博士 / 中山醫學大學 / 醫學研究所 / 100 / The importance and contribution of both the duration of receiving methadone maintenance treatment and the retention in treatment were well established for therapeutic success and better prognosis of heroin dependence. Retention in treatment and its related factors have been the important issues of research in improving the outcome of treatment program of heroin addiction. The rates of retention in treatment in Taiwan were lower than those of Europe, USA and other countries in the world. The goals of our survey were to detect the retention in treatment and its related factors of the patients with heroin addiction after receiving methadone maintenance treatment for one year in two hospitals in middle Taiwan, and the study results could improve the treatement outcome and establish the suitable treatment programs of heroin addiction in the future. The design of our study was a prospective, non-randomized cohort study and survival analysis was used to evaluate the risk factors of drop-out rate and stopping methadone maintenance therapy. Our sample composed of 995 patients with heroin dependence who received methadone maintenance therapy in the clinics of Chung Shan medical university medical center and Tsaotun psychiatric center, and they all agreed to take part in the survey. The measurement of the related risk factors in our study included the Severity of Dependence Scale, SDS (SDS-ch), World Health Organization Quality of Life (WHOQOL) questionnaire, Barratt Impulsiveness Scale, Family APGAR score, and the Center for Epidemiological Studies Depression Scale（CES-D）. The results of our survey showed that the retention in treatment was 65.7% in the third month, 61.7% in the sixth month, 58.6% in the twelfth month, and the drop-out rate was highest during the first 3 months of the treatment. The results of our study also demonstrated that those patients living with the sexual partner or their friends, being female, having no deferred prosecution, using lower dosage of methadone（lower than 60 mg）, poorer family support, higher psychological satisfaction of quality of life may increase the risk of stopping methadone maintenance treatment during the period of one-year treatment. It is important for the therapists to closely monitor those patients who have the above risk factors and it may decrease the drop-out rate. Besides, longer period of cohort study is warranted to study all risk factors, which may have impact on the retention in treatment of methadone maintenance therapy, then it may increase the retention in treatment and improve the treatment outcome. Therefore the treatment goal of decreasing the use of heroin may be achieved.
| Identifer | oai:union.ndltd.org:TW/100CSMU5534048 |
| Date | January 2012 |
| Creators | Ming-Hong, 謝明鴻 |
| Contributors | 賴德仁 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 146 |
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