藥癮者社會支持、壓力知覺與戒癮改變階段之模式建構

Abstract

本研究探究藥癮者藥癮程度、社會支持、壓力知覺與戒癮改變階段之現況、差異與關係。正式研究以613位受戒治人為樣本。研究者根據文獻建立探索性結構方程模式，並以SPSS及AMOS進行統計分析。 重要研究結果如下：1.不同性別之藥癮者其戒癮改變階段、準備改變分數有差異；2.不同主動戒癮尋求專業治療經驗之藥癮者其戒癮改變階段、準備改變分數有差異；3.藥癮程度構面、社會支持構面、壓力知覺構面與各戒癮改變階段、準備改變分數彼此間多數變項有兩兩顯著相關；4.藥癮程度、戒治時期社會支持、戒治時期壓力知覺與各戒癮改變階段結構方程模式之適配屬適當。在此類模式中，整體效果最大者為戒治時期社會支持對戒治時期壓力知覺失控感的影響；對各戒癮改變階段影響最大者為戒治時期社會支持；5.藥癮程度、預期出所後社會支持、預期出所後壓力與各戒癮改變階段結構方程模式之適配屬適當。在此類模式中，整體效果最大者皆是預期出所後社會支持對預期出所後壓力的影響；而藥癮程度對各戒癮改變階段影響效果最大。預期出所後社會支持、預期出所後壓力對沈思期、行動期、維持期未具顯著影響力；6.藥癮程度、整體社會支持、整體壓力知覺與各戒癮改變階段之原始結構方程模式之適配屬適當。預期出所後社會支持、預期出所後壓力僅對懵懂期有直接效果；7.藥癮程度、整體社會支持、整體壓力知覺與各戒癮改變階段之修改後結構方程模式之適配屬適當。在此類模式中，藥癮程度、戒治時期社會支持、戒治時期壓力知覺等潛在變項對各戒癮改變階段皆具有直接影響；預期出所後社會支持、預期出所後壓力對各戒癮改變階段具間接影響力。影響懵懂期效果最大者為藥癮程度；戒治時期社會支持或戒治時期壓力知覺則對沈思期、行動期、維持期影響效果最大。 研究者根據研究結果提出下列建議：1.建立評估戒癮改變動機之妥適制度，瞭解藥癮戒治者改變動機；2. 協助藥癮戒治者建立社會支持網絡，並延續其至出所；3.協助藥癮戒治者發展良好的壓力因應能力；4.提供個別性的處遇服務，提昇其戒癮改變動機與能力。

This study focused on the status quo, differences, and relationships among the addicts' severity of drug abuse, social support, stress, and stages of change. This research was based on the data collected from the 613 subjects in the Drug Abuse Treatment Centers. The researcher established exploratory an structural equation model by literatures and using statistical analysis to understand. The important findings were as follows: (1) There was significant difference between male and female in the stages of change and in the readiness of change. (2) In the stages of change and in the readiness of change, there was significant difference between the addicts who have and have not sought professional treatment. (3) There were significant correlations between the dimension of severity of drug abuse, dimension of social support, dimension of stress, and dimension of stages of change. (4) The measures and structural models of addiction severity, social support of drug abuse treatment time, stress of drug abuse treatment time, and stages of change had appropriate goodness-of-fit. In such models, social support of drug abuse treatment time had the greatest effects on the sense of losing control, social support of drug abuse treatment time had the greatest effects on stages of change. (5) The measures and structural models of addiction severity, expected social support after release, expected stress after release, and stages of change had appropriate goodness-of-fit. In such models, expected social support after release had the greatest effects on expected stress after release, addiction severity had the greatest effects on stages of change. Expected social support after release and expected stress after release had no direct effect on stage of contemplation, stage of action, and stage of maintenance. (6) The original measures and structural models of addiction severity, social support, stress, and stages of change had appropriate goodness-of-fit. Expected social support after release and expected stress after release had a direct effect on stage of precontemplation. (7) The modified measures and structural models of addiction severity, social support, stress, and stages of change had appropriate goodness-of-fit. In such models, addiction severity, social support of drug abuse treatment time and stress of drug abuse treatment time had direct effects on stages of change. Expected social support after release and expected stress after release had indirect effects on stages of change. Addiction severity had the greatest effects on stage of precontemplation. Social support of drug abuse treatment time or stress of drug abuse treatment time had the greatest effects on stage of contemplation, stage of action, stage of maintenance. Based on the findings, the researcher made the following recommendations: (1) establishing a system of assessment for understanding the drug addicts' motivation of change; (2) assisting the drug addicts in establishing a social support network and continuing it after release; (3) assisting the drug addicts in learning to cope ; (4) giving individual treatment for enhancing their motivation and ability to change.