Andersen Marcia, Paliwoda Joseph, Kaczynski Richard, Schoener Eugene, Harris Carlton, Madeja Cheryl, Reid Herbert, Weber Christine, Trent Calvin
Personalized Nursing LIGHT House, Inc., Plymouth, Michigan 48170, USA.
Am J Drug Alcohol Abuse. 2003;29(4):847-59. doi: 10.1081/ada-120026264.
Forty-five active substance abusers with HIV/AIDS voluntarily participated in a substance abuse treatment research study with interviews at intake, 6 months and 12 months. These participants were engaged in treatment for a minimum of 45 days and a maximum of 90 days. The study used a nursing model of care, The Personalized Nursing LIGHT model, to integrate treatment for HIV/AIDS with substance abuse treatment. The LIGHT model seeks to enhance patient well being directly and thereby to support interventions that decrease substance use and improve management of chronic disease. The substance abuse treatment team included a nurse who used the LIGHT model and coordinated an integrated care protocol. The nurse accompanied clients on visits to their physicians for HIV treatment and facilitated the integration of medical recommendations with the substance abuse treatment. Six-month posttest data were gathered on all 45 participants and 12-month posttest interviews were accomplished with 29 of them. At 6 months, 78% of the respondents (35/45) reported no drug use in the past 30 days, and, at 12 months, 79% (23/29) were drug free for the past month. Significant decreases from intake to 6 months were detected on Addiction Severity Index (ASI) composite scores for drug use (p < 0.01), alcohol use (p < 0.04), medical severity (p < 0.02), psychiatric severity (p < 0.01), legal problems (p < 0.04), and employment difficulty (p < 0.01). Improvement of 6-month drug use composite scores was related significantly to treatment duration (R = 0.42; p < 0.01). Significant decreases in ASI measures of drug use (p < 0.01), alcohol use (p < 0.01), employment difficulty (p < 0.01), and family/social problems (p < 0.01) also occurred at 12 months. Well being, as measured by a Global Well Being Index, was found to improve significantly at 6 months (p < 0.02) and 12 months (p < 0.07). Concurrently, significant improvement was observed on Medical Outcomes Study-36-Item Short-Form Health Survey (SF-36) measures of general health and health functioning. These changes were noted at 6 months in the general health (p < 0.02), mental health (p < 0.01), social functioning (p < 0.01), role/emotional status (p < 0.04), and vitality (p < 0.01) subscales. At 12 months, the social functioning (p < 0.01) subscale responses were further decreased.
45名同时患有艾滋病病毒/艾滋病的药物滥用者自愿参与了一项药物滥用治疗研究，在入组时、6个月和12个月时接受访谈。这些参与者接受治疗的时间最短为45天，最长为90天。该研究采用了一种护理模式，即个性化护理LIGHT模式，将艾滋病病毒/艾滋病治疗与药物滥用治疗相结合。LIGHT模式旨在直接提高患者的幸福感，从而支持减少药物使用和改善慢性病管理的干预措施。药物滥用治疗团队包括一名使用LIGHT模式并协调综合护理方案的护士。该护士陪同患者就诊于治疗艾滋病的医生，并促进将医疗建议与药物滥用治疗相结合。收集了所有45名参与者的6个月后测数据，并对其中29人进行了12个月后的测访谈。在6个月时，78%的受访者（35/45）报告在过去30天内未使用药物，在12个月时，79%（23/29）在过去一个月内未使用药物。从入组到6个月，成瘾严重程度指数（ASI）中药物使用（p < 0.01）、酒精使用（p < 0.04）、医疗严重程度（p < 0.02）、精神严重程度（p < 0.01）、法律问题（p < 0.04）和就业困难（p < 0.01）的综合得分显著下降。6个月时药物使用综合得分的改善与治疗持续时间显著相关（R = 0.42；p < 0.01）。在12个月时，ASI中药物使用（p < 0.01）、酒精使用（p < 0.01）、就业困难（p < 0.01）和家庭/社会问题（p < 0.01）的指标也显著下降。通过全球幸福感指数衡量的幸福感在6个月时（p < 0.02）和12个月时（p < 0.07）显著改善。同时，在医疗结果研究-36项简短健康调查（SF-36）的总体健康和健康功能指标上观察到显著改善。这些变化在6个月时出现在总体健康（p < 0.02）、心理健康（p < 0.01）、社会功能（p < 0.01）、角色/情绪状态（p < 0.04）和活力（p < 0.01）子量表中。在12个月时，社会功能（p < 0.01）子量表的反应进一步下降。
