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[社会工作者在美沙酮维持治疗诊所提供的干预服务的有效性]

[Effectiveness of intervention services provided by social workers in methadone maintenance treatment clinics].

作者信息

Gu Jing, Zhao Yu-teng, Zhong Ying, Xu Chu-jun, Pan Wen-liang, Fan Li-rui, Xu Hui-fang, Wang Ming

机构信息

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2012 Nov;46(11):999-1003.

Abstract

OBJECTIVE

To investigate the effectiveness of psychosocial services provided by social workers in reducing dropout rate and increasing treatment dosage in methadone maintenance treatment (MMT) users.

METHODS

From May in 2009 to April in 2010, 300 MMT users were recruited from three MMT clinics in Guangzhou, and were randomly allocated into the intervention group and the control groups. The control group (152 cases) received standard MMT services while the intervention group (148 cases) received additional services provided by social workers. Methadone dosage, dropout rate, perceptions toward MMT etc. were compared between the two groups.

RESULTS

The 1-month dropout rate of the control and intervention groups were 19.7% (30/152) and 6.8% (10/148) (P < 0.05) respectively; the 6-month dropout rate of the control and intervention groups were 75.5% (115/152) and 50.7% (75/148) (P < 0.05) respectively. The intervention group had higher average treatment dosage than the control group ((56.0 ± 21.2) vs (64.4 ± 23.1) ml/d, (58.0 ± 24.0) vs (66.1 ± 26.6) ml/d, P < 0.05). At 1-month and 6-month, the intervention group had higher scores of MMT-related perception ((1.26 ± 0.68) vs (1.84 ± 0.95), (1.55 ± 0.83) vs (2.44 ± 1.23), P < 0.05), self-efficacy of maintenance ((3.68 ± 1.33) vs (4.20 ± 1.05), (3.80 ± 1.38) vs (4.43 ± 0.79), P < 0.05) and satisfaction toward MMT((4.08 ± 0.54) vs (4.15 ± 0.60), (4.01 ± 0.67) vs (4.31 ± 0.64), P < 0.05) as compared to the control group. The reverse was true for the score of negative experiences ((1.05 ± 0.86) vs (0.96 ± 0.92), (1.46 ± 0.87) vs (1.11 ± 1.07), P < 0.05).

CONCLUSION

The psychosocial interventions provided by social workers were effective in reducing dropout rate, increasing treatment dosage and improving cognitions of MMT users.

摘要

目的

探讨社会工作者提供的心理社会服务在降低美沙酮维持治疗(MMT)使用者的脱失率及提高治疗剂量方面的有效性。

方法

2009年5月至2010年4月,从广州的三家MMT诊所招募300名MMT使用者,并随机分为干预组和对照组。对照组(152例)接受标准的MMT服务,干预组(148例)接受社会工作者提供的额外服务。比较两组的美沙酮剂量、脱失率、对MMT的认知等。

结果

对照组和干预组的1个月脱失率分别为19.7%(30/152)和6.8%(10/148)(P<0.05);对照组和干预组的6个月脱失率分别为75.5%(115/152)和50.7%(75/148)(P<0.05)。干预组的平均治疗剂量高于对照组((56.0±21.2)对(64.4±23.1)ml/d,(58.0±24.0)对(66.1±26.6)ml/d,P<0.05)。在1个月和6个月时,干预组在MMT相关认知得分((1.26±0.68)对(1.84±0.95),(1.55±0.83)对(2.44±1.23),P<0.05)、维持自我效能感((3.68±1.33)对(4.20±1.05),(3.80±1.38)对(4.43±0.79),P<0.05)以及对MMT的满意度((4.08±0.54)对(4.15±0.60),(4.01±0.67)对(4.31±0.64),P<0.05)方面均高于对照组。负面体验得分则相反((1.05±0.86)对(0.96±0.92),(1.46±0.87)对(1.11±1.07),P<0.05)。

结论

社会工作者提供的心理社会干预在降低脱失率、增加治疗剂量及改善MMT使用者的认知方面是有效的。

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