心理干预对美沙酮维持治疗患者康复及家属心理健康状况的影响

Effects of mental intervention on the rehabilitation of patients with methadone maintenance treatment and the mental healthstatus of their families

目的探讨心理干预对美沙酮维持治疗患者康复及家属心理健康状况的影响。方法将368例美沙酮维持治疗患者家属随机分为两组，研究组168名，对照组200名，两组均接受常规美沙酮维持治疗服务指导，研究组在此基础上予以集体与个别相结合的家庭心理干预治疗，观察1a。于心理干预前及干预1a末，对两组家属采用流凋中心用抑郁量表、焦虑自评量表、家庭负担会谈量表和自编认知状况调查表进行测评分析，对啊组治疗者采用功能失调性状况评定量表进行测评分析，并统计两组患者的服药依从率、复吸率。结果干预后研究组家属焦虑自评量表、流调中心用抑郁量表、家庭负担会谈量表评分均较干预前显著下降（P〈0．01），且显著低于对照组（P〈0．01）；对照组家属仅焦虑自评量表评分较治疗前显著下降（P〈0．01）。干预后研究组家属对美沙酮维持治疗的康复作用、戒断症状、护理技能的不了解率较治疗前显著下降（P〈0．01），且显著低于对照组（P〈0．01），对照组家属各项目评定与干预前比较差异无显著性（P〉0．05）；干预后研究组患者服药依从率显著高于对照组（P〈0．01），年复吸率和功能失调性状况评定量表总分均显著低于对照组（P〈0．01）。结论心理干预不仅能解除家属的诸多思想顾虑、提高应对措施，也能提高美沙酮维持治疗患者的治疗依从性，降低复吸率，促进心理和社会功能恢复。

Objective To explore the effects of mental intervention on the rehabilitation of patients with methadone maintenance treatment （MMT） and the mental health status of their families. Methods 368 families of patients receiving MMT were divided into research （n= 168） and control group （n= 200）, both groups received serving guidance of routine MMT, and research group did group plus individual family mental intervention additionally for I years. Before mental intervention and at the end of 1 year, assess- ments were carried out with the Center for EpidemiologicaI Studies Depression （CES-D）, Self-rating Anxi- ety Scale （SAS）, Family Burden Interview Scale （FBIS） and Self-made Cognition Questionnaire （SCQ） in families, with the Dysfunctional Attitudes Scale （DAS） in patients and patients＇ drug compliance and re- lapse rate added up. Results After intervention, families＇ SAS, CES-D, FBIS score lowered more signifi- cantly compared with pre-intervention in research group （P〈0.01） and than in control group （P〈0.01） ; only families＇ SAS score lowered more significantly compared with pre-intervention in control group （P〈 0.01）. After intervention, the rate of unfamiliar with MMT rehabilitative action, withdrawal symptom and nursing skills lowered more significantly compared with pre-intervention in families of research group （P〈20.01） and than in ones of control group （P〈0.01）, there were no significant differences in each item assessment between pre- and post-intervention （P〉0.05） ; after intervention, patients＇ drug compliance rate was significantly higher （P〈0.01） and annual relapse rate and the DAS total score lower （P〈0.01） in research than in control group. Conclusien Mental intervention can not only relieve families＇ concern and improve coping measures, but improve patients＇ treatment compliance, lower relapse rate and promote psychological and social functional rehabilitation.