Theses Doctoral

Measure of Intention to Provide Patient-centered Care to People Experiencing Opioid Addiction and Overdose Among EMS Providers in the State of Maine

Allen, Denise Roberta

The current opioid epidemic is devastating our communities. The American Medical Association’s Task Force on opioid addiction has identified stigma as a primary target of intervention for mitigating this epidemic. Stigma is a mark of disgrace or being objectionable. Experiences of stigma and resulting shame serve only to fuel health inequities experienced by people with opioid addiction. Emergency Medical Services (EMS) have an important role to play in mitigating this epidemic as entry-level providers in the healthcare system. The quality of that patient-provider encounter had the potential to shift intrinsic motivation to seek and maintain addiction treatment. Patient-centered care is identified as supporting therapeutic communication and is well-suited for rural EMS operations in Maine. The purpose of this research was to examine predictors of intention to provide patient-centered care to people experiencing opioid addiction and overdose (OAO) among EMS providers in the state of Maine.
A cross-sectional online survey of currently licensed EMS providers offered a direct measure of intention to give patient-centered care to people experiencing OAO. Multiple regression analysis identified four predictor variables for intention: job satisfaction, exploring patient perspective, sharing information and power, and dealing with communicative challenges. The fitted model resulted in a significant R2 = .529, (F (4, 734) = 226.381, p < .001) exceeding the critical F statistic
(F (4,739) = 2.384, p = .05), thus confirming the predictive value of the coefficients. Results suggested that EMS providers at all license levels will benefit from interventions that expand their knowledge of the medical definition of addiction and patient-centered care. EMS providers will also benefit from adopting approaches that support exploring the patient perspective and sharing information and power such as Motivational Interviewing and human performance strategies to develop awareness of socially conditioned biases that moderate provider attitudes. These evidence-based interventions could elevate the standard of care provided by EMS and reduce experiences of stigma in the patient-provider encounter. Reductions in stigma increase self-worth and prime motivation to seek and maintain treatment, thereby closing the treatment gap that exists for those experiencing opioid addiction in the state of Maine.

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More About This Work

Academic Units
Health and Behavior Studies
Thesis Advisors
Fullilove, Robert
Ph.D., Columbia University
Published Here
March 2, 2018