Dynamic effects among patients' treatment needs, beliefs, and utilization: a prospective study of adolescents in drug treatment.
Dynamic effects among patients' treatment needs, beliefs, and utilization: a prospective study of adolescents in drug treatment.
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患者治疗需求、信念和利用之间的动态影响：青少年药物治疗的前瞻性研究。
DOI：
10.1111/j.1475-6773.2005.00399.x
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发表时间：
2005
影响因子：
3.4
通讯作者：
Morral,AndrewR
中科院分区：
文献类型：
--
作者：
Schell,TerryL;Orlando,Maria;Morral,AndrewR
目的：记录药物使用问题、药物治疗的使用和被认为可以增加治疗利用率的易患信念之间的前瞻性、互惠关系。数据来源。由药物滥用治疗中心进行的青少年持续性治疗研究(PETS-A)。这是一项纵向研究，最初参与了两项CSAT研究中的一项；一个样本包括476名接受住院药物治疗的青少年，另一个样本包括519名接受门诊治疗的青少年。研究设计：本研究使用12个月期间收集的五波数据来检验四个变量之间的时间关系：治疗剂量、药物使用问题、耐药性自我效能和感知治疗需要(PNT)。这项纵向研究的数据使用交叉滞后面板模型进行分析，并使用结构方程建模技术来估计两个样本中这四个变量之间的前瞻性、互换关系，同时控制几个协变量。主要发现：PNT和低耐药性自我疗效均导致后续治疗水平较高。然而，低自我效能感预示着药物问题的增加，而PNT则预示着药物问题的减少。结论：对于心理障碍来说，理解心理变量在卫生服务利用中的作用是复杂的，因为影响治疗的信念也会影响疾病本身。让青少年继续接受药物治疗的努力应该集中在让年轻人相信治疗可以帮助他们解决问题，而不是让他们相信他们不能独自抵抗药物。虽然这两种信息都提高了治疗的利用率，但后一种信念破坏了治疗的效果。
Objective.To document the prospective, reciprocal relationships among substance use problems, utilization of drug treatment, and predisposing beliefs thought to increase treatment utilization.Data Source.Persistent Effects of Treatment Study‐Adolescent (PETS‐A), conducted by the Center on Substance Abuse Treatment. This was a longitudinal study of youths originally participating in one of two CSAT studies; one sample included 476 youths receiving residential drug treatment, and the other included 519 youths receiving outpatient treatment.Study Design.This study uses five waves of data collected over a 12‐month period to examine the temporal relationships among four variables: treatment dose, substance use problems, drug resistance self‐efficacy, and perceived need for treatment (PNT). Data from this longitudinal study were analyzed using cross‐lagged panel models, and structural equation modeling techniques were used to estimate the prospective, reciprocal relationships among these four variables in each of the two samples, while controlling for several covariates.Principal Findings.Both PNT and low drug resistance self‐efficacy led to higher levels of subsequent treatment. However, low self‐efficacy presaged increases in drug problems while PNT predicted decreases.Conclusions.Understanding the role of psychological variables in the utilization of health services is complicated for psychological disorders because beliefs that affect treatment can also influence the disorder itself. Efforts to keep adolescents in drug treatment should focus on convincing youth that treatment can help them with their problems, rather than convincing them that they cannot resist drugs on their own. While both messages increase treatment utilization, the latter belief undermines the effects of treatment.