海洛因依赖者参加美沙酮维持治疗中存在的问题:小组焦点访谈研究  

QUALITATIVE SUVERY ON PARTICIPATING METHADONE MAINTENANCE TREATMENT FOR HEROIN DEPENDENT PATIENTS IN SHANGHAI:FOCUS GROUP INTERVIEW

作　　者：江海峰[1] 杜江[1] 王兆薇 吴霏 Yih-Ing Hser 赵敏[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海200030 [2]University of California,Los Angeles,California,USA

出　　处：《中国药物依赖性杂志》2011年第6期428-432,共5页Chinese Journal of Drug Dependence

基　　金：科技部支撑计划(2008BA149B00);国家自然科学基金项目(30971048)

摘　　要：目的:了解影响海洛因依赖者参与美沙酮维持治疗(methadone maintenance treatment,MMT)及脱失的相关问题,为MMT门诊制定提高参与率和依从性的干预措施提供依据和线索。方法:分别对上海市的美沙酮维持治疗门诊的9名工作人员和12名正在接受MMT治疗的海洛因依赖者举办小组焦点访谈(focus group,FG),通过半结构式访谈和开放式提问,采集和总结工作人员和患者在MMT参与和维持治疗过程中面临的问题。对访谈内容进行录音和文字记录,并使用定性研究方法分析访谈内容。结果:研究对象指出,在MMT参与和维持过程中主要面临4方面阻碍,影响其参与MMT治疗的积极性和治疗维持率,分别是:(1)部分海洛因依赖者对美沙酮、MMT存在偏见和误解导致对治疗的阻抗;(2)MMT便捷性较差,例如日常门诊时间与工作时间冲突和门诊间转诊不便捷等;(3)每日治疗费用增加了患者的经济负担;(4)海洛因依赖者对司法部门监控的担心。结论:本研究结果提示有必要研究和发展针对性策略以提高MMT的参与率和依从性,例如:宣传教育、经济资助及更人性化的服务。Objective：To explore the factors associated with involvement or drop out of methadone maintenance treatment（MMT） in Shanghai,and develop target strategies to improve access,utilization of MMT.Methods：Nine MMT providers and 12 patients participated in two focus groups following semi-structured interview outlines designed to solicit perceptions and opinions of MMT in Shanghai.Discussions were tape-recorded,transcribed.Qualitative methodology was adopted for analysis.Results：Participants identified four major types of barriers in participating and remaining in MMT：（1） patients＇ misconception about MMT and therefore resistance of the treatment;（2） inconvenience to reach services at clinics,such as MMT clinics＇ operation hours conflicting regular working hours and the lack of transferability between clinics in different localities;（3） financial pressure such as the fees for daily methadone made many drug users not afford the treatment;and（4） fear of being exposed and arrested blocked patients to dare to enroll in MMT.Conclusion：Findings highlight the need to strengthen a comprehensive measure including：further education,financial incentives and humane control measure.

关 键 词：海洛因依赖 美沙酮维持治疗 定性研究 

分 类 号：R512.91[医药卫生—内科学]