Cross-cultural adaptation of the drug-taking confidence questionnaire drug version for use in Brazil

Patterns of substance use recovery following residential treatment: A repeated measures latent profile analysis

INTRODUCTION

Ongoing improvement to residential treatment for substance use disorders is critical as it typically targets people with the highest need. Assessing multiple recovery indicators, such as cravings and mental health, at intake and following discharge is important in evaluating treatment effectiveness. To refine services, research should explore whether there are subgroups of individuals with different patterns of recovery following treatment.

METHODS

Participants (n = 554) were attending Australian Salvation Army residential treatment services for substance use issues. Data were collected by surveys at intake and 3-month post-discharge ('early recovery'). Recovery indicators were cravings, confidence to resist substance use and the Depression, Anxiety and Stress Scale. Subgroups of individuals based on these recovery indicators ('profiles') were identified using repeated measures latent profile analysis.

RESULTS

Five profiles were identified, three profiles improved over time (81.4%) and two (18.6%) deteriorated across all indicators. These two profiles had the poorest mental health and addiction scores at intake and reported shorter time in treatment compared to the three profiles showing improvement. There were no demographic or substance type differences between profiles.

DISCUSSION AND CONCLUSIONS

By considering initial severity and multiple recovery indicators at early recovery, this study suggests that individuals at-risk of poor early recovery can be identified at intake. This opens opportunities for tailored treatment approaches to address both mental health and substance use, thereby potentially improving treatment outcomes and reducing the risk of relapse.

What Client Demographic, Substance Use, Mental Health, Treatment, and Psychological Variables Predict Residential Treatment Completion for Substance Use Disorders?

Residential treatment is a common option for individuals with moderate to severe substance use disorders. In a cohort of individuals who accessed residential treatment, we investigated client demographic, substance use, mental health, treatment, and psychological predictors of treatment completion. Participants were a retrospective cohort of 1056 (15–69 years) individuals admitted to residential treatment facilities across Queensland, Australia, from January 2014 to December 2016. Participant characteristic information was obtained at admission, including the Depression Anxiety Stress Scale 21 (DASS-21). A multiple logistic regression model was conducted with treatment completion as the outcome. The overall rate of treatment completion was 14.3%. Mild to moderate (aOR = 0.48 [0.28–0.84], p = .010) and severe to extremely severe (aOR = 0.35 [0.17–0.74], p = .006) stress on the DASS-21 at service entry was significantly associated with a lower likelihood of treatment completion. Participants with higher levels of stress at service entry were less likely to complete treatment, representing a missed opportunity to provide targeted support during high-risk periods for individuals with substance use disorders. Further research investigating the nature and causes of stress in-between, during, and following presentations to residential treatment is needed.

Post-treatment Outcomes and Changes in Health Literacy of People Discharged from Specialist Substance Use Disorder Treatment Services

Health literacy comprises an individual’s ability to adequately access, understand and utilise health information, enabling effective navigation of the healthcare system. Low health literacy is a problem for people living with substance use disorders (SUDs). This study aims to examine whether health literacy changes for people discharged from specialist SUD treatment services. Two hundred thirty-one people recruited from residential SUD treatment services across New South Wales, Australia, completed a questionnaire upon entry into the service and again at 6 months post-treatment. Treatment outcomes were also measured. Three health literacy profiles were identified: lowest (n = 52, 22.5%), moderate (n = 111, 48.1%) and highest health literacy (n = 68, 29.4%). Lowest and moderate profiles showed improved health literacy at 6 months. However, the lowest profile still had significantly lower health literacy, quality of life and higher levels of psychological distress compared with participants in the highest profile at 6 months. People within the lowest health literacy profile improved, although they continued to experience lower health literacy and some poorer treatment outcomes. Health literacy interventions tailored for people within lowest health literacy profiles should be implemented and assessed for effectiveness within specialist SUD treatment services.

