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探索长期美沙酮依赖患者的生活质量认知:一项定性研究。

Exploring perceived quality of life in long-term methadone-dependent patients: a qualitative study.

作者信息

Hosseini Seyed Hamzeh, Fendereski Farnaz, Yazdani Fereshteh, Hamzehgardeshi Zeinab

机构信息

Psychosomatics Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Harm Reduct J. 2024 Dec 21;21(1):225. doi: 10.1186/s12954-024-01140-5.

Abstract

BACKGROUND AND AIM

Considering opioid use disorder (OUD) as one of the major global concerns, methadone maintenance treatment (MMT) has been documented the core treatment for such dependence in the affected individuals. With regard to the significant role of quality of life (QoL) in evaluating the outcomes of various treatment methods in this line, the present study was to explore perceived QoL in long-term methadone-dependent patients (MDPs).

MATERIALS AND METHODS

Applying a qualitative research design, this study was performed on 25 long-term MDPs, selected by purposive sampling with maximum variation. The data were also collected through semi-structured, in-depth interviews until data saturation was reached, and then analyzed via the MAXQDA10 software program and conventional content analysis.

RESULTS

The themes mined from the qualitative data were (i) satisfaction with improvements of physical-mental deterioration, with two main categories, viz. (a) improved physical efficiency and (b) improved mental efficiency; (ii) satisfaction with having a meaning in life, comprised of two categories, i.e., (a) hope for the future and (b) new beginnings in life; (iii) positive self-perception, made up of four main categories of (a) Increased Confidence and Self-Acceptance, (b) Positive Self-Acceptance and Improved Self-Image, (c) Improved Decision-Making Abilities, and (d) More Effective Coping with Stressful Situations; (iv) satisfaction with perceived social capital, consisting of two categories, namely, (a) strong social support and (b) no worry of the stigma of substance use; (v) growth in marital satisfaction, with two main categories of (a) increased libido and (b) effective communication with one's spouse; and (vi) physical-mental exhaustion caused by MMT, containing three categories, i.e., (a) fear of physical harm induced by MMT, (b) stigma and discrimination due to MMT, and (c) financial hardship following MMT.

CONCLUSION

The study results revealed that QoL in MDPs was associated with their satisfaction with improvements of physical-mental deterioration, satisfaction with having a meaning in life, positive self-perception, satisfaction with perceived social capital, growth in marital satisfaction, and physical-mental exhaustion caused by MMT. Accordingly, it was suggested to reduce the negative impacts of MMT, such as stigma and discrimination due to MMT and the related treatments, on QoL in opioid-dependent patients (ODPs) and boost its benefits in their daily life.

摘要

背景与目的

鉴于阿片类物质使用障碍(OUD)是全球主要关注的问题之一,美沙酮维持治疗(MMT)已被证明是治疗此类成瘾个体的核心方法。鉴于生活质量(QoL)在评估该领域各种治疗方法效果方面的重要作用,本研究旨在探讨长期美沙酮依赖患者(MDPs)的生活质量感知。

材料与方法

本研究采用定性研究设计,对25名长期MDPs进行研究,通过目的抽样选取具有最大变异性的样本。通过半结构化深度访谈收集数据,直至达到数据饱和,然后使用MAXQDA10软件程序和传统内容分析法进行分析。

结果

从定性数据中挖掘出的主题包括:(i)对身心状况改善的满意度,包括两个主要类别,即(a)身体机能改善和(b)心理机能改善;(ii)对生活有意义的满意度,包括两个类别,即(a)对未来的希望和(b)生活中的新起点;(iii)积极的自我认知,由四个主要类别组成,即(a)信心增强与自我接纳、(b)积极的自我接纳与自我形象改善、(c)决策能力提高、(d)更有效地应对压力情况;(iv)对感知到的社会资本的满意度,包括两个类别,即(a)强大的社会支持和(b)不用担心药物使用的污名化;(v)婚姻满意度提高,包括两个主要类别,即(a)性欲增强和(b)与配偶有效沟通;(vi)MMT导致的身心疲惫,包括三个类别,即(a)对MMT引起身体伤害的恐惧、(b)因MMT产生的污名化和歧视、(c)MMT后的经济困难。

结论

研究结果表明,MDPs的生活质量与他们对身心状况改善的满意度、对生活有意义的满意度、积极的自我认知、对感知到的社会资本的满意度、婚姻满意度提高以及MMT导致的身心疲惫有关。因此,建议减少MMT及其相关治疗对阿片类物质依赖患者(ODPs)生活质量的负面影响,如因MMT产生的污名化和歧视,并提高其在日常生活中的益处。

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