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物质滥用强化门诊治疗结束后,参与后续护理课程和自助小组的预测因素。

Predictors of participation in aftercare sessions and self-help groups following completion of intensive outpatient treatment for substance abuse.

作者信息

McKay J R, McLellan A T, Alterman A I, Cacciola J S, Rutherford M J, O'Brien C P

机构信息

Department of Psychiatry, University of Pennsylvania School of Medicine, Treatment Research Center, Philadelphia 19104, USA.

出版信息

J Stud Alcohol. 1998 Mar;59(2):152-62. doi: 10.15288/jsa.1998.59.152.

Abstract

OBJECTIVE

The goals of this study were to identify predictors of greater participation in aftercare treatment sessions and self-help groups during the first 3 months following completion of a 4-week intensive outpatient rehabilitation (IOP) program.

METHOD

The subjects were 138 male veterans who met DSM-III-R criteria for lifetime diagnoses of both alcohol and cocaine dependence (n = 67), alcohol dependence only (n = 48) or cocaine dependence only (n = 23); completed an IOP program; and expressed a desire to enter a formal aftercare program. Analyses examined relationships between predictor variables from five different domains and number of aftercare sessions and self-help groups attended in the last week of each month of the follow-up period.

RESULTS

Of the many potential predictor variables that were examined, only remission from cocaine and alcohol dependence during IOP and higher AIDS risk behavior scores in the prior 6 months contributed independently to the prediction of greater participation in aftercare. Further analyses identified several variables that were differential predictors of participation in individualized relapse prevention aftercare versus standard 12-step focused group aftercare. More years of cocaine use, greater current legal problems and a lack of current alcohol dependence predicted greater self-help participation at the level of a trend.

CONCLUSIONS

The achievement of remission from substance use dependence during IOP may be an important criterion for moving to the next level of care. However, the results of the present study also point to the need for an increased focus on factors present during the course of aftercare in future studies of retention in aftercare following outpatient rehabilitation.

摘要

目的

本研究的目的是确定在完成为期4周的强化门诊康复(IOP)项目后的前3个月内,更多参与后续护理治疗课程和自助小组的预测因素。

方法

研究对象为138名男性退伍军人,他们符合DSM-III-R标准中关于酒精和可卡因依赖的终生诊断标准(n = 67),仅酒精依赖(n = 48)或仅可卡因依赖(n = 23);完成了IOP项目;并表示希望进入正式的后续护理项目。分析考察了来自五个不同领域的预测变量与随访期每个月最后一周参加的后续护理课程和自助小组数量之间的关系。

结果

在研究的众多潜在预测变量中,只有在IOP期间可卡因和酒精依赖的缓解以及前6个月较高的艾滋病风险行为得分独立地有助于预测更多参与后续护理。进一步分析确定了几个变量,这些变量是参与个体化预防复发后续护理与标准的12步聚焦小组后续护理的差异预测因素。更多年的可卡因使用、当前更大的法律问题以及目前没有酒精依赖在趋势水平上预测了更多的自助参与。

结论

在IOP期间实现物质使用依赖的缓解可能是进入下一护理水平的重要标准。然而,本研究结果也指出,在未来关于门诊康复后后续护理留存率的研究中,需要更多地关注后续护理过程中存在的因素。

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