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接受美沙酮维持治疗项目的海洛因成瘾者的生活质量及其决定因素:与来自普通人群的匹配对照者的比较。

Quality of life and its determinants for heroin addicts receiving a methadone maintenance program: Comparison with matched referents from the general population.

作者信息

Lin Chung-Ying, Chang Kun-Chia, Wang Jung-Der, Lee Lukas Jyuhn-Hsiarn

机构信息

Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.

出版信息

J Formos Med Assoc. 2016 Sep;115(9):714-27. doi: 10.1016/j.jfma.2015.07.007. Epub 2015 Sep 28.

Abstract

BACKGROUND/PURPOSE: Quality of life (QoL) is found to be lower in heroin addicts; however, few studies examine detailed QoL performance and related factors in heroin patients attending a methadone maintenance treatment program (MMTP). The study thus aimed to explore QoL and its determinants for publicly-funded and self-paid patients attending an MMTP.

METHODS

Participants were recruited in Jianan Psychiatric Center, Tainan, Taiwan, during their first clinic visit for the MMTP. Age-, sex-, education-, and municipality-matched referents were collected from the 2001 Taiwan National Health Interview Survey database. The participants had a mean age of 38.29 years [standard deviation (SD) = 7.65 years] for publicly-funded (n = 129) and 37.97 years (SD = 7.16 years) for self-paid (n = 105) MMTP patients. Matched referents (n = 217) were 37.74 years (SD = 7.44 years). All participants were measured with the brief version of the World Health Organization's Quality of Life (WHOQOL-BREF) assessment. MMTP patients additionally went through tests for the hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV).

RESULTS

Both publicly-funded and self-paid MMTP patients had lower QoL scores than their matched counterparts in the physical and psychological domains (p < 0.05) after control for confounding by age, sex, education, and municipality. Detailed individual item analyses showed that publicly-funded MMTP patients had lower scores for almost all items related to the physical, psychological, and social domains as compared to the referents because of HIV infection (p < 0.05).

CONCLUSION

To improve the QoL of heroin users coming for MMTP, we recommend that clinicians pay attention to the comorbidity of HIV infection and individual items/facets.

摘要

背景/目的:研究发现海洛因成瘾者的生活质量(QoL)较低;然而,很少有研究考察接受美沙酮维持治疗项目(MMTP)的海洛因患者的详细生活质量表现及相关因素。因此,本研究旨在探讨接受MMTP的公费和自费患者的生活质量及其决定因素。

方法

研究对象在台湾台南建安精神科中心首次就诊接受MMTP时招募。年龄、性别、教育程度和城市匹配的对照对象从2001年台湾国民健康访谈调查数据库中收集。公费MMTP患者(n = 129)的平均年龄为38.29岁[标准差(SD)= 7.65岁],自费MMTP患者(n = 105)的平均年龄为37.97岁(SD = 7.16岁)。匹配的对照对象(n = 217)平均年龄为37.74岁(SD = 7.44岁)。所有参与者均接受世界卫生组织生活质量简表(WHOQOL - BREF)评估。MMTP患者还接受了乙肝病毒、丙肝病毒和人类免疫缺陷病毒(HIV)检测。

结果

在控制年龄、性别、教育程度和城市等混杂因素后,公费和自费MMTP患者在生理和心理领域的生活质量得分均低于其匹配的对照对象(p < 0.05)。详细的单项分析表明,由于HIV感染,公费MMTP患者在几乎所有与生理、心理和社会领域相关的项目上得分均低于对照对象(p < 0.05)。

结论

为提高前来接受MMTP的海洛因使用者的生活质量,我们建议临床医生关注HIV感染的合并症以及各个项目/方面。

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