Exploring Factors that Impact Provider Experience while Caring for Pregnant People Who Use Substances in Ontario: A Qualitative Descriptive Phenomenology
Bibliographic record
Abstract
ABSTRACT Objectives: Existing literature on the experiences of health care providers caring for pregnant people who use drugs suggests that providers do not enjoy their work, and describes discordant relationships between providers and patients, and major deficits of time, training, and resources. Little is known about the factors that lead to improved experiences for providers caring for pregnant people who use drugs. This research aims to understand the factors that affect the subjectively experienced phenomenon of providing health and social services for pregnant people who use drugs in Ontario. Methods: We conducted structured interviews with social service and health care providers from across Ontario who had worked with pregnant people who use drugs at some point over the last year. Interviews focused on provider philosophy of care, past training and education, organizational practices, and general experience. We utilized a descriptive phenomenological qualitative methodology and interview transcripts were analyzed thematically. Results: We interviewed 7 providers. Overall, the majority of participants described enjoyment in their work and were passionate about the care of their patients. Factors that impacted experience were categorized into personal-level (philosophy, personal experience), interpersonal-level (relationships, trust), community-level (interdisciplinary care networks), and structural-level (marginalization, underfunding) factors. Conclusions: Personal-, interpersonal-, and community-level factors generally improved the experience of providers, while structural factors impeded positive experiences. To improve the experience of providers in a widespread manner, structural factors must be addressed, as personal-, interpersonal-, and community-level factors have limited potential for widespread change. Objectifs: La littérature existante sur les expériences des prestataires de soins de santé qui s’occupent des personnes enceintes qui consomment des drogues suggère que les prestataires n’apprécient pas leur travail, et décrit des relations discordantes entre les prestataires et les patients, ainsi que des déficits importants en termes de temps, de formation et de ressources. On sait peu de choses sur les facteurs qui améliorent l’expérience des prestataires de soins aux personnes enceintes qui consomment des drogues. Cette recherche vise à comprendre les facteurs qui affectent le phénomène subjectivement expérimenté de la prestation de services sociaux et de santé aux personnes enceintes qui consomment des drogues en Ontario. Méthodes: Nous avons mené des entretiens structurés avec des prestataires de services sociaux et de santé à travers l’Ontario qui avaient travaillé avec des personnes enceintes qui ont consommées des drogues à un moment ou à un autre au cours de l’année écoulée. Les entretiens ont porté sur la philosophie de soins des prestataires, leur formation et leur éducation antérieures, leurs pratiques organisationnelles et leur expérience générale. Nous avons utilisé une méthodologie qualitative phénoménologique descriptive et les transcriptions des entretiens ont été analysées de manière thématique. Résultats: Nous avons interrogé 7 prestataires. Dans l’ensemble, la majorité des participants ont indiqué qu’ils aimaient leur travail et qu’ils étaient passionnés par les soins prodigués à leurs patients. Les facteurs qui ont eu un impact sur l’expérience ont été catégorisés au niveau personnel (philosophie, expérience personnelle), au niveau interpersonnel (relations, confiance), au niveau communautaire (réseaux de soins interdisciplinaires) et au niveau structurel (marginalisation, sous-financement). Conclusions: Les facteurs personnels, interpersonnels et communautaires ont généralement amélioré l’expérience des prestataires, tandis que les facteurs structurels ont entravé les expériences positives. Afin d’améliorer l’expérience des prestataires de manière généralisée, les facteurs structurels doivent être abordés, car les facteurs personnels, interpersonnels et communautaires ont un potentiel limité de changement généralisé.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".