背景:美沙冬維持治療已被證明能在靜脈注射海洛因成癮者中,有效地降低傳染愛滋病毒風險。為了讓海洛因成癮者減少使用海洛因,個案需要一個有動機且持續性的行為變化,而此行為變化也成為海洛因治療是否成功的關鍵。在動機階段模式(Transtheoretical Model, TTM)中,動機階段的變化是動態形式,故本研究之目的為調查接受美沙冬維持療法的海洛因成癮者,對於改變使用海洛因行為的動機高低程度,以及與改變動機高低程度相關的因子為何。方法:本研究為一個橫斷面描述性研究,共邀請150位接受美沙冬維持療法的海洛因成癮個案,分別以中文版the University of Rhode Island Change Assessment (URICA)評估個案的改變海洛因使用行為之動機,並以多重迴歸分析檢驗海洛因使用嚴重程度、自覺使用海洛因的優缺點、社會人口學、毒品使用史、是否感染血行性病毒等因子與改變使用海洛因行為動機高低程度的相關性。結果:依據中文版URICA評估接受美沙冬維持療法的海洛因成癮者的改變動機改變程度平均為10.94 (標準差為1.74)。海洛因成癮程度愈嚴重者、認為使用海洛因的優點愈少者、認為使用海洛因的缺點愈多者,改變海洛因使用行為的動機程度愈高。結論:本研究顯示海洛因成癮嚴重度和自覺使用海洛因的優缺點與海洛因成癮者的改變動機高低程度有關,此結果可做為美沙冬維持療法中,提升改變動機介入之參考。
Background: Methadone maintenance therapy (MMT) has been shown to effectively reduce the risk of transmission of Human Immunodeficiency Virus for injecting drug users. Addicts need to keep an intentional and sustained behavior change to decrease heroin use and receive MMT. Therefore, the behavior change is crucial in them. In transtheoretical model (TTM), the stages of change are dynamic variables. This study aimed to explore the level of readiness to change in heroin addicts receiving MMT and the factors associated with the level of readiness to change. Methods:This cross-sectional study enrolled 150 heroin addicts who went to receive MMT. The level of readiness to change heroin-using behaviors was measured by the Chinese version of the University of Rhode Island Change Assessment (URICA). The associations between the readiness to change and the severity of heroin dependence measured by Chinese version of the Severity of Dependence Scale, the pros and cons of heroin use measured by Decisional Balance, demographic data, awareness of being infected by blood born virus and history of illicit drug use were examined by multiple regression. Results:The mean score of readiness to change measured by the URICA was 10.94 (± 1.74). Higher severity of heroin dependence and the more cons and the less pros of heroin use were associated with higher level of readiness to change. Conclusion:The results supported that the severity of heroin dependence, the pros and cons of heroin use were associated with the level of motivation to change heroin-using behaviors. These results may serve as the basis to promote the motivation of people receiving MMT to change their heroin use.