云南省德宏州美沙酮维持治疗海洛因依赖者生存质量及影响因素

Analysis of quality of life and its influencing factors of heroin dependent patients with methadone maintenance therapy in Dehong prefecture, Yunnan province

目的了解云南省德宏州参加美沙酮维持治疗的海洛因依赖者的生存质量，并分析其影响因素。方法于2011年1月对云南省德宏州芒市、瑞丽、陇川、盈江和梁河等5个县（市）正在参加美沙酮维持治疗的海洛因依赖者，按照等比例分层抽样法抽取462例进行现场访谈，使用WHO生存质量测定量表简表（QOL—BREF）进行问卷调查，了解调查前4周调查对象在生理领域、心理领域、社会关系领域、环境领域的生存质量，并结合其入组时收集的基线资料，分析生存质量及其影响因素。结果462例调查对象年龄为（37．80±9．13）岁，男性占97．6％（451／462），女性占2．4％（11／462）。文化程度多为小学（35．93％，166／462）和初中（37．23％，172／462），未婚者占31．39％（145／462），已婚者占58．44％（270／462）。参加美沙酮维持治疗的海洛因依赖者总的生存质量与健康状况得分为（54．11±6．74）分，生理领域的生存质量得分为（14．31±2．23）分，心理领域得分为（13．28±1．79）分，社会关系领域得分为（13．90±2．52）分，环境领域得分为（12．63±1．77）分。年龄在30—40岁之间、未婚、高中或中专及以上文化程度、接受美沙酮维持治疗前吸毒时间大于10年、美沙酮维持治疗时间小于半年、收入来源不是固定工作的调查对象在各领域的生存质量均较低。首次吸毒年龄在16～30岁者生理领域、心理领域的生存质量较低[得分分别为（14．29±2．25）、（13．22±1．84）分]，在接受美沙酮维持治疗前单纯注射使用毒品、注射与其他方式混合使用毒品者在生理领域、心理领域、社会关系领域的生存质量较低[前者各领域得分依次为（13．92±2．25）、（13．08±1．67）、（13．25±2．60）分，后者各领域得分依次为（13．67±2．52）、（13．43±1．71）、（13．80±2．56）分]。结论参加并坚持美沙酮维持治疗有利于改善海洛因成瘾者的生存质量。年龄、婚姻状况、文化程度、吸毒年限、维持治疗持续时间等是影响其生存质量的因素。

Objective To investigate the quality of life of heroin dependent patients with methadone maintenance therapy and its influencing factors. Methods Totally 462 heroin dependent patients who were receiving methadone maintenance therapy in Mangshi, Ruili, Longchuan, Yingjiang, Lianghe of Dehong prefecture, Yunnan province were randomly selected using proportional stratified sampling and interviewed with the WHO Quality of Life-BREF （QOL-BREF） in order to understand their quality of life in the fields of physical, psychological, social relationships, and environmental function during 4 weeks ago before interviewing,and the influencing factors of the quality of life. Results Among the 462 patients,451 patients （97. 6% ） were male and 11 （2. 4% ） were female. Their average age was （37.80 ±9. 13） years old; 145 patients （31.39%） unmarried,270 patients （58.44%） were married; 35.93% （166/462） of patients had primary school education,37.23% （172/462） of patients had senior high school education. The patients had a score of 54. 11 ± 6. 74 for total quality of life and well being and a score of 14. 31 ± 2. 23, 13.28 ± 1.79,13.90 ± 2. 52,12. 63 ± 1.77 for physical, psychological, social relationships and environmental function,respectively. The quality of life for physical, psychological, social relationships and environmental function of the group of patients which ages between 30 to 40, unmarried, high middle school and above education,length of drug addiction more than 10 years before receiving treatment, treatment duration less than 6 months, incoming from temporary job were with lower score for total quality of life and well being. The quality of life for physical, psychological was lower for those aged between 16 and 30 when becoming first time drug user, which scores were 14. 29 ± 2. 25 and 13.22 ± 1.84, respectively. The quality of life for physical, psychological, social relationships of the group of patients which injecting drug only or injecting drug with other manners before receiving treatment were lower, which scores were 13.92 ± 2. 25,13.08 ± 1.67, 13.25 ± 2. 60 for injecting drug only and 13.67 ± 2. 52,13.43 ± 1.71,13.80± 2. 56 for injecting drug with other manners. Conclusion Attending and keeping methadone maintenance therapy could improve the quality of life of heroin dependent patients. Age, marriage status, education, time of drug use, treatment duration may be the influential factors.