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研究生: 賴律均
Lai, Lu-Chun
論文名稱: 使用海洛因之C型肝炎感染者在美沙冬與C肝治療之順從性研究
A study of methadone maintenance treatment and hepatitis C treatment adherence amongst hepatitis C infected heroin users
指導教授: 李思賢
Lee, Tony Szu-Hsien
口試委員: 李子奇
Lee, Tzu-Chi
林滄耀
Lin, Tsang-Yaw
口試日期: 2021/07/14
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系健康促進與衛生教育碩士在職專班
Department of Health Promotion and Health Education_Continuing Education Master's Program of Health Promotion and Health Education
論文出版年: 2021
畢業學年度: 109
語文別: 中文
論文頁數: 63
中文關鍵詞: 海洛因C型肝炎美沙冬維持療法服藥順從性
英文關鍵詞: heroin, hepatitis C, methadone maintenance therapy, adherence
研究方法: 次級資料分析
DOI URL: http://doi.org/10.6345/NTNU202101327
論文種類: 學術論文
相關次數: 點閱:153下載:9
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  • 本研究目的是了解藥癮C型肝炎感染者,在美沙冬維持療法與C型肝炎治療之情形,並探討美沙冬維持療法是否提升C型肝炎治療之順從性。本研究透過衛生福利部「替代治療作業管理系統」及醫院所屬「醫療管理系統」之次級資料庫進行分析。針對2017-2020年本國籍,於中部某地區教學醫院曾參與美沙冬維持治療合併C型肝炎感染者,藉由卡方、t-test、複迴歸分析背景變項與治療的關係;而美沙冬參與天數、美沙冬服藥順從性、C型肝炎全口服直接作用抗病毒藥物(directly acting antivirals, DAAs)參與天數,進行相關分析,分析美沙冬參與天數與美沙冬及C型肝炎服藥順從性關係。
    本研究共分析169人,結果顯示,在患者第一次加入美沙冬維持治療時,其服藥順從性與婚姻狀態有顯著差異;患者是否有愛滋在第一次加入美沙冬維持治療時有差異;美沙冬維持治療服藥順從性是否提升C型肝炎治療順從性則無顯著差異。研究建議應鼓勵藥癮者C型肝炎感染者治療C肝,相關醫療人員亦需積極治療藥癮者C型肝炎患者,讓患者可以在治療藥癮的同時C肝也被治癒。

    In this study is examine whether methadone maintenance therapy(MMT) increased hepatitis C therapy adherence among a cohort of hepatitis C people who inject drugs (PWIDs). This study analyzed the secondary database. There were 169 PWIDs participants who accessed MMT from 2007-2020 and participated the hepatitis C treatment in the same hospital.We used the Chi-Squared Test, t-test and multiple regression analysis to examined relationship between demographic variables and hepatitis C treatment and medication adherence of methadone.
    In this study showed that the adherence of the patients with methadone treatment and the marital status were significantly different when they first joined the methadone maintenance treatment; the patients had AIDS were significantly difference when they first joined methadone maintenance therapy; there was no significant difference between the adherence of methadone treatment and the adherence of treatment with hepatitis C. The results of this study suggested that health staffs should encourage PWIDs with hepatitis C treat hepatitis C positively.

    謝辭 i 摘要 ii Abstract iii 目錄 iv 表目次 vi 圖目次 vii 第一章 緒論 1 第一節 研究背景 1 第二節 研究動機 4 第三節 研究目的 6 第四節 研究假設 6 第五節 名詞解釋 7 第二章 文獻探討 8 第一節 藥物濫用之現況 8 第二節 感染C型肝炎之現況 14 第三節 美沙冬維持療法與藥物濫用相關研究 20 第四節 美沙冬維持療法與C型肝炎治療相關研究 25 第五節 服藥順從性研究 27 第六節 小結 29 第三章 研究材料與方法 30 第一節 理論基礎 30 第二節 研究架構 32 第三節 研究對象 33 第四節 研究工具 33 第五節 研究倫理 33 第六節 研究變項操作定義 34 第七節 研究資料處理 35 第四章 研究結果 36 第一節 背景變項與藥物治療相關變項現況 36 第二節 背景變項與C肝治療變項現況 40 第三節 背景變項與美沙冬服藥順從性 42 第五章 結果討論 47 第一節 藥癮者背景變項與C型肝炎治療現況 47 第二節 藥癮者背景變項與美沙冬維持療法相關性 48 第三節 美沙冬服藥順從性與C肝治療服藥順從性之相關性 49 第六章 結論與建議 50 第一節 結論 50 第二節 研究建議 51 第三節 研究限制 52 參考文獻 53

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