Satisfaction to community methadone maintenance treatment and its influencing factors among drug users
-
摘要: 目的 了解广东省15家社区美沙酮维持治疗门诊的辅助服务提供情况及受治者满意度影响因素。方法 对广东省15家社区美沙酮维持治疗门诊的747例受治者进行横断面调查，了解其一般人口学特征、实际接受到的门诊服务情况、期望得到的门诊服务，以及对门诊的满意度。结果 747例受治者中，男性671例，女性76例，平均年龄为（38.34±5.84）岁；大部分受治者接受过门诊提供的入组时美沙酮知识讲解（95.72%）、剂量调整（96.12%）、健康教育（89.02%）及定期讨论病情（85.27%）等服务，曾接受过门诊医生为其制定治疗计划（57.16%）、提供艾滋病治疗服务（52.21%）、丙肝转诊服务（61.85%）及丙肝药物治疗服务（50.47%）的比例则较低；半数以上受治者期望门诊像医院一样有夜间门诊（54.22%），仅少部分受治者期望门诊维持现状（25.03%）、提供疾病治疗或转介服务（18.21%）及期望治疗收费调整（16.20%）；所有受治者对门诊满意度的平均得分为（69.74±12.08）分。多重线性回归结果显示，剂量调整（β'=0.11）、制定治疗计划（β'=0.08）、定期讨论病情（β'=0.09）、入组时美沙酮知识讲解（β'=0.08）、健康教育（β'=0.09）、丙肝药物治疗（β'=0.17）、艾滋病药物治疗（β'=-0.15）、期望门诊维持现状（β'=0.09）、治疗收费的调整（β'=-0.13）、提供疾病治疗或转介服务（β'=-0.11）10个因素影响受治者对门诊辅助服务的满意度。结论 目前 MMT 门诊提供的辅助服务尚未能满足受治者需求，门诊服务质量仍有待进一步提高，以提高受治者的满意度。Abstract: Objective To examine service provision in 15 community methadone maintenance treatment(MMT) clinics in Guangdong province and to identify factors influencing the satisfaction to the MMT among drug users.Methods We investigated 747 drug users from 15 community-based MMT clinics in Guangdong province during December 2011 to January 2012.We collected information on sociodemography of the participants,the services provided in MMT clinics,and the expectation of the participants towards the MMT clinics.A questionnaire including 18 items was used to assess the satisfaction to MMT clinics in the participants.Results Of all the participants,671 were male and 76 were female,with an average age of 38.34±5.84 years.Most of the participants reported the services provided by the MMT clinics,such as methadone related knowledge(95.72%),adjustment of methadone dose(96.12%),health education(89.02%),and consultation for rehabilitation(85.27%) and a part of participants reported the services of treatment planning(57.16%),human immunodeficiency virus(HIV) treatment(52.21%),and the referral service for hepatitis C diagnosis(61.85%) and treatment(50.47%).More than a half of the participants(54.22%) expected to use MMT service at night;25.03% expected to keep the status quo of the MMT clinics 18.21% excepted treatment to other diseases or referral services by the clinics;and 16.20% excepted the decrease of treatment cost.The average satisfaction score of the participants was 69.74±12.08.Multivariate linear regression analyses revealed that factors influencing satisfaction status of the participants included adjustment of methadone dose(β'=0.11),establishment of treatment plan(β'=0.08),discussion for rehabilitation(β'=0.09),education on methadone related knowledge at the enrollment(β'=0.08),health education(β'=0.09),hepatitis C treatment(β'=0.17),and HIV treatment(β'=-0.15).The participants expecting the clinics to keep the status quo of the MMT had a higher satisfaction score(β'=0.09) and those expecting treatment to other diseases or referral services(β'=-0.11) and adjustment of MMT charge by the clinics(β'=-0.13) had a lower satisfaction score.Conclusion The services provided by community MMT clinics could not meet the requirements of the participants and further efforts are needed urgently to improve the accessibility of MMT and the satisfaction of MMT users.
-
Key words:
- methadone maintenance treatment /
- support service /
- satisfaction
-
[1] 陈雯,赵醴丽,凌莉,等.广东省首批社区美沙酮维持治疗试点效果评价[J].中国公共卫生,2009,25(12):1416-1418. [2] 封苏琴,周建波,郭燕丽,等.海洛因成瘾者社区美沙酮维持治疗效果评价[J].中国公共卫生,2010,26(7):924-925. [3] 俸卫东,翁毓秋,甘志高,等.柳州市吸毒人群艾滋病预防干预效果评价[J].中国公共卫生,2010,26(1):37-38. [4] 中华人民共和国卫生部,中华人民共和国公安部,国家食品药品监督管理局.社区药物维持治疗方案[R].北京:卫生部,2006. [5] Marchand KI,Oviedo-Joekes E,Guh D,et al.Client satisfaction among participants in a randomized trial comparing oral methadone and injectable diacetylmorphine for long-term opioid-dependency[J].BMC Health Serv Res,2011,11:174. [6] 杨跃进,贠赟.414例美沙酮维持治疗门诊患者偷吸海洛因相关因素分析[J].中国保健营养(中旬刊),2013(2):590-592. [7] 杨放,林鹏,龙其穗,等.阿片类物质成瘾者参加社区美沙酮维持治疗影响因素的定性研究[J].华南预防医学,2008(3):15-18. [8] 卫生部、公安部、国家食品药品监督管理局关于印发《滥用阿片类物质成瘾者社区药物维持治疗工作方案》的通知[Z].卫疾控发 [9] 杨放,林鹏,何群,等.美沙酮维持治疗患者脱失情况影响因素的 Logistic 分析[J].中国艾滋病性病,2011(5):543-546. [10] 杜存,刘英杰,熊晓燕,等.影响美沙酮维持治疗依从性及相关因素的定性研究[J].中国药物依赖性杂志,2009(5):413-419. [11] 温添娣,孔燕群,罗颖照,等.健康教育干预对美沙酮门诊患者生活质量的影响[J].中国医药指南,2012(18):681-682. [12] Perez De Los Cobos J, Trujols J,Valderrama JC,et al.Patient perspectives on methadone maintenance treatment in the Valencia Region:dose adjustment,participation in dosage regulation,and satisfaction with treatment[J].Drug Alcohol Depend,2005,79(3):405-412. [13] 程晓莉,肖永康.安徽省首批社区美沙酮维持治疗基本情况分析[J].安徽医学,2009(8):907-909. [14] 胡珺,周志英,朱福,等.和谐的医患关系与病人满意度[J].中国医学伦理学,2009(1):51-52. [15] 张锐敏,冯忠堂,张力群.海洛因等阿片类物质依赖的临床诊断与治疗[M].太原:山西科学技术出版社,1999:399-411. [2006] 256号. -
点击查看大图
计量
- 文章访问数: 781
- HTML全文浏览量: 212
- PDF下载量: 28
- 被引次数: 0
下载:
