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物质使用障碍患者的共同决策:一项为期一年的随访研究。

Shared decision making in patients with substance use disorders: A one-year follow-up study.

机构信息

Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Álvaro Cunqueiro, SERGAS, Vigo, Spain; Translational Neuroscience Research Group, Galicia Sur Health Research Institute (IIS-Galicia Sur), SERGAS-UVIGO, CIBERSAM, Vigo, Spain.

Canary Islands Health Research Institute Foundation (FIISC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) Spain.

出版信息

Psychiatry Res. 2023 Nov;329:115540. doi: 10.1016/j.psychres.2023.115540. Epub 2023 Oct 11.

Abstract

Patient-centered care in therapeutic processes has been associated with better clinical outcomes, however, it remains a poorly studied aspect in Substance Use Disorder (SUD). The study aimed to evaluate patient's preferences, perceived participation in treatment decisions and activation level; and how they predict retention, pharmacological adherence and substance use during one-year follow-up. Logistic regression models were used to analyze the association between independent variables, along with a wide number of sociodemographic and clinical covariates, and outcomes. Most patients prefer a shared or passive role when making decisions about their treatment, and showed concordance between their preferred and perceived roles. In the univariate models, perceiving more involvement than desired showed a higher likelihood of treatment discontinuation at 12 months, and substance use at 6 and 12 months. No significant associations were found between the remaining decisional variables or the degree of activation with the assessed outcomes. A majority of SUD patients prefer and perceive to be involved in the decision-making process about their treatment. Patients perceiving more involvement than desired might experience an excess of responsibility that could negatively influence treatment continuation and substance use. Limitations of the study preclude any definitive conclusion, and more research is needed to confirm these results.

摘要

治疗过程中的以患者为中心的护理与更好的临床结果相关,但在物质使用障碍(SUD)中仍然是一个研究不足的方面。本研究旨在评估患者的偏好、对治疗决策的感知参与度和激活水平,以及它们如何预测在一年随访期间的保留率、药物治疗依从性和物质使用情况。使用逻辑回归模型来分析独立变量与广泛的社会人口学和临床协变量之间的关联,并分析结果。大多数患者在决定自己的治疗时更喜欢共同或被动的角色,并且他们的偏好和感知角色之间存在一致性。在单变量模型中,感知到的参与度超过期望与 12 个月时的治疗中断以及 6 个月和 12 个月时的物质使用的可能性更高。在评估的结果中,没有发现决策变量或激活程度之间存在显著关联。大多数 SUD 患者更喜欢并认为自己参与了治疗决策过程。感知到的参与度超过期望的患者可能会承担过多的责任,这可能会对治疗的持续时间和物质使用产生负面影响。研究的局限性排除了任何明确的结论,需要进一步的研究来证实这些结果。

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