[Users' perception of a harm reduction program in an outpatient drug dependency treatment center].
OBJECTIVE
We analyzed the perspective of users enrolled in a harm reduction program that provides syringe exchange, an educational room for «warmth and coffee», a methadone maintenance program, a room for supervised drug consumption, a place for personal hygiene, and medical and psychosocial follow-up. The particularity of this program lies in its integration within an outpatient drug treatment center forming part of a general hospital.


METHODS
We performed a descriptive study using qualitative methods. Theoretical sampling was conducted. Twelve in-depth interviews and one focus group composed of eight users were carried out. Information analysis was based on grounded theory. Literal transcriptions were coded and subsequently sorted into broad categories. Three researchers participated in this process and finally a fourth researcher triangulated the results.


RESULTS
Five dimensions were identified in the users' discourse: accessibility, service, relationship, localization, and identity. Each consisted of several topics that were evaluated based on the participants' experiences and expectations. The dimension of identity emerged as a distinctive element in patient-program bonding.


CONCLUSIONS
The users' overall evaluation of the program was positive. Facilitators and barriers influencing patient-program bonding were identified and participants suggested ways to remove barriers. The coexistence among users of the harm reduction program and patients treated conventionally provoked ambivalence but the team's management was deemed helpful in easing the difficulties arising from this situation.
CAS Vall d'Hebron, Servicio de Psiquiatría, Hospital Universitario Vall d'Hebron, Barcelona, España. cdaigre@vhebron.net
Constanza
C
Daigre
Marina
M
Comín
Laia
L
Rodríguez-Cintas
Nuria
N
Voltes
Alba
A
Alvarez
Carlos
C
Roncero
Begoña
B
Gonzalvo
Miguel
M
Casas
D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D040242:Risk Reduction Behavior; D019966:Substance-Related Disorders / Q000628:therapy*; D055815:Young Adult