中国物质依赖者治疗阻碍因素的初步研究

发布时间：2018-05-31 15:56

本文选题：物质依赖者 + 治疗阻碍量表(BTI)　；参考：《中南大学》2013年硕士论文

【摘要】：目的：1.系统了解物质依赖者寻求治疗的阻碍因素。2.对治疗阻碍因素评定量表(Barriers to Treatment Inventory, BTI)进行信效度分析。方法：采用治疗阻碍评定量表(BTI)对来自湖南省三所戒毒机构的、符合美国精神障碍诊断和统计手则(DSM-IV)关于物质依赖诊断标准的262例物质依赖者进行调查研究。结果：1.物质依赖者寻求治疗的阻碍因素：内部阻碍因素方面主要表现为：“我能很好的掌握毒品的使用情况”(31.3%)、“如果我去接受治疗,我的家人会因此而蒙羞”(30.1%)以及“个人方面的原因”(48.1%)；外部阻碍因素方面主要表现为“家里有事情要做,很难有时间去接受治疗”(61.1%)、“很难找到与我日常工作安排没有冲突才治疗程序”(60.3%)、“接受治疗的地方距离太远”(56.9%)、“我不知道哪里可以接受治疗”(83.2%)、“没法前往治疗场所”(93.9%)、“暂时经济困难,我必须要等候一段时间才能得到治疗”(74.4%)和“要得到治疗,我的手续可能过于繁杂”(87.8%)。 2.对BTI量表中条目进行了相关性分析,结果显示因子3“害怕治疗(FT)”中条目12“我曾经有过很糟糕的治疗经历”与因子3中其它条目相关性差,并发现条目12的因子载荷很小或无统计学意义(r=0.026,P=0.767),因此,条目12被删除了不再进一步分析。BTI量表的信度为0.72说明内部一致性较好；验证性因子分析的结果表明BTI量表具有良好的结构效度,即量表的结构与构造的结构基本一致,说明此量表是可行及可信的。 3.物质依赖者的内部和外部治疗阻碍因素结果：内部治疗阻碍因素方面：本研究结果显示：年龄组：年纪小于30岁的吸毒者比大于30岁的吸毒者更表现出因子2“负性的社会支持(NSS)"(γ=-0.19,P=0.038)和因子4“个人方面的原因(PC)”(γ=-0.31,P0.001)方面的治疗阻碍；主要使用毒品组：以“冰毒”为主的吸毒者比其他物质滥用者更表现出因子1“认识不到自己的问题(AP)”(γ=0.44,P0.001)、因子2“负性的社会支持(NSS)”(γ=0.25,P=0.010)以及条目14"担心在治疗过程中见到一些我不愿意见到的人”(γ=-0.15,P=0.005)方面的治疗阻碍；曾经有过治疗经历组：曾经有过治疗经历的吸毒者比从未有过治疗经历的吸毒者更表现出因子1“认识不到自己的问题(AP)”(γ=0.20,P=0.012)方面的治疗阻碍；婚姻状况组：已婚吸毒者比未婚吸毒者更表现出条目17“我讨厌别人问我隐私方面的问题”(γ=-0.11,P=0.030)方面的治疗阻碍；主要毒品持续时间组：持续时间越长的吸毒者越表现出条目5“我能很好的掌握毒品的使用情况”(γ=-3.7,P0.001)方面的治疗阻碍；性别组及教育程度组：对所有四个因子及17个条目均无显著差异。外部治疗阻碍因素方面：本次调查中的物质依赖者被分成三类：类别1：大多数(59%)的物质依赖者对所有外部阻碍的赞成率非常高,所以被称为主要类别阻碍类别：类别2：22%的物质依赖者对所有外部阻碍的赞成率较低,所以被称为低阻碍类别；类别3：19%的物质依赖者回答因子5“治疗时间与日常工作相冲突(TC)”阻碍因素的赞成率为零,回答因子6“治疗机构难以获得(TA)”和因子7“治疗场所难以进入(ED)”阻碍因素的条目时赞成率几乎是百分之百,这两因子主要体现在治疗机构或治疗场所方面的阻碍因素,所以被称为系统级阻碍类别。物质依赖者的个体特征年龄和成瘾物质的特征主要使用毒品是影响物质依赖者分类的影响因素。结论：1.我国物质依赖者接受治疗前均会遇到各种阻碍因素；不同个体特征的物质依赖者会表现出不同的阻碍因素和阻碍类别,干预时要不同对待。2.修订后的中文版BTI量表具有良好的信效度,可作为调查我国物质依赖者治疗阻碍因素的研究工具。
[Abstract]:Objective : 1 . To understand the obstructive factors for the treatment of substance - dependent persons . 2 . To analyze the validity of treatment - obstructive factor scale ( BTI ) .

