定性和定量评估患有酒精依赖的长期无家可归者的减少伤害目标设定情况。
Qualitatively and quantitatively evaluating harm-reduction goal setting among chronically homeless individuals with alcohol dependence.
作者信息
Collins Susan E, Grazioli Véronique S, Torres Nicole I, Taylor Emily M, Jones Connor B, Hoffman Gail E, Haelsig Laura, Zhu Mengdan D, Hatsukami Alyssa S, Koker Molly J, Herndon Patrick, Greenleaf Shawna M, Dean Parker E
机构信息
Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA.
Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA.
出版信息
Addict Behav. 2015 Jun;45:184-90. doi: 10.1016/j.addbeh.2015.02.001. Epub 2015 Feb 8.
INTRODUCTION
Most treatment programs for alcohol dependence have prioritized alcohol abstinence as the primary treatment goal. However, abstinence-based goals are not always considered desirable or attainable by more severely affected populations, such as chronically homeless people with alcohol dependence. Because these individuals comprise a multimorbid and high-utilizing population, they are in need of more focused research attention that elucidates their preferred treatment goals. The aim of this secondary study was therefore to qualitatively and quantitatively document participant-generated treatment goals
METHODS
Participants were currently or formerly chronically homeless individuals (N=31) with alcohol dependence who participated in a pilot of extended-release naltrexone and harm-reduction counseling. Throughout the treatment period, study interventionists elicited participants' goals and recorded them on an open-ended grid. In subsequent weeks, progress towards and achievement of goals was obtained via self-report and recorded by study interventionists. Conventional content analysis was performed to classify participant-generated treatment goals
RESULTS
Representation of the three top categories remained stable over the course of treatment. In the order of their frequency, they included drinking-related goals, quality-of-life goals and health-related goals. Within the category of drinking-related goals, participants consistently endorsed reducing drinking and alcohol-related consequences ahead of abstinence-based goals. Quantitative analyses indicated participants generated an increasing number of goals over the course of treatment. Proportions of goals achieved and progressed towards kept pace with this increase
CONCLUSIONS
Findings confirmed hypotheses that chronically homeless people with alcohol dependence can independently generate and achieve treatment goals towards alcohol harm reduction and quality-of-life improvement.
引言
大多数酒精依赖治疗项目都将戒酒作为主要治疗目标。然而，对于受影响更严重的人群，如患有酒精依赖的长期无家可归者来说，基于戒酒的目标并不总是被认为是理想的或可实现的。由于这些个体患有多种疾病且医疗利用率高，他们需要更有针对性的研究关注，以阐明他们偏好的治疗目标。因此，这项二次研究的目的是定性和定量地记录参与者提出的治疗目标。
方法
参与者为目前或曾经长期无家可归且患有酒精依赖的个体（N = 31），他们参与了长效纳曲酮和减少伤害咨询的试点项目。在整个治疗期间，研究干预人员引出参与者的目标，并将其记录在一个开放式表格中。在随后的几周里，通过自我报告获取目标的进展情况，并由研究干预人员记录下来。采用传统内容分析法对参与者提出的治疗目标进行分类。
结果
在治疗过程中，三大类目标的占比保持稳定。按出现频率排序，它们包括与饮酒相关的目标、生活质量目标和与健康相关的目标。在与饮酒相关的目标类别中，参与者始终认可在基于戒酒的目标之前减少饮酒及与酒精相关的后果。定量分析表明，参与者在治疗过程中提出的目标数量有所增加。实现和朝着目标取得进展的目标比例也随之增加。
结论
研究结果证实了以下假设，即患有酒精依赖的长期无家可归者能够独立提出并实现减少酒精危害和改善生活质量的治疗目标。
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