Background:

Substance use disorders (SUDs) in physicians impact their professional responsibilities toward patients. Understanding the difficulties of physicians with SUDs would facilitate early identification and reduce the complications they face in various domains, particularly in settings where there are no physician-health care programs. In this background, we aimed to understand the challenges physicians with SUDs face at their workplace.

Methods:

Qualitative in-depth interviews of 21 physicians receiving treatment from a tertiary care addiction medicine center for their SUD were conducted and, based on the transcripts from the interview after coding and recoding, through inductive content analysis, themes and subthemes were identified.

Results:

The following occupational challenges were identified: direct consequences of the psychoactive effect of the substance, adverse effects on clinical care and service delivery, impairment in regularity and punctuality, changes in the physicians’ behaviors, changes in the work environment and diverse responses of colleagues and the hospital administration toward substance use-related actions, ethical issues at workplace, and effects on career growth.

Conclusions:

SUDs in physicians have a significant impact on their functioning at work, affecting patient care, interpersonal relationships as well as career growth. Knowledge of occupational challenges among physicians with SUD will help us in understanding the severity of the problem.

中文翻译：

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物质使用障碍医师的职业挑战：一项定性研究

背景：

医生的物质使用障碍 (SUD) 会影响他们对患者的职业责任。了解患有 SUD 的医生的困难将有助于早期识别并减少他们在各个领域面临的并发症，特别是在没有医生保健计划的环境中。在此背景下，我们旨在了解 SUD 医生在其工作场所面临的挑战。

方法：

对接受三级护理成瘾医学中心治疗的 21 名 SUD 医生进行了定性深入访谈，并根据编码和重新编码后的访谈记录，通过归纳内容分析，确定了主题和子主题。

结果：

确定了以下职业挑战：物质的精神作用的直接后果、对临床护理和服务提供的不利影响、规律性和准时性的损害、医生行为的变化、工作环境的变化以及同事和同事的不同反应医院管理部门对药物使用相关行为、工作场所的道德问题以及对职业发展的影响。

结论：

医生的 SUD 对他们的工作功能有重大影响，影响患者护理、人际关系以及职业发展。SUD 医生对职业挑战的了解将有助于我们了解问题的严重性。