预防复吸方案对海洛因依赖者焦虑及自我效能感的影响

Effect of relapse prevention program on the anxiety and self-efficacy in heroin addict

目的:预防复吸的是戒毒的重点和难点,我国目前尚无预防海洛因依赖复吸的有效手段,本研究设计了一套预防复吸方案并评定其对海洛因依赖者的短期效果。方法:对50名劳教海洛因依赖者(实验组)进行为期2个月预防复吸训练和3个月回归社会后干预,另50名劳教海洛因依赖者为对照(对照组),采用成瘾行为严重程度指数(ASI)、焦虑自评量表(SAS)、Beck抑郁问卷(BDI)、自我效能量表、自尊量表(SES)评估干预前后的效果。结果:实验组在焦虑、自我效能感、自尊3个方面改善程度与对照组相比,差异有显著性意义(分别为7.85±6.20和1.07±5.42,t=4.98,P=0.00;3.88±3.60和0.08±2.89,t=5.29,P=0.00;3.83±3.31和0.78±2.55,t=4.58,P=0.00),3个月时的随访结果显示实验组的复吸率低于对照组(分别为63%和83%,χ2=4.54,P=0.03),实验组ASI总分改善程度较对照组相比,差异有显著性意义(分别为0.59±0.75和0.06±0.60,t=4.22,P=0.00)。结论:预防复吸方案可降低吸毒者的焦虑,提高自我效能感和自尊水平,并可有效降低3个月期复吸率,促进其康复,应加强对海洛因依赖者的心理康复训练,以提高戒毒效果。

AIM:The most difficulty and focus of drug dependence treatment is relapse prevention.A relapse prevention program has been designed because no effective prevention intervention is available in China at present,and the short term efficacy of this relapse prevention program for heroin addicts is assessed. METHODS:A relapse prevention program which included 2 months of relapse prevention training and 3 months of aftercare intervention was employed to 50 heroin addicts in Labor Camp(experimental group),and other 50 heroin addicts,who received only the labor correction were as the controls(control group).The addiction severity index(ASI),self rating anxiety scale(SAS),Beck depression inventory(BDI), self efficacy scale and self esteem scale(SES) were used to assess the effect before and after intervention. RESULTS:The improvements of scores of SAS,self efficacy and self esteem in the experimental group were significantly different from those in the control group(7.85±6.20 vs 1.07±5.42,t=4.98,P=0.00;3.88±3.60 vs 0.08±2.89,t=5.29,P=0.00;3.83±3.31 vs 0.78±2.55,t =4.58,P=0.00).The 3 month follow up showed that the relapse rate in the experimental group was lower than that in the control group(63%vs 83%,χ2=4.54,P=0.03),and the total score of ASI in the experimental group(0.59±0.75) had more improvements than that in the control group(0.06±0.60)(t=4.22,P=0.00). CONCLUSION:The relapse prevention program can decrease the anxiety, improve the self efficacy and self esteem of heroin addicts.It also can decrease the 3 month relapse rates and promote the rehabilitation of heroin dependence.It is suggested that psychosocial intervention and relapse prevention should be emphasized in the treatment of drug dependence.