McNeese-Smith Donna K, Faivre Clare L, Grauvogl Cynthia, Warda Nipa Umme Shefa, Kurzbard Marc A
Donna K. McNeese-Smith, MN, EdD, CNE-BC, University of California, Los Angeles, School of Nursing. Clare L. Faivre, RN, PHN, MSN/Ed, Department of Addictions, Kaiser Permanente, Oakland, California. Cynthia Grauvogl, MSN, RN-C, CADC, CEAP, School of Nursing, California State University, Fullerton. Nipa Umme Shefa Warda, MS, Integrated Substance Abuse Programs, University of California, Los Angeles, School of Nursing. Marc A. Kurzbard, MD, Department of Addiction Medicine, Kaiser Permanente, Oakland, California.
J Addict Nurs. 2014 Jul-Sep;25(3):130-6; quiz 137-8. doi: 10.1097/JAN.0000000000000035.
Previous research has determined that substance abuse treatment (SAT) is effective under managed care within residential treatment and outpatient treatment, but we have not followed patients after treatment completion. This study examined SAT in both an intensive day treatment and an outpatient treatment program in a large health maintenance organization, with mandatory 12-step participation. We conducted interviews (N = 72) at the beginning, upon completion, and 6 months after completion of treatment. Variables measured were substance use, quality of life, symptoms, functionality, and patient satisfaction as well as Drug Abuse Treatment and Assessment Resources (DATAR) score and treatment completion. Before treatment, DATAR scores were high: 7.68 on a scale of 1-9, indicating serious addictions. Patients showed significant improvement in all variables measured, upon completion of SAT, and additional improvement again 6 months later. Eighty-three percent of subjects completed treatment. Unique advantages of treatment in this setting were discussed, as well as the importance of referral and support from nurses and other healthcare professionals.
先前的研究已确定，在管理式医疗下，住院治疗和门诊治疗中的药物滥用治疗（SAT）是有效的，但我们在治疗结束后并未对患者进行跟踪。本研究在一个大型健康维护组织中，对强化日间治疗和门诊治疗项目中的SAT进行了考察，要求患者强制参加12步康复计划。我们在治疗开始时、结束时以及结束后6个月进行了访谈（N = 72）。所测量的变量包括药物使用、生活质量、症状、功能状况、患者满意度以及药物滥用治疗与评估资源（DATAR）评分和治疗完成情况。治疗前，DATAR评分较高：在1至9分的量表上为7.68分，表明存在严重成瘾问题。患者在SAT结束时，所有测量变量均有显著改善，6个月后又有进一步改善。83%的受试者完成了治疗。讨论了在此环境下治疗的独特优势，以及护士和其他医疗专业人员转诊和支持的重要性。
