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吸引青少年(青少年和年轻人)改变频繁使用大麻:初级保健中的动机增强治疗(MET)。

Engaging Youth (Adolescents and Young Adults) to Change Frequent Marijuana Use: Motivational Enhancement Therapy (MET) in Primary Care.

机构信息

Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, United States of America.

Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, United States of America; Northeastern University Bouve College of Health Sciences, School of Nursing, United States of America.

出版信息

J Pediatr Nurs. 2019 Nov-Dec;49:24-30. doi: 10.1016/j.pedn.2019.08.011. Epub 2019 Aug 29.

Abstract

PURPOSE

To characterize information elicited from adolescent/young adults with frequent cannabis use in Motivational Enhancement Therapy (MET), and determine whether differences exist across stages of change (SOC) for reducing use.

DESIGN AND METHODS

Primary care patients 15-24 years old using cannabis ≥3 times/week enrolled in a pilot randomized intervention trial. All youth were offered two 1-hour MET sessions. Content analysis was used to code and categorize main reasons for use, alternative behaviors, goals, values, pros and cons of change, and compared results between youth in Pre-Contemplation vs. Contemplation SOC.

RESULTS

Fifty-six youth completed MET session 1, 46 completed session 2. Most reported their main reason for use was related to emotional coping, negative feelings were a top-3 trigger, and distraction was an alternative way to meet their needs. Youth most frequently described progress in education or career/job as 1-year goals. More than half identified family as a very important value. They most frequently reported pros of using less related to achieving goals, self-improving, and saving money, and a con related to stress/coping. Compared to youth in Pre-Contemplation SOC, those in Contemplation were more likely to identify relationships as both a pro and con of using less cannabis.

CONCLUSIONS

MET can reveal developmentally appropriate goals, healthy values, and ambivalence about cannabis use that can be used to facilitate movement along the stages of behavior change toward reduction/cessation.

PRACTICE IMPLICATIONS

Brief motivational therapy can be used in primary care to gather information important in helping youth to reduce cannabis use.

摘要

目的

描述在动机增强治疗(MET)中经常使用大麻的青少年/年轻人提供的信息,并确定在减少使用的改变阶段(SOC)之间是否存在差异。

设计和方法

在一项试点随机干预试验中,每周使用大麻≥3 次的 15-24 岁的初级保健患者被纳入研究。所有年轻人都提供了两次 1 小时的 MET 课程。内容分析用于对主要使用原因、替代行为、目标、价值观、改变的利弊进行编码和分类,并比较处于前沉思阶段和沉思阶段的年轻人的结果。

结果

56 名青年完成了 MET 第 1 次课程,46 名青年完成了第 2 次课程。大多数人报告说,他们使用大麻的主要原因与情绪应对有关,负面情绪是前三大诱因,而分散注意力是满足他们需求的替代方式。青年最常描述的是在教育或职业/工作方面取得进展作为 1 年的目标。超过一半的人将家庭视为非常重要的价值观。他们最常提到的使用大麻减少的好处与实现目标、自我提升和省钱有关,而一个缺点与压力/应对有关。与处于前沉思阶段的 SOC 的年轻人相比,处于沉思阶段的年轻人更有可能将人际关系视为减少大麻使用的好处和坏处。

结论

MET 可以揭示与发展阶段相适应的目标、健康的价值观以及对大麻使用的矛盾心理,这些都可以用来促进行为改变阶段朝着减少/停止使用的方向前进。

实践意义

简短的动机治疗可以在初级保健中使用,以收集有助于年轻人减少大麻使用的重要信息。

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