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个体和系统因素对药物滥用治疗等待时间的影响。

Individual and system influences on waiting time for substance abuse treatment.

作者信息

Carr Carey J A, Xu Jiangmin, Redko Cristina, Lane D Timothy, Rapp Richard C, Goris John, Carlson Robert G

机构信息

Center for Interventions, Treatment, and Addictions Research, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA.

出版信息

J Subst Abuse Treat. 2008 Mar;34(2):192-201. doi: 10.1016/j.jsat.2007.03.005. Epub 2007 May 23.

Abstract

Waiting time is a contemporary reality of many drug abuse treatment programs, resulting in substantial problems for substance users and society. Individual and system factors that influence waiting time are diverse and may vary at different points in the treatment continuum. This study assessed waiting time preceding clinical assessment at a centralized intake unit and during the period after the assessment but before treatment entry. The present study included 577 substance abusers who were enrolled in a large clinical trial of two brief treatment interventions in a midsize metropolitan area in Ohio. Bivariate analyses identified individual and system factors that influenced preassessment and postassessment waiting time, as well as total wait to treatment services. Multivariate analyses demonstrated that longer wait time for an assessment is influenced by being court referred, less belief in having a substance abuse problem, and less desire for change. A shorter wait to actually enter treatment is predicted by having a case manager, being more ready for treatment, and having less severe employment and alcohol problems. The different influences present during the two waiting periods suggest that assessment and treatment programs need to implement system changes and entry enhancement interventions that are specific to the needs of substance abusers at each waiting period.

摘要

等待时间是许多药物滥用治疗项目当前面临的现实情况,给药物使用者和社会带来了诸多重大问题。影响等待时间的个人因素和系统因素多种多样,且在治疗连续过程的不同阶段可能有所不同。本研究评估了在一个集中接收单位进行临床评估之前以及评估之后但在开始治疗之前这段时间的等待时间。本研究纳入了577名药物滥用者,他们参与了俄亥俄州一个中等规模大都市地区两项简短治疗干预措施的大型临床试验。双变量分析确定了影响评估前和评估后等待时间以及等待治疗服务总时长的个人因素和系统因素。多变量分析表明,评估等待时间较长受到法庭转介、对存在药物滥用问题的信念较低以及改变意愿较低的影响。有个案管理员、对治疗准备更充分以及就业和酒精问题不太严重,则预示着实际开始治疗的等待时间较短。两个等待阶段存在的不同影响表明,评估和治疗项目需要实施针对每个等待阶段药物滥用者需求的系统变革和入院强化干预措施。

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