THE EFFECT OF A MOTIVATIONAL INTERVIEWING ......Amphetamine dependence Emotional & Behavior problems...
Transcript of THE EFFECT OF A MOTIVATIONAL INTERVIEWING ......Amphetamine dependence Emotional & Behavior problems...
Klansuwan A, M.N.S., RN*
Takviriyanun N, Ph.D, RN**
Jirapramukpitak T, MD, Ph.D*** *Princess Mother National Institute on Drug Abuse Treatment,
**Faculty of Nursing, Thammasat University
***Faculty of Medicine, Thammasat University
THE EFFECT OF A MOTIVATIONAL INTERVIEWING TOGETHER WITH COGNITIVE BEHAVIORAL THERAPY PROGRAM ON THE ADHERENCE
BEHAVIORS OF AMPHETAMINE DEPENDENCE PATIENTS IN ONE TREATMENT CENTER
IN PATHUM THANI PROVINCE
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Amawasee KlansuwanSenior Nurse Princess Mother National Institute on Drug Abuse Treatment
(PMNIDAT)
West Africa appears
to have become an
established source
of the
methamphetamine
The established
market for
methamphetamine in
East and South-East
Asia continues
to grow, while there
are also indications
of increasing
methamphetamine
use in parts of North
America and
Europe.
(UN Office on Drugs and Crime, 2015)
Background and significance of problems
Effect of
Amphetamine
1.Physical and mental symptoms
2.Cognition problems
3. Behavior problems
4. Socio-economic problems
4(Sujittra Ritmontri and Manop Kanatoa, 2513, UNODC, 2015)
Brain addicted
chronic &
relapse disease(Markou & Koob, 1991; Munn &
Wise,1992, NIDA, 2012)
Amphetamine dependence
Emotional &
Behavior problems (NIDA, 2014, Galante , et al.,
2015)
cognitive
distortions(Beck, et al., 1993 )
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No motivation to
quit Amphetamine
dependence
(Jamieson, 2008)Use long time
for treatment(NIDA, 2012)
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Amphetamine dependence need help and appropriate
treatment.
∗ There is no single treatment for all substance abuse patients. UN
Office on Drugs and Crime, 2012 [UNODC])
(Burke, et al., 2003; Dunn, Deroo, & Rivara, 2002; Hettema, et al., 2005, Donovan, Rosengren, Downey, Cox, & Sloan, 2001; Miller, Yahne, & Tonigan, 2003; Mullins,Suarez, Ondersma, & Page, 2004; Schneider, Casey, & Kohn, 2000; Winhusen et al., 2008, Moyers & Houck, 2011)
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MI for prepare patients to another
intensive drug treatment
Objective
This quasi-experimental study was conducted to determine the effectiveness of motivational interviewing (MI) together with cognitive behavioral therapy (CBT) on the adherence behaviors of amphetamine-dependent patients (ADPs).
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∗ The seventy-two samples were ADPs undergoing rehabilitation at a treatment center in Pathum ThaniProvince, Thailand.
∗ The samples were randomized evenly into experimental and control groups.
∗ The latter received only standard care, while the former were given additional MI and eight sessions of CBT.
∗ Data were collected before and after the trial, using questionnaires concerning the adherence behaviors of substance abusers.
METHODS&PARTICIPANTS
∗ The intervention was integrated motivational interviewing and cognitive behavioural therapy plus standard care, which was compared with standard care alone.
∗ —“motivation building”—concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. (Miller et al, 2002)
∗ —“action”—supports and facilitates change using cognitive behavioural approaches. (Beck ,1995, Carroll et al, 1998)
∗ 8 therapy sessions were delivered 3 wks.
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Intervention
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Intervention
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Intervention
∗ SPSS∗ Independent t-test ∗ Chi-Square test∗ Fisher’s Exact test ∗ Descriptive statistics
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The data analyzed.
∗ The results of the study revealed that after the trial, 94.44 percent of the samples had motivation to practice adherence behaviors.
∗ Also, the program was able to improve motivation significantly by changing it from the stage of contemplation to the stage of having motivation (x2=21.34, p<.05).
∗
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Results
Before After
Not change change χ2 p
contemplation 29 (80.56) 2 (5.56) 27 (75.00) 26.07 0.00
Motivational 7 (19.44) 7 (19.44) 0 (0.00)
motivation to practice adherence behaviors.
∗ In addition, the mean score for adherence behaviors after the trial was significantly higher than that before the trial and that of the control group (p<.05).
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Results
the adherence behaviors score
Experimental group (n=36) Control group (n=36)
score M SD scoreM
SD t p
Before 35-140 83-121 103.44 9.73 69-123 103.14 13.34 0.11 0.45
After 35-140 107-139 125.36 13.47 82-127 109.36 7.06 7.06 0.00***
p< .00***
the adherence behaviors
∗ These findings suggest that MI together with CBT is able to improve the adherence behaviors of amphetamine-dependent patients in their rehabilitation at treatment centers. The effect of the program on the adherence behaviors, however, may be extended in future studies with larger samples.
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