Moos R H, King M J
Program Evaluation and Resource Center, Department of Veterans Affairs Health Care System, Palo Alto, CA 94304, USA.
J Subst Abuse Treat. 1997 Jan-Feb;14(1):71-80. doi: 10.1016/s0740-5472(96)00189-4.
The study sought to identify patient characteristics that predict participation in substance abuse treatment in community residential facilities (CRFs) and to examine the association between patient characteristics, participation in treatment, and outcomes at discharge from CRFs.
A sample of 2,794 patients with substance abuse disorders was assessed at entry into and discharge from a representative set of 88 CRFs nationwide.
In general, patients' psychological distress, motivation for treatment, prior involvement in self-help, and social resources predicted more engagement in CRF services and activities; prior inpatient treatment and the history of a psychiatric disorder predicted less engagement. These patient characteristics also predicted outcomes at discharge; more important, participation in treatment was positively and independently associated with such discharge outcomes as completion of the program and moving into stable residence. In addition, there was some evidence that participation in treatment counteracted the negative effects of high-risk patient characteristics on outcome.
Participation in treatment is as important a predictor of outcomes at discharge from CRFs as are patient characteristics at intake to treatment. Suggestions are made about how providers can enhance patients' motivation to participate and remain in treatment.
本研究旨在确定能够预测社区居住设施（CRF）中物质滥用治疗参与情况的患者特征，并考察患者特征、治疗参与情况与CRF出院结局之间的关联。
对全国88个具有代表性的CRF中2794名物质滥用障碍患者在入院时和出院时进行了评估。
总体而言，患者的心理困扰、治疗动机、先前参与自助的情况以及社会资源能够预测其更多地参与CRF服务和活动；先前的住院治疗和精神疾病史则预测参与度较低。这些患者特征还能预测出院结局；更重要的是，参与治疗与项目完成及搬入稳定住所等出院结局呈正相关且具有独立相关性。此外，有证据表明参与治疗抵消了高风险患者特征对结局的负面影响。
参与治疗与入院时的患者特征一样，都是CRF出院结局的重要预测因素。针对提供者如何提高患者参与治疗并坚持治疗的动机提出了建议。
