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越南北方山区接受美沙酮维持治疗的吸毒者的就业能力和工作效率:一项横断面研究。

Ability to join the workforce and work productivity among drug users under methadone maintenance treatment in a mountainous area of Northern Vietnam: a cross-sectional study.

作者信息

Nong Vuong Minh, Boggiano Victoria L, Nguyen Lan Huong Thi, Nguyen Cuong Tat, Nguyen Long Hoang, Xuan Bach Tran, Nguyen Hung Van, Hoang Canh Dinh, Latkin Carl A, Vu Minh Thuc Thi

机构信息

Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.

University of California Berkeley School of Public Health, Berkeley, California, USA.

出版信息

BMJ Open. 2017 Jul 26;7(7):e016153. doi: 10.1136/bmjopen-2017-016153.

Abstract

OBJECTIVES

A major measure of treatment success for drug users undergoing rehabilitation is the ability to enter the workforce and generate income. This study examines the absenteeism and productivity among people who inject drugs (PWID) enrolled in methadone maintenance treatment (MMT) in Northern Vietnam.

SETTING

We conducted a cross-sectional study in two clinics in Tuyen Quang province.

PARTICIPANTS

A total of 241 patients enrolled in MMT.

PRIMARY AND SECONDARY OUTCOME MEASURES

Patients' work productivity was measured using the WPAI-GH instrument (Work Productivity and Activity Impairment Questionnaire: General Health V2.0). We also collected additional characteristics about participants' employment history, such as proficient jobs, whether they actively found a new job and be accepted by employers.

RESULTS

Most of the participants (>90%) were employed at the time of the study. Rates of absenteeism (missed work), presenteeism (impairment while working) and overall loss of productivity were 15.8%, 5.6% and 11.2%, respectively, as measured by the WPAI-GH questionnaire. The most proficient job was 'freelancer' (17.5%), followed by 'blue-collar worker' (10.6%) and 'farmer' (10.2%). Only 26.8% of patients reported that they actively sought jobs in the past. About half of them had been refused by employers because of their drug use history and/or HIV status. We found no statistically significant difference between patients enrolled in MMT for <1 year and those who had been enrolled >1 year. Factors associated with higher work productivity included not endorsing problems in mobility, self-care or pain; being HIV-negative and having greater MMT treatment adherence.

CONCLUSION

Our study highlights the high employment rate and work productivity among PWID in MMT programmes in remote areas of Northern Vietnam. The results can help to improve the quality and structure of MMT programmes across Vietnam and in other countries.

摘要

目的

对于接受康复治疗的吸毒者而言,治疗成功的一项主要衡量标准是进入劳动力市场并获得收入的能力。本研究调查了越南北方参加美沙酮维持治疗(MMT)的注射吸毒者的旷工率和生产力情况。

背景

我们在宣光省的两家诊所开展了一项横断面研究。

参与者

共有241名参加美沙酮维持治疗的患者。

主要和次要结局指标

使用WPAI-GH工具(工作生产力与活动障碍问卷:一般健康状况V2.0)来衡量患者的工作生产力。我们还收集了有关参与者就业史的其他特征,例如熟练工种、是否积极寻找新工作并被雇主录用。

结果

大多数参与者(>90%)在研究期间有工作。根据WPAI-GH问卷测量,旷工率(缺勤)、出勤主义(工作时受损)和总体生产力损失率分别为15.8%、5.6%和11.2%。最常见的熟练工种是“自由职业者”(17.5%),其次是“蓝领工人”(10.6%)和“农民”(10.2%)。只有26.8%的患者报告他们过去积极寻找工作。其中约一半人因吸毒史和/或艾滋病毒感染状况而被雇主拒绝。我们发现参加美沙酮维持治疗<1年的患者与参加>1年的患者之间无统计学显著差异。与较高工作生产力相关的因素包括不存在行动、自我护理或疼痛方面的问题;艾滋病毒检测呈阴性以及美沙酮维持治疗依从性更高。

结论

我们的研究凸显了越南北方偏远地区参加美沙酮维持治疗项目的注射吸毒者的高就业率和工作生产力。研究结果有助于改善越南及其他国家美沙酮维持治疗项目的质量和结构。

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本文引用的文献

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Economic vulnerability of methadone maintenance patients: Implications for policies on co-payment services.
Int J Drug Policy. 2016 May;31:131-7. doi: 10.1016/j.drugpo.2016.01.017. Epub 2016 Feb 2.
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Patient Satisfaction with Methadone Maintenance Treatment in Vietnam: A Comparison of Different Integrative-Service Delivery Models.
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Impact of a methadone maintenance therapy pilot in Vietnam and its role in a scaled-up response.
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The reductions in monetary cost and gains in productivity with methadone maintenance treatment: one year follow-up.
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