Methods : A survey was conducted on 262 substance - dependent persons from three drug addicts in Hunan Province , who were in compliance with the diagnostic criteria of mental disorders in the United States ( DSM - IV ) , on the criteria of substance dependence diagnosis by using the treatment - obstruction rating scale ( BTI ) .

Results : 1 . The barriers to the treatment of substance - dependent persons were : " I can well master the use of drugs " ( 31.3 % ) , " if I go to treatment , my family will be ashamed " ( 30.1 % ) and " personal reasons " ( 48.1 % ) ;
" I don ' t know where to treat " ( 60.3 % ) , " I don ' t know where to receive treatment " ( 60.3 % ) , " I don ' t know where to receive treatment " ( 83.2 % ) , " I don ' t know where to treat " ( 83.2 % ) , " I don ' t know where to receive treatment " ( 83.2 % ) , " I have to wait for some time to get treatment " ( 74.4 % ) and " to get treatment , my procedure may be too complicated " ( 87.8 % ) .

2 . The correlation analysis of the entries in the BTI scale showed that the entry 12 " I used to have a bad treatment experience " in the " fear treatment ( FT ) " had a poor correlation with other entries in the factor 3 , and found that the factor loading of the entry 12 was very small or had no statistical significance ( r = 0.026 , P = 0.767 ) . Therefore , the entry 12 was deleted no further analysis . The reliability of the BTI scale was 0.72 , and the internal consistency was good ;
The results of confirmatory factor analysis indicate that the BTI scale has good structural validity , that is , the structure of the scale is basically consistent with the structure of the structure , which indicates that the scale is feasible and credible .

3 . Internal and external treatment of substance - dependent factors : Internal treatment barriers : The results of this study show that the age group : drug users who are younger than 30 years of age are more likely to have a factor of 2 " negative social support ( NSS ) " ( 纬 = - 0.19 , P = 0.038 ) and factor 4 " personal reasons ( PC ) " ( 纬 = - 0.31 , P0.001 ) than those who are more than 30 years old ;
Drug groups were mainly used : drug addicts with " ice poison " showed a factor of 1 " less than their own problems ( AP ) " ( 纬 = 0.44 , P0.001 ) , factor 2 " negative social support ( NSS ) " ( 纬 = 0.25 , P = 0.010 ) and entry 14 " fear of seeing some of the people I don ' t want to see in the course of treatment " ( 纬 = - 0.15 , P = 0.005 ) ;
There was once a treatment experience group : drug users who had experienced treatment had a higher level of treatment than those who had experienced a treatment experience than those who had not experienced treatment ( AP ) ( 纬 = 0.20 , P = 0.012 ) ;
marital status group : married drug addicts showed an entry 17 " I hate people asking questions about privacy concerns " ( 纬 = - 0.11 , P = 0.030 ) .
The longer the main drug duration group : the longer the drug addict the longer the duration of the drug , the better the treatment impeded the use of drugs " ( 纬 = - 3.7 , P0.001 ) ;
Gender and degree of education : There was no significant difference in all four factors and 17 entries . The substance - dependent persons in this survey were classified into three categories : category 1 : the majority ( 59 per cent ) of the substance - dependent persons were very high in favour of all external barriers , so they were called the main categories of obstruction categories : category 2 : 22 per cent of the substance - dependent persons had a lower preference for all external barriers , and were therefore referred to as low - barrier categories ;
Category 3 : 19 % of the substance - dependent response factor 5 " treatment time and day - to - day work - to - day conflict ( TC ) " barrier factor is almost 100 per cent , and the two factors mainly reflect barriers to the treatment facility or the treatment site , which are called the system - level barrier categories . The main use of drug dependence - based individual characteristic ages and addictive substances is the factor affecting the classification of substance - dependent persons .

Conclusion : 1 . There are various obstacles before the treatment of the substance - dependent persons in China .
Different individual characteristics of substance - dependent persons exhibit different barrier factors and hinder the categories , and should be treated differently at the time of intervention . 2 . The revised BTI scale has good faith validity , which can be used as a research tool for investigating the factors of Chinese drug dependence treatment .
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.64

【参考文献】