Involving drug users in treatment decisions: An exploration of potential problems
Involving drug users in treatment decisions: An exploration of potential problems
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DOI：
10.1080/09687630701391604
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发表时间：
2008-01-01
影响因子：
1.9
通讯作者：
Neale, Joanne
中科院分区：
文献类型：
--
作者：
Fischer, Jan;Neale, Joanne
目的：本文探讨了试图让非法药物使用者参与自己的治疗决策时可能出现的问题。方法：在两家专业社区处方机构和两家住宅康复机构进行半结构化访谈（n = 187）。 79 名新治疗客户接受了采访，其中 59 人在三个月后接受了重新采访。还对 27 名机构工作人员和 22 名转介吸毒者接受治疗的个人进行了访谈。结果：实施吸毒者参与戒毒治疗决策的困难可分为五个大标题：（1）吸毒者的感知特征、需求和期望； （二）专业人员的态度； (3) 治疗遭遇的动态； (4)治疗方案设计； (5) 影响服务提供的结构性因素。结论：虽然让吸毒者参与治疗决策是可以实现的，但问题可能是巨大且复杂的。更多财政资源，以增加治疗方案的可用性和可及性；改善服务提供商与其客户之间的沟通；对教育、培训和技能发展的投资都可以潜在地促进客户参与。尽管如此，全面参与决策的一些限制可能是不可避免的，甚至是必要的。
Aims: This paper explores the problems that can arise when trying to involve illicit drug users in decisions about their own treatment. Methods: Semi-structured interviews (n = 187) were conducted in two specialist community prescribing agencies and two residential rehabilitation agencies. Seventy-nine new treatment clients were interviewed, and 59 of these were re-interviewed three months later. Interviews were also conducted with 27 agency staff and 22 individuals who had referred the drug users into treatment. Findings: Difficulties in implementing user involvement in drug treatment decision making could be grouped under five broad headings: (1) the perceived characteristics, needs and expectations of drug users; (2) the attitudes of professionals; (3) the dynamics of treatment encounters; (4) treatment programme design; and (5) structural factors affecting service provision. Conclusions: While involving drug users in treatment decisions is achievable, the problems can be substantial and complex. More financial resources to increase the availability and accessibility of treatment options; improved communication between service providers and their clients; and an investment in education, training and skills development can all potentially promote client participation. Nonetheless, some constraints to full involvement in decision making are likely to be inevitable and even necessary.