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Harm reduction principles for healthcare settings

BACKGROUND: Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduct...

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Autores principales: Hawk, Mary, Coulter, Robert W. S., Egan, James E., Fisk, Stuart, Reuel Friedman, M., Tula, Monique, Kinsky, Suzanne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655864/
https://www.ncbi.nlm.nih.gov/pubmed/29065896
http://dx.doi.org/10.1186/s12954-017-0196-4
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author Hawk, Mary
Coulter, Robert W. S.
Egan, James E.
Fisk, Stuart
Reuel Friedman, M.
Tula, Monique
Kinsky, Suzanne
author_facet Hawk, Mary
Coulter, Robert W. S.
Egan, James E.
Fisk, Stuart
Reuel Friedman, M.
Tula, Monique
Kinsky, Suzanne
author_sort Hawk, Mary
collection PubMed
description BACKGROUND: Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. METHODS: Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. RESULTS: We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. CONCLUSION: This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of their disclosure of negative health behaviors, given that health behaviors are not binary or linear but operate along a continuum based on a variety of individual and social determinants.
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spelling pubmed-56558642017-10-31 Harm reduction principles for healthcare settings Hawk, Mary Coulter, Robert W. S. Egan, James E. Fisk, Stuart Reuel Friedman, M. Tula, Monique Kinsky, Suzanne Harm Reduct J Research BACKGROUND: Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. METHODS: Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. RESULTS: We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. CONCLUSION: This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of their disclosure of negative health behaviors, given that health behaviors are not binary or linear but operate along a continuum based on a variety of individual and social determinants. BioMed Central 2017-10-24 /pmc/articles/PMC5655864/ /pubmed/29065896 http://dx.doi.org/10.1186/s12954-017-0196-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Hawk, Mary
Coulter, Robert W. S.
Egan, James E.
Fisk, Stuart
Reuel Friedman, M.
Tula, Monique
Kinsky, Suzanne
Harm reduction principles for healthcare settings
title Harm reduction principles for healthcare settings
title_full Harm reduction principles for healthcare settings
title_fullStr Harm reduction principles for healthcare settings
title_full_unstemmed Harm reduction principles for healthcare settings
title_short Harm reduction principles for healthcare settings
title_sort harm reduction principles for healthcare settings
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655864/
https://www.ncbi.nlm.nih.gov/pubmed/29065896
http://dx.doi.org/10.1186/s12954-017-0196-4
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