Ghent University, Department of Orthopedagogics, Belgium.
Int J Nurs Stud. 2011 Oct;48(10):1244-57. doi: 10.1016/j.ijnurstu.2011.03.009. Epub 2011 Apr 11.
Attention from researchers and health care workers to the quality of life (QoL) of opiate users is growing, but most studies are quantitative, giving limited attention to the consumer's perspective. No information is available on how opiate-dependent individuals themselves perceive QoL and what they see as the important components that contribute to a good QoL.
This qualitative study aims to expand our knowledge concerning opiate-dependent individuals' perceptions of a good QoL and the impact of methadone on components of a good QoL.
In-depth interviews were conducted with 25 opiate-dependent individuals aged between 26 and 46 years old who started a methadone maintenance treatment at least 5 years ago. Purposive sampling was used to recruit participants with different socio-demographic characteristics and drug use profiles. The interviews were audio-tape recorded, transcribed verbatim and analysed thematically.
Thematic analyses revealed five key themes contributing to a good QoL for opiate-dependent individuals: (1) having social relationships, (2) holding an occupation, (3) feeling good about one's self, (4) being independent and (5) having a meaningful life. Opiate-dependent individuals valued methadone's ability to help them function normally, overcome their psychological problems and dependence on illicit opiates, and support them in achieving certain life goals. On the other hand, stigmatisation, discrimination, dependence on methadone and the drug's paralysing effects on their emotions were mentioned as common negative consequences.
The findings of this study highlight the importance of supporting opiate-dependent individuals in their daily life by means of practical, social and environmental support (alongside pharmacological treatment) in order to improve their QoL. This study further illustrates the ambivalent influence of methadone on opiate-dependent individuals' QoL, and demonstrates how something commonly perceived as a 'good' can also be a 'bad' for some people. Efforts should be made to limit the negative consequences of methadone on opiate-dependent individuals' QoL, while increasing its potential benefits.
研究人员和医护人员对阿片类药物使用者生活质量(QoL)的关注日益增加,但大多数研究都是定量的,对消费者的观点关注有限。目前尚无信息表明阿片类药物依赖者自身如何感知 QoL,以及他们认为哪些是对良好 QoL 有贡献的重要组成部分。
本定性研究旨在扩展我们对阿片类药物依赖者对良好 QoL 的感知以及美沙酮对良好 QoL 组成部分的影响的认识。
对 25 名年龄在 26 岁至 46 岁之间的阿片类药物依赖者进行了深入访谈,这些参与者至少在 5 年前开始接受美沙酮维持治疗。采用目的抽样法招募具有不同社会人口学特征和药物使用特征的参与者。对访谈进行了录音、逐字记录,并进行了主题分析。
主题分析揭示了五个有助于阿片类药物依赖者获得良好 QoL 的关键主题:(1)拥有社会关系;(2)有职业;(3)自我感觉良好;(4)独立;(5)有有意义的生活。阿片类药物依赖者重视美沙酮帮助他们正常运作、克服心理问题和对非法阿片类药物的依赖,并支持他们实现某些生活目标的能力。另一方面,他们提到了污名化、歧视、对美沙酮的依赖以及该药物对他们情绪的麻痹作用等常见的负面影响。
本研究结果强调了通过实际、社会和环境支持(以及药物治疗)在日常生活中支持阿片类药物依赖者的重要性,以提高他们的 QoL。本研究进一步说明了美沙酮对阿片类药物依赖者 QoL 的双重影响,并展示了一些人普遍认为的“好”东西对另一些人来说也可能是“坏”的。应努力限制美沙酮对阿片类药物依赖者 QoL 的负面影响,同时增加其潜在益处。