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研究生:簡佳璋
研究生(外文):Chia-Chang Chien
論文名稱:接受美沙冬替代療法之海洛英依賴個案性需求探討
論文名稱(外文):Sexual desire of Methadone replacement therapy in heroin dependence subjects
指導教授:朱元祥朱元祥引用關係
指導教授(外文):Yuan-Hsiang Chu
學位類別:碩士
校院名稱:樹德科技大學
系所名稱:人類性學研究所
學門:其他學門
學類:其他不能歸類之各學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:95
中文關鍵詞:海洛因、性需求、美沙冬
外文關鍵詞:heroin addictionsexual desiremethadone replacement
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本研究的主要目的在了解接受美沙冬替代治療與否之海洛因使用者的人口學分佈、人格特質、雙親教養態度、評估其心理健康狀況相異性並且探討接受美沙冬替代治療後影響性需求的相關因素,方法:本研究以立意取樣,採描述性研究法與個案對照研究法,利用雙親教養態度(PBI)、人格特質(EPO)、述情障礙(alexithymia)、華人健康問卷(CHQ) 及性需求(SDI)收集資料,研究樣本為男性139人,女性27人,並進一步分析實際參與每個月追蹤的個案其性需求變化,研究樣本為男性65人,女性10人,為期三個月。結果:綜合本研究結果顯示Drop out (退出組)與 case (個案組)個案的教育年限(p=.08)與精神健康狀態(p=.044),人格特質中的神經質(p=.05),雙親教養態度中的父親扮演關懷角色(p= .017),代表無法接受美沙冬規則治療的個案其具有較低的教育年限,有較差的精神健康狀態,亦具有高神經質的人格特質,而父親的關懷角色亦扮演重要的地位,以及整體性需求方面,發現海洛因個案與人格特質中的外向性以及雙親教養中的父保護具有相關性分別為整體性需求和艾氏人格量表內外向性(EPO-E) 呈現中度正相關(p<.05);父親保護呈現中度負相關(p <.05)。進一步分析發現,性需求頻率、一般性性需求、教育年限、父親關懷為有無再次收案的預測因素。另外將接受美沙冬治療之個案組納入廣義線性模式分析(GEE),發現顯示性需求在使用美沙冬治療前後有統計學上顯著的差異(p=.018)且呈現正向改善的趨勢。另外,發現性需求會受到個案的性別與教育年限交互作用(p=.01),使用年數(p=.002),注射毒品之頻率(p=.001)有相關。結論: 因此可以預測個案接受美沙冬治療後可以改善海洛因依賴個案的性需求低下問題,如此在門診評估或是接受美沙冬治療初期便可了解,個案之屬性及未來可能針對性需求問題會有預期之治療效果。

Purpose: The main purpose of this research is to understand whether or not methadone replacement therapy has differing effects between the demographics, personalities, and parental bonding instrument for populations of heroin users. Furthermore, we discuss the effect of methadone replacement therapy on sexual desire.Methods: In this purposive sampling study, we utilize the descriptive research method and case control study. Data was collected for Parental Bonding Instrument (PBI), Eysenck Personality Questionnaire (EPQ), alexithymia, Chinese Health Questionnaire (CHQ), and sexual desire inventory(SDI). Result: The sample population consisted of 139 male and 27 female subjects. 65 male and 10 female subjects were then followed monthly for three months for further analysis in changes in sexual desire. This research showed statistical significance between the drop out group and the case group for educational level (p=.08), mental health status (p=.044), personality trait of neurosis (p=.05), and the role of paternal care in the parental bonding instrument (p=.017). This represents that the cases that did not accept regular methadone treatment had a lower educational level, poorer mental health status, and a higher incidence of neurotic and psychotic personality traits. The research showed a moderately direct correlation between extroverts of the EPQ scale and sexual deisre ( p<.05), and a moderately inverse correlation between paternal protection and libido ( p<.05) in cases of heroin users. Further analysis showed the frequency of sexual needs, sexual desire, level of education, and paternal care to be predicting factors for the factors of re-enrollment in the study. Moreover, upon using generalized linear regression analysis (GEE) on cases who received methadone treatment, a direct and improving correlation was found in sexual desire of cases pre and post treatment with statistical significance (p=.018). Furthermore, the results showed that sexual desire is affected by gender and level of education (p=.01), years of usage (p=.002), and frequency of drug injection (p=.001). Conclusion: Therefore, we can predict that the issue of decreased sexual deisre experienced by heroin users may be improved after methadone treatment; moreover, after carrying out clinical evaluations and primary methadone treatments, we have reached the preliminary conclusion that, in the future, efficacious treatment may be anticipated for heroin users experiencing sexual desire problems.

中文摘要 I
英文摘要 II
誌謝 IV
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 3
第三節 重要名詞釋義 5
第四節 研究假設 7
第五節 研究限制 8
第二章 文獻探討 9
第一節 海洛因依賴 9
第二節 美沙冬替代療法 14
第三節 性需求概念 18
第四節 海洛英藥癮及美沙冬替代治療產生的性功能問題 24
第三章 研究方法 29
第一節 研究架構 29
第二節 研究假設 31
第三節 研究對象 32
第四節 研究工具 34
第五節 實施程序 37
第六節 資料處理 38
第四章 研究結果 40
第一節 為退出組(drop out)與個案組(case)人口學資料 40
第二節 為個案組(cases)與退出組(drop out cases)之雙親教養、人格特質、述情障礙、精神健康狀態差異性分析 52
第三節 人格類型、述情障礙與雙親教養態度間及整體性需求間之關係 55
第四節 有無意願接受美沙冬治療之預測因子 58
第五節 廣義線性模式(Generalized Estimating Equation Models)分析結果 59
第五章 討論 61
第一節 海洛因與性需求之探討 62
第二節 性需求、物質濫用與性別及教育程度差異 64
第三節 性需求與雙親教養之相關性 65
第四節 性需求與個人特質之相關性 66
第六章 結論建議 67
第一節 結論 67
第二節 建議 69
第三節 優勢與限制 71
參考文獻 72

圖目錄
圖2-1 台灣地區濫用藥物尿液檢驗統計圖 10
圖3-1 接受美沙冬替代治療與否之海洛因依賴個案與性相關之研究架構 29

表目錄
表2-1-1 美沙冬常見副作用及原因 16
表4-1-1 有無再次收案與人口學變項之比較 48
表4-2-1 Drop out 組與case組雙親教養態度教養、人格特質、述情障礙、精神健康狀態、性需求之T檢定比較 54
表4-3-1 影響整體性需求之人格類型述情障礙與雙親教養態度相關因素 57
表4-3-2 線性迴歸儉吝模式父親保護為影響性需求的預測因子 57
表4-4-1 Logistic迴歸儉吝模式性需求頻率、一般性性需求、教育年限及父親關懷為Drop out的預測因子 58
表4-5-1 整體性需求與美沙冬治療時間、使用年數、使用毒品頻率及年數、性別與教育年限相關性 60

附件目錄
附件1 研究問卷施測同意書 86
附件2 基本資料表 87
附件3 華人健康問卷 88
附件4 艾氏人格問卷(成人版) 90
附件5 雙親教養態度評量表 91
附件6 台灣版多倫多述情量表 93
附件7 性需求量表 94

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