National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Lyndon Community, Orange, Australia.
Drug Alcohol Rev. 2018 Apr;37 Suppl 1(Suppl Suppl 1):S404-S414. doi: 10.1111/dar.12656. Epub 2018 Jan 18.
Aboriginal residential rehabilitation services provide healing for Aboriginal people who misuse substances. There is limited available research that empirically describes client characteristics of these services. This study examined 5 years of data of a remote Aboriginal residential rehabilitation service.
Retrospective analysis of 329 client admissions to Orana Haven Drug and Alcohol Rehabilitation Centre from 2011 to 2016. Multinomial and binary logistic regressions were conducted to identify trends in the data.
There were 66 admissions recorded annually, of which most identified as Aboriginal (85%). Mean length of stay was 56 days, with one in three (36%) discharging within the first month. A third (32%) completed, 47% self-discharged and 20% house-discharged from the program. Client age significantly increased over time (P = 0.03), with most aged from 26 to 35. Older clients were significantly more likely to readmit (P < 0.002) and stay longer than 90 days (P = 0.02). Most clients were referred from the criminal justice system, significantly increasing from 79% (2011-2012) to 96% (2015-2016) (P < 0.001) and these clients were more likely to self-discharge (P < 0.01). Among a subset of clients, most (69%) reported concerns with polysubstance use and half (51%) reported mental illness.
The current study makes a unique contribution to the literature by empirically describing the characteristics of clients of a remote Aboriginal residential rehabilitation service to more accurately tailor the service to the client's needs. Key recommendations include integrating these empirical observations with staff and client perceptions to co-design a model of care, standardise data collection, and routinely following-up clients to monitor treatment effectiveness.
原住民居住康复服务为滥用药物的原住民提供治疗。目前可用的实证描述这些服务客户特征的研究有限。本研究对一个偏远地区原住民居住康复服务机构的 5 年数据进行了回顾性分析。
对 2011 年至 2016 年期间进入奥兰纳港湾药物和酒精康复中心的 329 名患者的入院情况进行了回顾性分析。采用多项和二项逻辑回归分析来确定数据中的趋势。
每年有 66 人入院，其中大多数为原住民（85%）。平均住院时间为 56 天，三分之一（36%）在第一个月内出院。三分之一（32%）的患者完成了治疗，47%的患者自行出院，20%的患者从项目中转为居家治疗。患者年龄随时间显著增加（P = 0.03），大多数年龄在 26 至 35 岁之间。年龄较大的患者再次入院的可能性显著更高（P < 0.002），且住院时间超过 90 天的可能性也更高（P = 0.02）。大多数患者是从刑事司法系统转介而来，这一比例从 2011-2012 年的 79%显著增加到 2015-2016 年的 96%（P < 0.001），这些患者更有可能自行出院（P < 0.01）。在一组患者中，大多数（69%）报告存在多物质使用问题，一半（51%）报告存在精神疾病。
本研究通过实证描述偏远地区原住民居住康复服务机构的客户特征，为文献做出了独特贡献，从而更准确地根据客户的需求调整服务。关键建议包括将这些实证观察与员工和客户的看法相结合，共同设计护理模式，规范数据收集，并定期跟踪患者以监测治疗效果。
