Y Hpc VigT NAIM T H A N G 10 • S 6 1/2012
giam, tr?i giam, ca sd giio due, trudng giio dudng'. Quyet d|nh sS 910/2004/QO-BCA(X13) ngSy 13/09/2004 ciia B§ trtfdng BJ Cdng an.
B$ Ndi vv-B$ Qudc phdng-Bd T i l chinh-Bd Y t e (1993), " Thdng bf lidn Bd sS: 12/TTLB ngiy 2d/12/1993 cua id ndi vp - Bd QuSc phdng - Bd Tai chinh • Bd Y tS hudng dSn dipt hidn eht dd dn, mjic, d, td chdc phdng, chda bdnh, phdng ngda tai nan iao ddng, bdnh nghi nghidp cho ph^m nhdn'.
Bd Cong an-Bd Y US (2010), " Thdng tdildnBd sd: IH/2010/mB-BCA-BYr n^y 09/0a/2010 eda BdCdngan-Bd Yt£hudng£n dipchidn KCB eho can ph^m nhdn, b^ vidn, hgc sinh iai cic aisdytd
Nhi nude-.
Bd Cdng an ( 2 0 1 1 ) , "BS in phdt diSidSmtfi y tff Cdng an nhdn dSn glal doan 2dll-202li:
Tdng cgc HJu ciSn-K; biu$t, Bd Cdng an.
Ban chi d9o tdng kfft caSng t i c t^m glQ; t^m giam (2008), 'Hudng din vd vide to chdc UH^
hidn tdng Irit cdng tic tam gid', tam giam'. Cong van sd 2302/BCA-Cll cOa Ban chi dao tdng kg cdng tic tam giff, tam giam, Bd Cdng an.
B S Hda Binh ( 2 0 0 4 ) , 'NghUn cHU xiy rt/ng md hlnh tSchdc Idiim chda bdnh cho nhin dn tai cie bdnh vidn Quin ddi". Tap chi Y hgc QuSn SI/ sd d9c san, trang: 87.
THUC TRANG SlJfC KHOE CUA HOC VIEN CAI NGHliN MA TUY TAI TRUNG T A M CHJlA B £ N H GIAO DUC U O DONG XA H 6 I TRUlCrc VA SAU KHI THUC HIEN CAC GIAI PHAP CAN THIEP
va cinh Sdn*, U Vin NhSn"
T 6 M TAT
Sau 3 n3m thu'c hi^n cdc giai phdp can thl|p tal bung tam Phu VSn cho thay, stfe khod cua hgc vien cai nghidn ma tuy dtfde cai thl^n dang ke:
- Ty le hpc vien ttf danh gia stfc khod tot hon mOt chut va tot hdn nhieu tSng, hl^u qud can thl^p dat 42,7 va 23,9%.
- Sd lan dm dau trung binh trong thdng trudc dieu ba thap hon budc can thiep (0,5 I3n so vdl 0,8 lan) vd thap hdn ddi chQhg (0,5 ISn so vdl 0,9 ian).
- Ty le mdc b&ih qua widm b^h ngoai bii gidm:
42,7% so vdl 69,4% budc can thl|p vd 42,7% so vdl 69,0% so vdl ddi chuhg, h l ^ qud can t h l ^ dat 26,5%.
ABSTRACT:
Current situation of health practitioners with drug detoxification In Treatment Center of
labor and social education before and after implementation of intervention measures After three years of imptementatton of lnten«ntion measures in oenbal Phu Van showed that health pracbtioners debixifkabon was signilKantty Improved:
- Percentage of students self-evaluate a llWe better health and better growth, effective Interventions to reach 42.7 and 23.9%.
- Number of Bmes the average stekness In a month
* Sdiao ddng thudng binh va xd hpi TP. Ho Chi Minh
"Sd YteTP. Ho Chlt^inh
Phan bipn khoa hgc: GS.TS. Ddo Vdn DQng 48
befbre die sun/ey is kiwer than before Intervention (0:5 times compared vwtti 0.8 bmes) and tower than tiie cnrtid (0.5 times compared to 0.9 times).
