| 摘要: | 自 2005 年開始，衛生福利部積極推動愛滋藥癮減害計畫，自辦理減害計畫及美沙冬替代治療開始，注射藥癮者每年新增愛滋感染呈逐年下降之趨勢。本研究在探討美沙冬戒癮治療執行時之退出治療的相關因素為何？希望有助於提高個案留置，降低流失，進而作為改善之依據。 本研究以南部某精神專科醫院美沙冬門診藥癮個案為樣本，採世代回溯，病歷研究法，從 2010年 1 月 1 日~2013 年 12 月 31 日病歷記錄新收個案，加以條件篩選之後，收集藥癮個案之治療前人口社會學資料等靜態資料及治療中等動態資料，以 T 檢定、變異數分析(ANOVA)及羅吉斯迴歸分析(logistic regression analysis)等統計方法，以統計軟體分析各背景因素與個案退出治療之相關性。 依研究結果推論性統計來看，年齡愈大，海洛因一天使用超過四次的頻率，嗎啡驗尿陽性率(%)介於 76~100%間的比例愈高，留置時間愈短。與家人互動情形愈好，美沙冬最高劑量大於 60 mg 與小於或等於 60mg 相比較，最高劑量愈多，美沙冬喝藥出席率(%)愈高，留置在藥癮治療愈久。未滿半年個案完成高中職以上學歷的比例較低。喝藥天數與各連續變項間之皮爾森相關係數分析，顯著正相關，美沙冬最高劑量及美沙冬喝藥出席率，愈高者，其喝藥天數愈高。顯著負相關，海洛因使用頻率、美沙冬初始劑量、及嗎啡驗尿陽性率，愈高者，其喝藥天數愈低。 本研究發現有靜態資料及動態資料之自變項可做為流失之預測因素。雖然代表性因樣本數少而受限制，但是所收集的資料是美沙冬藥癮個案的紙本病歷及電腦系統病歷資料，統計分析結果具真實性，仍可當作替代治療臨床之參考。
In 2005, the Ministry of Health and Welfare actively promoted HIV drug addiction harm reduction plans. Since the handle harm reduction plans and methadone substitution treatment was started, every annual increase number of HIV infection showed trend to decreased year by year. This study will be focusing on why methadone addiction drop-out during the treatment. This research will be one of the reference for the future improvement. In our study, methadone clinic drug addiction cases were sampled from a psychiatric hospital in southern Taiwan. By using the method of retrospective and medical record research, the medical records were selected from January 1, 2010 to December 31, 2013. Also, the treatment of drug addiction cases, before the sociology demographic information and so on, were collected too. These data would run through the T test,analysis of variance(ANOVA), logistic regression analysis and other statistical methods. The connection with the cases’ background information and the reason of the case drop-out of treatment would be analyzed by statistical software. According to inferential statistical point of view, the greater the age, the percentage of positive for urine morphine was increase between 76% to 100% and the retention time was shorter, when heroin was frequently used more than four times in a day. Interaction with family situation was better. To compare the dose of methadone between more than 60 mg and less or equal 60 mg, taking more dose of methadone, increased the attendance rate of methadone treatment and also maintained longer retention in drug addiction treatment. A lower proportion of cases completed senior high school education under six months of retention. Between take methadone number of days and the continuous variables analyzed with the Pearson correlation coefficient, significant positive correlation, the highest dose of methadone and methadone attendance rate were higher, the more day for taking methadone. On the contrary,significant negative correlation, the frequency of heroin use, an initial dose of methadone and morphine urine positive rate were higher, the less day for taking methadone. Our study found out there were independent variables of static data and dynamic data of the loss that can be used as predictive factors. Although the number of the samples were less resulted representative restricted, the information collected methadone drug addiction cases medical history from paper and medical records of computer system. The result of the statistical analyze was still reliable. It can still be a reference for clinical treatment. |
