美沙酮维持治疗依从性影响因素的结构方程模型分析  

Methadone Maintenance Treatment Adherence Influence Factors Analysis by the Structural Equation Model

作　　者：王岩[1] 朱长才[1] 熊峰[1] 许珊丹[1] 陈亮[1] 

机构地区：[1]武汉科技大学医学院公共卫生学院,430065

出　　处：《中国卫生统计》2016年第4期575-577,581,共4页Chinese Journal of Health Statistics

基　　金：国家社会科学基金(编号:14BSH089)

摘　　要：目的 采用结构方程模型,探讨湖北省内美沙酮维持治疗者依从性的影响因素。方法 以自拟的《美沙酮维持治疗基本情况问卷》、Morisky服药依从性量表以及社会支持量表为调查工具,采用不记名的方式对目标人群进行一对一的访谈式问卷调查收集研究数据。运用SPSS17.0进行描述性统计分析和探索性因子分析,采用Amos21.0软件构建结构方程模型。结果 探索性因子分析共提取6个公因子,分别为MMT认知、毒品自我抵触、家庭社会支持、经济状况、门诊治疗评价、美沙酮维持治疗依从性;最终进入结构方程拟合模型的有两个因子,分别为毒品自我抵制和美沙酮维持治疗依从性,结果显示χ~2/df为1.448,主要拟合参数RMSEA、GFI、AGFI分别为0.035、0.994、0.976,模型拟合效果好。结论 是否连续服药、每月中断治疗天数、Morisky服药依从性量表可用于判断MMT依从性好坏;受治者对毒品的自我抵制情况对依从性有较大的影响,应加强健康教育和心理干预以提高依从性。Objective To investigate the influential factors of Methadone Maintenance Treatment adherence in Hubei province through the method of structural equation model. Methods Data was collected by means of one-on-one interviews with anonymous questionnaires, which included Methadone maintenance treatment adherence ,Morisky medication adherence scale, Social Support Rating Scale. Through SPSS17. 0 and Amos21.0, descriptive statistics analysis, exploratory factor analysis, and structural equation model were used to analyze the data. Results Exploratory factor analysis showed that 6 common factors were extracted, but only self resistance to drug and methadone maintenance treatment adherence entered terminal model. Accord- ing to the fitting results ,x2/df, RMSEA,GFI,AGFI were 1. 448,0. 035,0. 994,0. 976 ,respectively. Conclusion Treatment situation（ whether continuous）, discontinue treatment days per month and Morisky medication adherence scale could be used to judge of MMT adherence; self resistance to drug of MMT patients had great influence to the adherence, health education and psychological intervention should be strengthened to improve the adherence.

关 键 词：美沙酮维持治疗 依从性 探索性因子分析 结构方程模型 

分 类 号：R749.64[医药卫生—神经病学与精神病学]