Experiences of Hope after Treatment of Hepatitis C Infection-A Qualitative Study.

The aim of this study was to explore the experiences of hope people had after undergoing treatment for a hepatitis C virus infection (HCV). Between October 2019 and May 2020, 19 one-on-one interviews were conducted with people who inject drugs and had undergone HCV treatment. All participants had completed treatment and were documented as being virus-free. Data were audio recorded and then transcribed verbatim and analysed; a method inspired by reflexive thematic analysis. Those interviewed conveyed rich and nuanced descriptions of experiences of a life with HCV. Through the course of the analysis we developed four themes. The themes were formulated as metaphors aimed at capturing commonalities about how the participants seemed to "turn their gaze" after receiving HCV treatment: (1) turning their gaze backward; (2) turning their gaze inwards; (3) turning their gaze toward others and (4) turning their gaze forward. Participants' descriptions of their experiences relating to HCV were somewhat gloomy, and HCV treatment seemed to inspire hope and a brighter outlook on several areas of life.

Facilitators for use of oral healthcare services among people with substance use disorders: a qualitative study in Norway.

OBJECTIVE: Opioid maintenance treatment (OMT) patients in Norway are eligible for free oral healthcare services; however, oral health morbidity remains high and the uptake of services among this patient group is low. As knowledge of the reasons for the low uptake of services among OMT patients is insufficient, this study adopted a qualitative approach to explore this from the perspectives of patients and dental healthcare workers (DHWs). MATERIAL AND METHODS: Through focus group and individual interviews, data were collected from 63 participants: 30 patients receiving OMT and 33 DHWs. Key themes were identified through a thematic analysis. RESULTS: Teeth were a significant factor in OMT patients' quality of life and recovery. Accompaniment to scheduled dentist appointments was identified as a facilitator by both the patients and the DHWs. The dentist-patient relationship was also seen as an important facilitator of dental treatment; DHWs with previous experience of treating OMT patients were valued by patients because of their high verbal and non-verbal communication. CONCLUSIONS: Helping OMT patients attend dental appointments, improving the dentist-patient relationship, and expanding stakeholders' knowledge of OMT patients' right to oral healthcare services may increase the uptake and benefits of dental healthcare services among OMT patients. The current support framework within the OMT system has the potential to increase the communication and efficiency of dental healthcare services available to patients undergoing OMT.

Non-financial barriers in oral health care: a qualitative study of patients receiving opioid maintenance treatment and professionals' experiences.

BACKGROUND: People with substance use disorders often have poor oral health, which can negatively impact their quality of life. Since 2005, patients receiving opioid maintenance treatment (OMT) in Norway have been eligible for free oral health care services offered through public oral health clinics. Despite a large need for oral health services amongst patients in OMT, figures suggest that the use of these services is low amongst this patient group. It has been unclear which barriers that contribute to this. This qualitative study explores the underlying barriers to the use of oral health care services amongst patients in OMT, from the perspective of the patients as well as dental health care workers (DHW). METHODS: Through a combination of focus group interviews and individual interviews, data were collected from 63 participants; 30 patients in OMT and 33 DHW. Thematic analysis identified key themes for the use (or not) of oral health care services amongst patients in OMT. RESULTS: Both individual and structural barriers prevent OMT patients from using the free oral health care services offered to them. These barriers include struggling to attend appointments, anxiety and fear of dentists, discrepancies between patients' expectations and the services offered and perceived stigma. OMT patients' lack of information regarding their rights and access to oral health services was also a barrier, as was DHWs' lack of knowledge and information of the OMT system and what they can offer patients. CONCLUSIONS: OMT patients face several barriers in accessing and using oral health care services. However, through a number of relatively simple measures, it is possible that the use of oral health services amongst OMT patients can be increased.

Opioid and Polydrug Use Among Patients in Opioid Maintenance Treatment.

PURPOSE: Opioid maintenance treatment reduces a person's use of heroin. However, frequent substance use in treatment is a problem. AIM: To examine the association between opioid maintenance treatment and opioid/polydrug use, and whether social factors, adverse experiences, social resources, and quality of life are associated with opioid/polydrug use during the first 12 months in treatment. PATIENTS AND METHODS: Forty-seven participants from treatment units in Bergen, Norway participated in five waves of data collection. Every third month, a structured face-to-face interview collected self-reported data on sociodemographic characteristics, opioid/polydrug use, participants' social resources or adverse experiences, and quality of life. Data were collected as part of KVARUS, the National Quality Register for Substance Abuse Treatment. A multilevel binary logistic regression analysis was conducted to examine the association of opioid/polydrug use and time in current treatment. The analysis included regressions of opioid/polydrug use on time-invariant baseline adverse experiences and social resources, and time-varying reports of quality of life. RESULTS: There was a significant negative association between time in treatment and use of opioids, b =-0.89, SE = 0.19, p = <0.01. Furthermore, a negative association of age at substance use on polydrug use was found, b =-0.40, SE =0.19, p = 0.03. A higher overall quality of life was significantly associated with lower odds of opioid use during opioid maintenance treatment, b = -0.62, SE = 0.23, p = < 0.01. Social dimensions, participants' adverse experiences, and social resources were not associated with polydrug or opioid use. CONCLUSION: Opioid maintenance treatment is associated with lowered opioid use, but to a lesser degree with polydrug use. Our findings add quality of life as an important factor that should be given particular attention because it can offer insight to aspects that can affect the patients' opioid use.