Medication adherence and its correlates among patients affected by schizophrenia with an episodic course: A large-scale multi-center cross-sectional study in China

The Medication Adherence Rating Scale (MARS) is a fast, non-intrusive way of measuring adherence to medication in order to improve the management of patients with schizophrenia. The current cross-sectional study evaluated the reliability of the Chinese (Mandarin) version of the MARS and explored clinical and demographic correlates to medication adherence in a large sample of patients affected by schizophrenia with an episodic course in China. 1198 patients were recruited from 37 different hospitals in 17 provinces/municipalities of China and evaluated with the Medication Adherence Rating Scale (MARS), Clinical Global Impression-Severity of Illness (CGI-SI) and Sheehan Disability Scale-Chinese version (SDS-C). The MARS showed good internal consistency; Cronbach's alpha of total MARS was 0.83. Among the cohort of patients affected by schizophrenia with an episodic course, 28.5 % met the criteria of good adherence to antipsychotic medication; age, steady income, and severity of illness had significant effects on medication adherence. Medication adherence of patients affected by schizophrenia in mainland China was found to be relatively low, calling for urgent attention and intervention. Risk factors for non-adherence to medication among patients affected by schizophrenia with an episodic course include older age, unsteady income, being in the acute period of the disease, and severity of illness.

Structured Relapse Prevention Program for Chinese Patients in Hong Kong with Comorbidity of Substance Use and Mental Health Disorders: A Feasibility Study

The prevalence rate of substance misuse is high among people with mental illnesses. This study adopted an individualized structured relapse prevention program (SRPP) by using an integrative motivational interviewing (MI) and cognitive behavioral therapy (CBT) approach for people with dual diagnosis, i.e., substance use disorder (SUD) comorbid with mental illnesses, in a Chinese population. This study assessed the feasibility of the SRPP and its preliminary effects to provide directions for future wide-scale trials. The program consisted of eight one-to-one interviews conducted weekly. Each interview lasted 1 h. MI was scheduled in the first session, followed by six sessions of CBT and a final session for concluding remarks. The high recruitment and retention rates of the participants indicated that the SRPP was feasible in Hong Kong. Preliminary results reflected a significant increase in self-efficacy to abstain from substance misuse and a decrease in the psychiatric symptoms among the participants with SUD. These effects were sustained 3 months after the intervention. A large sample size and the inclusion of a control group are warranted in future trials to determine the causal relationship between treatment and effect.

ASPECTOS TEÓRICOS E METODOLÓGICOS PARA ADAPTAÇÃO CUTURAL E VALIDAÇÃO DE INSTRUMENTOS NA ENFERMAGEM

RESUMO Objetivo: identificar na literatura os referenciais metodológicos utilizados em estudos de adaptação cultural e validação de instrumentos na Enfermagem. Método: trata-se de uma revisão narrativa da literatura realizada a partir de um levantamento bibliográfico nas bases de dados LILACS, BDENF, IBECS, SciELO e PubMed em agosto e setembro de 2016. Resultados: analisou-se um total de 28 artigos. O referencial metodológico que tem sido utilizado para a adaptação cultural de instrumentos com maior frequência (22-78,57%) é o proposto por Beaton, Bombardier, Guillemin e Ferraz (2007); Beaton, Bombardier, Guillemin e Ferraz (2000) e Guillemin, Bombardier, Beaton. (1993). Esses autores propõem cinco etapas: tradução, síntese, retrotradução, comitê de juízes e pré-teste. A validação é classificada em três categorias: validade de conteúdo, de critério e de construto. Este estudo apontou que os critérios mais utilizados para a validação de instrumentos têm sido a validação de conteúdo (18-64,28%), de construto (13-46,43 %) e a validação de face (9-32,14%). Conclusão: nas pesquisas desenvolvidas na enfermagem tem sido valorizado seguimento de método criterioso com uso de instrumentos confiáveis e válidos. Neste sentido, o presente estudo tratou de referenciais empregados para a adaptação cultural e validação de instrumentos de medida. Identificou-se nos trabalhos os referenciais metodológicos mais empregados, os tipos de validação utilizados e os métodos que devem ser estimulados para garantir a confiabilidade e validade dos instrumentos.