阻碍阿片类物质依赖者参与社区美沙酮维持治疗因素探究

发布时间：2018-04-26 22:10

本文选题：MMT + 阿片类物质依赖　；参考：《昆明医科大学》2016年硕士论文

【摘要】：[目的]了解阿片类物质依赖者对MMT的认识与态度,了解阿片类物质依赖者参与美沙酮维持治疗的阻碍因素,为今后扩大MMT覆盖面,改进美沙酮维持治疗相关政策提供科学依据。[方法]本次调查为横断面调查,采用定量与定性调查相结合的方式收集目标对象的相关信息,采用立意抽样与同伴推动的方法获取样本。定量研究通过问卷调查,了解研究对象的基本信息,吸毒史、对MMT的认识及参与意愿等探究阻碍社区阿片类物质成瘾者参与美沙酮维持治疗的影响因素,同时对29名调查对象进行定性。数据录入采用Epi 3.0软件,采用SPSS21.0进行数据分析。[结果]共收集样本350例,有效问卷327例,男性288例(88.1%),女性39例(11.9%)；调查对象最小16岁,最大65岁,平均年龄39.68±9.26岁；汉族为主(70.95%),文化程度初中及以下占81.65%,婚姻情况主要以未婚者占43.43%,无业者占42.5%,常住居民267人(81.65%)。初次接触阿片类物质年龄18岁以下者占26.30%,主要使用阿片类物质为海洛因,使用方式非注射使用占38.53%,戒毒意愿强烈占67.58%,主要经济收入来源靠个人及家庭支持。调查对象有27人表示没听过美沙酮治疗(8.26%),33人不知道当地美沙酮门诊位置(10.10%),知晓途径主要通过同伴(43.8%)获得,美沙酮知识得分总计为8.60±2.07分。65.44%的调查对象表示今后会考虑参加美沙酮维持治疗,34.56%则不会考虑参加美沙酮维持治疗。调查对象未参与MMT的主要原因前五位是：美沙酮比毒品更难戒断(13.67%)、靠自己戒毒(12.66%)、美沙酮副作用更多(10.95%)、每天服药太麻烦(8.34%)、担心被抓/暴露身份(7.94%)。今后不愿参加MMT的调查对象对阿片类物质依赖和美沙酮维持治疗认识错误更多。不同人口学特征的调查对象参加MMT的阻碍因素不同。[结论]本次调查研究对象选择未参与MMT的主要阻碍因素是：美沙酮比毒品更难戒断、靠自己戒毒、美沙酮副作用更多、每天服药太麻烦、担心被抓和担心暴露身份。内部阻碍因素是主要阻碍因素,其中以错误认知为主,不愿参加MMT的调查对象错误认知更严重。阿片类物质依赖者主要通过同伴获得美沙酮维持治疗相关信息,也是造成其对美沙酮维持治疗错误认知的主要原因,建议重视对这部分人群的同伴教育,重视美沙酮维持治疗的完整性,加强对医疗工作人员的规范化培训,通过同伴骨干向目标群体传递正确的信息,同时可以利用同伴推动法来提高美沙酮维持治疗的覆盖率。加强与公安等相关部门的合作,加强各种方式的社会宣传,扩大信息传播面,让社会大众对药物依赖危害有深刻认知的同时转变对物质依赖者标签化印象,减少社会歧视。联合相关部门组织各类活动,使阿片类物质依赖者参与其中,为其恢复社会功能提供条件。根据不同地区人口学特征灵活改进美沙酮服务,有效利用资源,提高服务的可及性与便利度。
[Abstract]:[objective] to understand the knowledge and attitude of opioid addicts on MMT, and to understand the factors hindering the participation of opioid addicts in methadone maintenance therapy, so as to expand the coverage of MMT in the future. To improve the policy of methadone maintenance therapy to provide scientific basis. [methods] this investigation is a cross-sectional investigation, which combines quantitative and qualitative investigation to collect the relevant information of the target object, and obtains the sample by the method of idea sampling and peer drive. A quantitative study was conducted to find out the basic information of the subjects, the history of drug abuse, the awareness of MMT and the willingness to participate in the investigation of the factors affecting the participation of community opioid addicts in methadone maintenance therapy. At the same time, 29 subjects were analyzed qualitatively. Epi 3.0 software is used for data input and SPSS21.0 is used for data analysis. [results] A total of 350 samples were collected, 327 valid questionnaires, 288 males with 88.1D and 39 females with 11.90.The subjects were the youngest 16 years old, the maximum 65 years old, the average age 39.68 卤9.26 years. The majority of the Han nationality were 70.95am, 81.65% of the middle school students were educated, 43.43 were unmarried, 42.5 were unemployed, 267 permanent residents were 81.65. The age of first contact with opioid substances was 26.30. The main opioid substances were heroin, non-injection drug use was 38.53, and the willingness to detoxify was 67.58. The main source of income depended on personal and family support. Twenty-seven people surveyed said that they had not heard of methadone treatment. 33 people did not know the local methadone clinic location. The total knowledge score of methadone was 8.60 卤2.07. 65.44% of the respondents indicated that 34.56% of them would consider participating in methadone maintenance therapy in the future, but they would not consider participating in methadone maintenance therapy. The main reasons for not participating in MMT were as follows: methadone was more difficult to quit 13.67 than drugs, 12.66 to detoxify by oneself, 10.95 to methadone side effects, 8.3445 to take medicine every day, worried about being caught / exposed to the identity of 7.940.The main reasons for not participating in MMT were as follows: (1) methadone was more difficult to quit than drugs, 12.66%, 10.95% of methadone side effects, and 8.34% (8.34%). Subjects who were reluctant to participate in MMT had more misunderstandings about opioid dependence and methadone maintenance therapy. Participants with different demographic characteristics had different barriers to participating in MMT. [conclusion] the main factors hindering the selection of subjects who did not participate in MMT were: methadone was more difficult to quit than drugs, self-detoxification, more side effects of methadone, too much trouble to take medicine every day, fear of being caught and fear of exposure to identity. The internal hindrance factor is the main hindrance factor, and the wrong cognition is more serious in the subjects who do not want to participate in MMT. It is suggested that attention should be paid to peer education in opioid addicts, who mainly obtain information about methadone maintenance therapy through their peers, which is also the main reason for their misperception of methadone maintenance therapy. We should pay attention to the integrity of methadone maintenance therapy, strengthen the standardized training of medical staff, transmit correct information to the target group through peer backbone, and improve the coverage rate of methadone maintenance treatment by peer-driven method at the same time. Strengthen the cooperation with the public security and other relevant departments, strengthen various forms of social propaganda, expand the spread of information, so that the public have a profound understanding of the harm of drug dependence, while changing the labelling of substance dependent people to reduce social discrimination. To organize various activities in conjunction with relevant departments to enable opioid dependent persons to participate and to provide conditions for their social recovery. According to the demographic characteristics of different regions, methadone service can be improved flexibly, and the availability and convenience of the service can be improved by utilizing resources effectively.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.64

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