Qualitatively and quantitatively evaluating harm-reduction goal setting among chronically homeless individuals with alcohol dependence.
Qualitatively and quantitatively evaluating harm-reduction goal setting among chronically homeless individuals with alcohol dependence.
复制标题
定性和定量评估患有酒精依赖的长期无家可归者的减害目标设定。
DOI：
10.1016/j.addbeh.2015.02.001
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发表时间：
2015
影响因子：
4.4
通讯作者：
Dean,ParkerE
中科院分区：
文献类型：
--
作者：
Collins,SusanE;Grazioli,VéroniqueS;Torres,NicoleI;Taylor,EmilyM;Jones,ConnorB;Hoffman,GailE;Haelsig,Laura;Zhu,MengdanD;Hatsukami,AlyssaS;Koker,MollyJ;Herndon,Patrick;Greenleaf,ShawnaM;Dean,ParkerE
前言大多数酒精依赖的治疗方案都将戒酒作为首要的治疗目标。然而，基于禁欲的目标并不总是被认为是受影响更严重的人群所希望的或能够实现的，例如长期无家可归的酒精依赖者。由于这些人构成了一个多病态和高利用率的人群，他们需要更有针对性的研究关注，以阐明他们首选的治疗目标。因此，这项二级研究的目的是定性和定量地记录参与者产生的治疗目标方法参与者是目前或以前患有酒精依赖的慢性无家可归者(N=31)，他们参加了一项缓释纳曲酮和减少伤害咨询的试点。在整个治疗期间，研究干预者得出参与者的目标，并将其记录在开放式网格上。在接下来的几周里，目标的进展和实现通过自我报告获得，并由研究干预者记录。采用常规内容分析对参与者产生的治疗目标进行分类。结果在治疗过程中，前三大类别的代表性保持稳定。按照频率的顺序，它们包括与饮酒相关的目标，生活质量目标和与健康相关的目标。在与饮酒相关的目标类别中，参与者一致支持减少饮酒和与酒精相关的后果，而不是基于禁欲的目标。量化分析表明，参与者在治疗过程中产生了越来越多的目标。已实现和进展的目标比例与这一增长保持同步。结论研究结果证实了这样的假设，即长期无家可归的酒精依赖者可以独立产生并实现减少酒精危害和改善生活质量的治疗目标。
IntroductionMost treatment programs for alcohol dependence have prioritized alcohol abstinence as the primary treatment goal. However, abstinence-based goals are not always considered desirable or attainable by more severely affected populations, such as chronically homeless people with alcohol dependence. Because these individuals comprise a multimorbid and high-utilizing population, they are in need of more focused research attention that elucidates their preferred treatment goals. The aim of this secondary study was therefore to qualitatively and quantitatively document participant-generated treatment goalsMethodsParticipants were currently or formerly chronically homeless individuals (N= 31) with alcohol dependence who participated in a pilot of extended-release naltrexone and harm-reduction counseling. Throughout the treatment period, study interventionists elicited participants' goals and recorded them on an open-ended grid. In subsequent weeks, progress towards and achievement of goals was obtained via self-report and recorded by study interventionists. Conventional content analysis was performed to classify participant-generated treatment goalsResultsRepresentation of the three top categories remained stable over the course of treatment. In the order of their frequency, they included drinking-related goals, quality-of-life goals and health-related goals. Within the category of drinking-related goals, participants consistently endorsed reducing drinking and alcohol-related consequences ahead of abstinence-based goals. Quantitative analyses indicated participants generated an increasing number of goals over the course of treatment. Proportions of goals achieved and progressed towards kept pace with this increaseConclusionsFindings confirmed hypotheses that chronically homeless people with alcohol dependence can independently generate and achieve treatment goals towards alcohol harm reduction and quality-of-life improvement.