of life outcomes. However, a less well considered dimension of such services is that they are places of living and dying. This paper looks at the experiences of staff in dealing with issues of death and dying. Method In depth qualitative interviews were held with 22 staff in 5 different providers and who had experienced, in total, 27 deaths of people with intellectual disability. Results The data highlight that staff felt providing a good quality of care at the end of life was an important but unrecognised dimension of their work. This work could be broken down into several different phases, dying, death and beyond death. Bad deaths were felt to be those deaths which prevented staff from 'being there' with individuals over those phases. [ABSTRACT FROM AUTHOR]

Intermittent self-catheterization (ISC) is a recommended treatment for people with a neuropathic bladder due to spinal injury. The majority of the literature to date has focused on the safety and the complication rates of ISC and use of different catheters. The aim of this paper explores the lived experience of people with spinal cord injury carrying ISC and the impact of service provision on rehabilitation. A qualitative approach was used based on grounded theory. Fifteen users (11 men and 4 women) of ISC took part in semi-structured interviews during 2009. Ages ranged from 24 to 68 years. The sample was recruited from the regional spinal unit. Thematic analysis was used to analyse the emergent themes. The results of the core theme, the patients' journey, related to the patients' perspectives of health service provision. Incontinence was the biggest problem to impact on quality of life. Successful bladder management was considered crucial to independence. The services provided by professionals in relation to ISC impacted on the rehabilitation process and patients' journey through the care system and independence. Service provision during acute rehabilitation was excellent; however, follow-up support was poor and failed to meet expectations. The findings of this study have potential to help professionals to identify factors in relation to the service provision important to spinal cord injured patients when learning and living with ISC. The information could be used to help those who may be resistant to ISC or have difficulty complying with the treatment and to aid with the teaching, advice giving and ongoing care. [ABSTRACT FROM AUTHOR]