- The rate of Infecbon through reduced medical outpabents: 42.7% compared to 69.4% before intenrention and 42.7% compared to 69.0% oompaied to the control, effective intenrentions to reach 26.5%.
I.
OAT V A Noi
Theo so lieu cua cac cd quan chu'c ndng, hien nay TP. H5 Chi Minh c6 khoing tren 30.000 ngu'di nghien ma tu^ (NMT) dang dtfdc cai nghien tai 20 'Trung tam (TT) ChuB benh giao due Iao dpng xa hpi (CBGDLDXH) thupc Sd Lao d$ng - Thtfdng binh vh XS h§l. Y thiit dtfpc h i l m hpa ma tiiy. Dang bp va chinh quyen TP. Ho Chi Minh da khan trudng thiK thi hang lo^t bidn phap mang tinh chat lau dai va cSp bach dS phdng chong te nan ma tuy.
Uy ban nhan dSn thanh pho da ra Quyet djnh ban h l n h Ke hoach thu'c hien chudng trinh muc tieu phong chong ma tuy; trong do cd muc tieu t$p trung quan |i^ ngudi nghien ma tuy de chiiii trj, phuc hoi sii'c khde va
Y HQC VigT NAM T H A N G 10 - SO 1/2012
nhSn each. Van de quan trong va cap bach la
vi$c kham, ehffa benh, e'hSm sdc va tang ctfdng sii'c khoe de nhffng ngffdi nghien ma tuy_cd day dii sdc khde hpc vSn hda, hoc nghe va iao dpng san xuat. Chiing tdi da tidn hanh nghien cffu nay nham muc tieu: Banh gia thut trang su'c Irhoe eua hoc vien cai nghien ma tuy tal trung tam CBGDLBXH tri/dc vi sau Irhi thi/e hien cie glii phip can thiep.
li. 061 TOgNG VA PHUONG PHAP NGHIEN COU 2.1. Boi tu'dng^ dia diem vi thdi gian nghien cuit
Ddi tudng nghien cffu: Hpc vien cai nghien ma tuy (CNMT) tai trung tam CBGDLDXH.
- Dia diem nghien ciru: TT Giao due Iao dpng xa hpi - Bao trd xa hpi Phii Vdn (gpi tat la Trung tam Phil V5n), ddn vj can thidp. TT Giao due lap dpng xa hdi Phii Dffe (gpi l^t la Trung tam Phu Offc), ddn vj ddi chiing.
Thdi gian nghien cffu: TCrthdng 12/2007 - 12/2011.
2.2. Phu'dng phap nghien cu'u
* Thi^ ke nghien euU: ia nghien aid dieu tra mo ta cdt ngang va can thiep cdng dong cd so sanh budc sau can thiep va so sanh vdi nhom chirng.
* dc phudng phap nghien cud:
- Phdng van hpc vien CNMT bSng bang hoi da chuan bj trffdc.
- Nghien eiid can thiep cpng dong: Ap dung cac glal phap ran thiep, danli gid hi?u qua sau 3 ndm thut hien cac glal phap, glal phdp ran thiep gom:
-1- Tap huan ndng cao trinh dp chuyen mdn nghiep vu cho can bp y te.
+ Truyen thdng - Giao due sffc khoe cho hoc vien CNMT.
+ Bien phap the due - the thao, Iao dpng bien phap.
+ Bien phap tam ly bien phap, vul chdl giai tri.
- Ttnh hieu qua ran thiep: HQCT = CSHQA - CSHQe (CSHQA: chi so hieu qua eiia ddn vj ran biiep; CSHQB: chi sd hieu qua aia ddn vj ddi chuhg).
ili. KlT QuA NGHIEN CCAj
Bing 1. Hpc vien tff danh gia ve tinh hinh sffc khoe ciia minh sau khi vao trung tam CNMT trffdc ya sau ran thiep.
