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中国美沙酮维持治疗中与患者满意度相关的因素。

Factors related to client satisfaction with methadone maintenance treatment in China.

作者信息

Li Li, Comulada W Scott, Lin Chunqing, Hsieh Julie, Luo Sitong, Wu Zunyou

机构信息

Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, USA.

Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, USA.

出版信息

J Subst Abuse Treat. 2017 Jun;77:201-206. doi: 10.1016/j.jsat.2017.02.012. Epub 2017 Feb 24.

Abstract

BACKGROUND

This study examined clients' treatment satisfaction with the services provided by methadone maintenance treatment (MMT) in China and explored relevant factors that are directly or indirectly associated with treatment satisfaction.

METHODS

The study used baseline data from a randomized controlled trial conducted among 2,448 clients from 68 MMT clinics in five provinces of China. The participants reported their demographic characteristics, treatment-related factors, depressive symptoms, treatment progression, counseling rapport, and treatment satisfaction. Structural equation modeling (SEM) was used to test the direct and indirect relationships among various factors and treatment satisfaction.

RESULTS

Clients' demographic characteristics, such as older age, had both a direct effect on treatment satisfaction and an indirect effect mediated by counseling rapport. Depressive symptoms and a lack of social support had a direct negative impact on treatment satisfaction and an indirect effect mediated by treatment progression and counseling rapport. Both mediators: treatment progression (estimate=0.227, p<0.01) and counseling rapport (estimate=0.229, p<0.01), showed positive associations with treatment satisfaction.

CONCLUSION

The findings reiterate the complex nature of MMT clients' treatment satisfaction and its interrelationship with multidimensional factors. The study has implications for evaluating the quality of care provided by MMT programs and suggests several strategies that can potentially improve MMT clients' level of treatment satisfaction.

摘要

背景

本研究调查了中国美沙酮维持治疗(MMT)服务的患者治疗满意度,并探讨了与治疗满意度直接或间接相关的因素。

方法

该研究使用了来自中国五个省份68家MMT诊所的2448名患者的随机对照试验基线数据。参与者报告了他们的人口统计学特征、治疗相关因素、抑郁症状、治疗进展、咨询融洽度和治疗满意度。采用结构方程模型(SEM)来检验各种因素与治疗满意度之间的直接和间接关系。

结果

患者的人口统计学特征,如年龄较大,对治疗满意度既有直接影响,也有通过咨询融洽度介导的间接影响。抑郁症状和缺乏社会支持对治疗满意度有直接负面影响,且通过治疗进展和咨询融洽度产生间接影响。两个中介变量:治疗进展(估计值=0.227,p<0.01)和咨询融洽度(估计值=0.229,p<0.01),均与治疗满意度呈正相关。

结论

研究结果重申了MMT患者治疗满意度的复杂性及其与多维度因素的相互关系。该研究对评估MMT项目提供的护理质量具有启示意义,并提出了几种可能提高MMT患者治疗满意度水平的策略。

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