预测 COMBINE 研究中治疗寻求者改变饮酒行为的准备程度。
Predicting treatment seekers' readiness to change their drinking behavior in the COMBINE Study.
机构信息
Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
出版信息
Alcohol Clin Exp Res. 2009 May;33(5):879-92. doi: 10.1111/j.1530-0277.2009.00905.x. Epub 2009 Mar 11.
BACKGROUND
Initial motivation and readiness to change (RTC) are complex constructs and have been important but inconsistent predictors of treatment attendance and drinking outcomes in studies of alcoholism treatment. Motivation can be described in multiple ways as simply the accumulation of consequences that push change, a shift in intentions, or engagement in various tasks that are part of a larger process of change.
METHOD
Using baseline data from participants in the COMBINE Study, this study reevaluated the psychometric properties of a 24-item measure of motivation derived from the University of Rhode Island Change Assessment Scale that yielded 4 subscales representing attitudes and experiences related to tasks of stages of Precontemplation, Contemplation, Action, and Maintenance Striving as well as a second-order factor score representing a multidimensional view of RTC drinking. A variety of hypothesized predictors of readiness and the stage subscales were examined using multiple regression analyses to better understand the nature of this measure of motivation.
RESULTS
Findings supported the basic subscale structure and the overall motivational readiness score derived from this measure. RTC drinking behavior was predicted by baseline measures of perceived stress, drinking severity, psychiatric comorbidity, self-efficacy, craving, and positive treatment outcome expectancies. However, absolute values were small, indicating that readiness for change is not explained simply by demographic, drinking severity, treatment, change process, or contextual variables.
CONCLUSION
This measure demonstrated good psychometric properties and results supported the independence as well as convergent and divergent validity of the measured constructs. Predictors of overall readiness and subscale scores indicate that a variety of personal and contextual factors contribute to treatment seekers' motivation to change in an understandable but complex manner.
背景
初始动机和改变意愿（RTC）是复杂的构念，在酒精治疗研究中，它们一直是治疗参与度和饮酒结果的重要但不一致的预测因素。动机可以通过多种方式来描述，例如，简单地积累推动改变的后果，改变意图，或参与各种任务，这些任务是更大的改变过程的一部分。
方法
本研究使用 COMBINE 研究参与者的基线数据，重新评估了源自罗德岛大学改变评估量表的 24 项动机测量的心理测量特性，该量表产生了 4 个分量表，代表与前沉思、沉思、行动和维持努力阶段相关的态度和经验，以及代表 RTC 饮酒多维观点的二阶因子分数。使用多元回归分析来检验各种假设的准备预测因子和阶段分量表，以更好地理解这种动机测量的性质。
结果
研究结果支持了基本分量表结构和从该测量中得出的总体动机准备得分。RTC 饮酒行为由基线感知压力、饮酒严重程度、精神共病、自我效能、渴望和积极的治疗结果预期等指标预测。然而，绝对值较小，表明改变意愿不仅仅可以通过人口统计学、饮酒严重程度、治疗、改变过程或环境变量来解释。
结论
该测量方法具有良好的心理测量特性，结果支持了所测量结构的独立性以及收敛和发散效度。总体准备度和分量表得分的预测因子表明，各种个人和环境因素以可理解但复杂的方式促进了治疗寻求者改变的动机。
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