Chi sd ddnh gia
-Van nhtf cij - Kem dl - Tdt hdn mot chiit (*) - Tot hdn nhieu (**) - Khonq blel/KTL
So sanh
Trung tam can thiep Tru'dc CT
n = 362 (1) 18,8 37,9 26,2 8,8 8,3
SauCT n = 300
(2) 27,7 16.0 40,0 15,3 1,0
Trung tam doi chulnq Tru'dc CT n = 434
(3) 23,0 37,3 19,4 6,2 14,1
SauCT n = 300
(4) 28,7 34,4 21,3 9,3 6,3 Pi,zc)<6,001; p 2,4(.)<0,001 p,',,..,<0,05; p ,..„..,<0,05
HQCT
(%)
42,7 23,9
• Tru'dc CT D Sau CT
TSthcnIt Tit hen tinh trsng sOc klio«
nhiSu
Bleu do 1. Hpc vien tff danh gia ve Bnh trang sffc khoe eua minh sau khi vao trung tam trffdc va sau can thiep
Ket qua bang 1 va bleu do 1 cho thay: ty le hpc vien tff danh gia vej:inh hinh sffe__khoe ciia minh
tdt hdn sau khi vao trung tam CNMT tang ien sau ran thiep ed y nghia thdng ke, cu the:
Y HpC VI$T NAM THANG 10 • S 6 1/2012
- Ty 1$ hpc vien dinh gid sffc khod cd tdt hdn m$t chiit tSng tff 26,2% trffdc can thl?p len 40,0%
sau can thl?p vdi p<0,001va cao hdn so vdl doi chiing (40,0% so vdl 21,3%) sff khic biet cd y nghia thdng ke vdi p<0,001, hl$u qud can thl^p d?t 42,7%.
- Ty l | hpc vien dinh gid sffc khod tdt hdn nhiSu tSng tff 8,8% tnidc ran thi?p ien 15,3% sau can thi?p vdl p<0,05 vd rap hdn so vdl doi chimg (15,3% so vdi 6,2%) si/ khde bl$t cd •) nghTa thong ke vdi p<0,05, hi^u qud ran thi^p d^t 23,9%.
Bing 2. Sd lln 5m dau trong thdng trffdc dieu tra ciia hpc vien CNMT t?l trung tSm trffdc vd sau ran thidp.
Chi sd ddnh gid
+ 1 ISn 6m dau (%) + 2 ISn dm dau (%) + 3 ISn dm dau (%) + 4 lan om dau (%) + 5 lan Sm dau hd len(%) + Sd lan dm dau TB (ISn)
Trung tdm can thl^p Tru'dc CT
n = 362 (1) 3,0 1,2 0,3 0,3 0,8 0,8
Sau CT n = 300
(2) 3,5 0,8 0,3 0,3 0,3 0,5
Trung tdm ddi chlinig Tru'dc CT n = 434
( 3 ) 3,2 1,1 0,6 0,4 1,4 1,0
Sau CT n = 300
( 4 ) 3,6 1,0 0,8 0,3 0,8 0,9
So sdnh (P)
P,!<0,01 Pi,.<0,01
Ty le hpc vien cd so ian om trong thang rao (5 lan trd len) gidm so vdi frffdc ran thipp (0,3% s vdi 0,8%) vd thap hdn so vdi doi chiing (0,3% so vdl 0,8%). So lan 6m trung binh ciia hpc vien trong thang trffdc dieu tra thap hdn so vdl trffdc ran thiep (0,5 lan so vdl 0,8 lin) vdi p<0,001 va thap hdn so vdi doi chuhg (0,5 lan so vdi 0,9 lan) vdi p<0,o6l.
Bang 3. Ty le mSe benh ciia hpc vien CNMT qua khdm benh ngpai trii tai trung tSm trffdc va sau ran thiep.
