Nielsen B, Nielsen A S, Wraae O
Department of Psychiatry, Odense University Hospital, Denmark.
J Nerv Ment Dis. 2000 Feb;188(2):101-7. doi: 10.1097/00005053-200002000-00006.
Predictors of compliance with psychosocial treatment were examined in a clinical sample of 150 patients seeking outpatient treatment for alcohol problems. Predictor variables were as follows: a) patient characteristics at the beginning of treatment and b) treatment characteristics of a matching model developed from the Conceptual System Theory. This model was based on the conceptual level of patients and therapists, and on the structure of the treatment. Using logistic regression analysis, we identified predictors of compliance in the motivation phase (first four consultations) and the active treatment phase (the remainder of the agreed treatment period of 12 months). Predictors of compliance in the motivation phase were a) therapists with a high conceptual level, characterized by an attitude toward the patients of empathetic and reflective listening; b) disulfiram; and c) psychopharmacological treatment. The only patient-related predictors of compliance in the active treatment phase were a) age below 40 and b) the presence of family and social problems, both factors predicting noncompliance. The only treatment-related predictor variables were a) the matching of patients with the structure of treatment and b) disulfiram during the first month of treatment, both factors predicting compliance. Two years after the beginning of treatment, those patients who completed the motivation phase as well as the active treatment phase had a significantly better psychosocial function than the noncompliant patients.
在一个由150名因酒精问题寻求门诊治疗的患者组成的临床样本中,对心理社会治疗依从性的预测因素进行了研究。预测变量如下:a)治疗开始时的患者特征;b)根据概念系统理论开发的匹配模型的治疗特征。该模型基于患者和治疗师的概念水平以及治疗结构。使用逻辑回归分析,我们确定了动机阶段(前四次咨询)和积极治疗阶段(商定的12个月治疗期的其余时间)依从性的预测因素。动机阶段依从性的预测因素是:a)概念水平高的治疗师,其特征是对患者持共情和反思性倾听的态度;b)双硫仑;c)心理药物治疗。积极治疗阶段与患者相关的唯一依从性预测因素是:a)年龄低于40岁;b)存在家庭和社会问题,这两个因素均预测不依从。与治疗相关的唯一预测变量是:a)患者与治疗结构的匹配度;b)治疗第一个月使用双硫仑,这两个因素均预测依从性。治疗开始两年后,完成动机阶段和积极治疗阶段的患者的心理社会功能明显优于不依从的患者。