Kelly Brian C, Liu Tieqiao, Zhang Guanbai, Hao Wei, Wang Jichuan
Purdue University, USA.
Mental Health Institute of Central South University, China.
Addict Behav. 2014 Aug;39(8):1265-71. doi: 10.1016/j.addbeh.2014.04.012. Epub 2014 Apr 13.
Although substance abuse treatment has been considerably scaled up in China, impediments to accessing these services remain among drug users. The authors examine the primary psychosocial barriers to drug treatment in this population and evaluate factors associated with these barriers. Barriers to accessing drug treatment were measured using the Barriers to Treatment Inventory (BTI). A Structural Equation Model was used to examine whether the internal barriers were associated with treatment history and frequent methamphetamine use as well as how demographic characteristics influence such barriers. We found four primary factors of internal barriers to drug treatment--absence of problem, negative social support, fear of treatment, and privacy concerns--to fit well. Demographic factors, notably age and employment status, indirectly influence barriers to treatment via other factors. Frequency of methamphetamine use and drug treatment history are directly associated with the absence of problem and negative social support dimensions of the BTI, and it is through these pathways that demographic factors such as age and employment status shape barriers to treatment. The findings indicate that perceived absence of a problem and negative social support are the barriers most influenced by the personal domains of Chinese drug users' lives. Efforts to engage drug users in China about drug treatment options may consider how these barriers are differentially perceived in order to effectively reach this population.
尽管中国的药物滥用治疗服务规模已大幅扩大,但吸毒者在获取这些服务方面仍存在障碍。作者研究了该人群接受药物治疗的主要心理社会障碍,并评估了与这些障碍相关的因素。使用治疗障碍量表(BTI)来衡量获取药物治疗的障碍。采用结构方程模型来检验内部障碍是否与治疗史、频繁使用甲基苯丙胺有关,以及人口统计学特征如何影响这些障碍。我们发现药物治疗内部障碍的四个主要因素——无问题意识、负面社会支持、对治疗的恐惧和隐私担忧——拟合良好。人口统计学因素,尤其是年龄和就业状况,通过其他因素间接影响治疗障碍。甲基苯丙胺的使用频率和药物治疗史与BTI中的无问题意识和负面社会支持维度直接相关,年龄和就业状况等人口统计学因素正是通过这些途径塑造了治疗障碍。研究结果表明,无问题意识和负面社会支持是受中国吸毒者生活个人领域影响最大的障碍。在中国,为使吸毒者参与药物治疗选择所做的努力可能需要考虑这些障碍的不同认知方式,以便有效地接触到这一人群。