Corse S J, Smith M
Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, USA.
J Subst Abuse Treat. 1998 Sep-Oct;15(5):457-67. doi: 10.1016/s0740-5472(98)00027-0.
Providers in prenatal care settings are well-positioned to help pregnant women with substance abuse problems take the first steps toward recovery. This study reports the results of the ANGELS Program, a program of enhanced prenatal care designed to reduce substance use among pregnant women. In a suburban office serving a broad range of pregnant women, certified nurse-midwives (CNMs) and on-site addictions counselors addressed substance abuse during prenatal care. This paper describes a cohort of 77 pregnant women who were identified as abusers of alcohol and/or other drugs at the start of pregnancy. According to a level of change rating assigned by the CNM at delivery, 51% of women were able to be largely abstinent during their pregnancy, 35% had reduced their use somewhat, and 14% had shown no change in use. Discriminant analysis techniques were used to learn what characteristics differentiated women in these three level of change groups. Baseline variables that differentiated the groups included severity of cocaine and cannabis use, psychosocial stressors, and initiation of prenatal care. Significant process variables included number of prenatal visits and contact with the addictions counselors. Clinical vignettes illustrate the differences among women in the three level of change groups. Implications of the results are discussed.
产前护理机构的医护人员处于有利位置，能够帮助有药物滥用问题的孕妇迈出康复的第一步。本研究报告了ANGELS项目的结果，该项目是一项强化产前护理计划，旨在减少孕妇的药物使用。在一个为广泛的孕妇群体服务的郊区诊所，认证护士助产士（CNMs）和现场成瘾顾问在产前护理期间处理药物滥用问题。本文描述了一组77名孕妇，她们在怀孕初期被确定为酒精和/或其他药物滥用者。根据分娩时CNM给出的改变程度评级，51%的女性在孕期能够基本戒酒，35%的女性药物使用有所减少，14%的女性药物使用情况没有变化。采用判别分析技术来了解哪些特征区分了这三个改变程度组的女性。区分这些组的基线变量包括可卡因和大麻使用的严重程度、心理社会压力源以及产前护理的开始时间。重要的过程变量包括产前检查次数和与成瘾顾问的接触情况。临床案例说明了三个改变程度组女性之间的差异。并讨论了结果的意义。
