Paper
Friday, July 15, 2005
Relationship of Perceived Health Status Among Pregnant Women and Premature Termination of Drug Treatment
Benita Jeanne Walton–Moss, DNS1, Linda McIntosh, PhD, RN, LPC2, Jessica Conrad, MSN, APRN, BC1, and Erika Kiefer, BSN1. (1) School of Nursing, Johns Hopkins University, Baltimore, MD, USA, (2) School of Nursing, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| Learning Objective #1: Describe the birth outcomes observed in a sample of drug dependent women enrolled in a comprehensive drug treatment program |
| Learning Objective #2: Describe differences in perceived health status between pregnant women who complete drug treatment and pregnant women who prematurely terminate treatment |
Substance abuse and dependence continues to be a significant problem but it is particularly concerning when it involves pregnant women who are substance dependent. Negative birth outcomes among drug-exposed infants notably include low birthweight and prematurity, the primary contributors to infant death. Positive birth outcomes depend, in part, on obtaining adequate prenatal care, ideally in comprehensive drug treatment programs. Unfortunately, women often do not remain in treatment until delivery. This study was conducted to better understand the physical and mental health status of low-income pregnant women in substance abuse treatment in urban environments. This analysis will report on differences between women who prematurely terminated treatment and women who completed treatment. This study was conducted in a program that provides comprehensive hospital-based treatment including intensive multidisciplinary services for substance abuse, mental health, obstetrical, gynecological, and family planning, and pediatric care. The women were predominantly African American in their late 20s, unemployed, never married, with less than a high school education, with either cocaine or opiate dependence. Upon entry into treatment, 159 women were interviewed about their perceptions of their health status as measured by the General Health Survey Form (SF36) and Brief Symptom Inventory (BSI). Approximately 60% completed treatment and 40%) failed to complete treatment. Birth outcomes looked similar between the two groups. Although SF36 scores were also similar, mental health as measured by the BSI were different. Women with BSI scores suggesting less psychiatric distress were more likely to leave treatment prior to completion compared to women who completed treatment suggesting that additional interventions may need to be directed toward pregnant women with better perceived mental health.