以家庭为中心的问题解决教育对药物滥用者复发率、自我效能感和自尊的影响。
The Effects of Family-Centered Problem-Solving Education on Relapse Rate, Self Efficacy and Self Esteem Among Substance Abusers.
作者信息
Habibi Rahim, Nikbakht Nasrabadi Alireza, Shabany Hamedan Maryam, Saleh Moqadam Amirreza
机构信息
Deputy Dean For International Affairs, Operating Room Department, Paramedical Faculty, Qazvin University of Medical Sciences, Qazvin, IR Iran.
Deputy Dean for International Affairs, Nursing and Midwifery Faculty, Tehran University of Medical Sciences, Tehran, IR Iran.
出版信息
Int J High Risk Behav Addict. 2016 Mar 1;5(1):e24421. doi: 10.5812/ijhrba.24421. eCollection 2016 Mar.
BACKGROUND
The success of drug abuse treatment and relapse prevention methods depends widely on not only pharmaceutical and non-pharmaceutical therapies but also self efficacy and self esteem promotion.
OBJECTIVES
The current study attempted to clarify the effects of Problem Solving Education (PSE) on relapse rate, self efficacy and self esteem among drug abusers.
PATIENTS AND METHODS
This non-controlled clinical trial (quasi-experimental) assessed 60 opium and heroin abusers who were willing to quit and were referred to the Mehr Center of Addiction Treatment and Rehabilitation Facility. The patients were allocated to two groups of 30 (intervention and control groups). While both groups received the routine care of the clinic, the intervention group also attended eight 45-minute family-centered PSE sessions. The Coopersmith Self esteem Inventory and Quit Addiction Self efficacy Questionnaire were filled out for all subjects before and after the intervention. Drug relapse was investigated four times with two-week intervals. The two groups were compared using chi-square and Student's-t tests. Logistic regression analysis was applied to determine factors affecting drug relapse.
RESULTS
A total of 45 individuals (21 and 24 in the intervention and control groups, respectively) completed the study. At baseline, the two groups had no significant difference regarding their mean scores of self esteem and self efficacy (P = 0.692 and 0.329, respectively). After the intervention, however, the mean changes of self esteem scores were 20.10 ± 3.75 for the intervention group and 4.50 for the control group (P < 0.001). The mean changes of self efficacy scores in the mentioned groups were 34 34.17 ± 5.19 and 9.03± 2.04, respectively (P < 0.001). Drug relapse after two weeks was correlated with age (OR = 1.216; P = 0.026; 95% CI: 1.024-1.445) and implementation of the intervention (OR = 0.036; P = 0.003; 95% CI: 0.004-0.322).
CONCLUSIONS
According to our findings, supplementing drug abuse treatment with cognitive behavior therapy, particularly PSE, can reduce relapse rate and enhance self efficacy and self esteem among patients.
背景
药物滥用治疗及预防复发方法的成功与否很大程度上不仅取决于药物和非药物疗法，还取决于自我效能感和自尊的提升。
目的
本研究旨在阐明问题解决教育（PSE）对药物滥用者复发率、自我效能感和自尊的影响。
患者与方法
这项非对照临床试验（准实验）评估了60名愿意戒毒且被转介至梅尔成瘾治疗与康复中心的鸦片和海洛因滥用者。患者被分为两组，每组30人（干预组和对照组）。两组均接受诊所的常规护理，干预组还参加了八次以家庭为中心、每次45分钟的PSE课程。在干预前后，为所有受试者填写库珀史密斯自尊量表和戒毒自我效能量表。每隔两周对药物复发情况进行四次调查。使用卡方检验和学生t检验对两组进行比较。应用逻辑回归分析来确定影响药物复发的因素。
结果
共有45名个体（干预组21名，对照组24名）完成了研究。在基线时，两组在自尊和自我效能感的平均得分方面无显著差异（分别为P = 0.692和0.329）。然而，干预后，干预组自尊得分的平均变化为20.10±3.75，对照组为4.50（P < 0.001）。上述两组自我效能感得分的平均变化分别为34.17±5.19和9.03±2.04（P < 0.001）。两周后的药物复发与年龄（OR = 1.216；P = 0.026；95%CI：1.024 - 1.445）和干预措施的实施（OR = 0.036；P = 0.003；95%CI：0.004 - 0.322）相关。
结论
根据我们的研究结果，用认知行为疗法，特别是PSE补充药物滥用治疗，可以降低患者的复发率，并提高自我效能感和自尊。
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