Chiso danh gid
- Ty le mSc benh (*) - Ty le khonq mSc benh
Trung tSm can thl$p Tru'dc CT
n = 362 ( 1 )
69,4 30,6
SauCT n = 300
(2) 42,7 57,3
Trunq tdm ddi chuYig Trudc CT
n = 434 (3)
78,2 21,8
Sau CT n = 300
(4) 69,0 31,0 So sanh 1 p, ,m<0,001; p ,„.,<0,001
HQa (%)
26,5
70 60 SO 40 30 20- 10 0
n Truxyc CT
• Sau CT
^
Bieu do 2. Ty le mSc b^nh cua hoc vien CNMT qua kham benh
ngoai tru tai trung tam truicfc va sau can thi?p
Y HQC VigT NAM T H A N G 10 - S6' 1/2012 Ket qua bang 3 va bieu do 2 cho thay: Ty le
mSc benh cua hpc vien CNMT qua kham benli ngoai tru tai trung t a m , sau can thiep thap lidn so v6i tru'dc can thiep va thap hdn so vdi trung tam doi Chung, cu the: giam tu" 69,4% tru'dc can thiep xuong con 4 2 , 7 % sau can thiep ( d trung tam can thiep) vdi p < 0 , 0 0 1 . Dong th6i t^ le nay d trung tam can thiep cung thap hdn d trung tSm doi chiitig (42,7% so vdi 69,0%), s y khac bi?t cd y nghTa thong ke vdi p < 0 , 0 0 1 , hieu qua can thiep dat 26,5%.
IV. BAN LUiBiN
Sau 3 nam thu'c hien cac giai phap can thiep tai Trung tam Phu Van, diung toi tien hanh danh gia hieu qua can thiep so sanh tnjdc sau can thiep va so sanh vdi dot diutig ta Trung tam Phu Diit.
Ve tinh hinh sii'c khoe ciia hoc vien, nhu"
chung ta deu biet nghien ma tuy la mot tinh trang nhiem doc chat ma tuy, gay ra roi loan d tiliig b6 phan, dan den suy nhutfc toan than, Chat ma tuy t6c dong sdm d a i he thwig than kinh, f m mach, ho hap, tieu hoa, t i S nieu, sinh due... do dd ngudi nghiai ma tuy thudng cd s i i t kheo yeu, cd cau beih aia ngudi nghien ma tuy rat phiit tap, nhu cau kham chife benh cao. Sau 3 nam thut hien cac giai phap cho thay hieu qua ro ret.
Ty Ie hoc vien td danh gia ve tinh hinh sii'c khoe ciia minh t»t hdn sau khi vao trung tam cai nghien ma tuy tang len so vdi tru'dc can thiep va so vdi doi chu^g. Sd khac biet ro y nghTa thong ke, cu the: ty le hpc vien danh gia sii'c khoe co tot hdn mpt chiit tSng tCr 26,2% tru'dc can thiep len 40,0% sau can thiep vdi P<0,001, hieu qua can thiep dat 42,7%. T y Ie hpc vien ty" danh gia sut khoe tcit hdn nhieu tang tiy 8,8% tru'dc can thiep Ien 15,3% sau can thiep vdi P<0,05 va cao hdn so vcfi trung tam khong can tfiiep (15,3% so vdi 6,2%) vdi P<0,05, hieu qua can thiep dat 23,9%. Nhu" vay cd the ndi rang ngay cam giac chii quan ciia chinh doi tu'dng nghien ma tuy cung cho thay sii'c khoe ciia hpc vien nghien ma tuy tai Trung tam Phii Van da co s i / cai thien
dang ke sau can thiep so vdi tru'dc can thiep va so vdi doi chiitig.
So lan 6m dau trung binh ciia hpc vien trong thang tru'dc dieu tra giam trLf 0,8 lan tru'dc can thiep xu6ng con 0,5 lan sau can thiep va thap hdn so vdi doi chiJng (0,5 lan so vdi 0,9 lan).
Oieu n^y cho thay sii'c khoe ciia hpc vien CNMT tai trung tSm Phu V§n (ap dung cac giai phap can thi^p) cd su" cai thien dang ke so vdl tru'dc can thiep va so vdi doi chutig. The hien so lan dm dau trung binh thap hdn va ty le hpc vien co so lan 6m dau nhieu giam xuong. Ty I? hpc vien NMT cd m3c benh qua kham benh ngoai trii giam hdn so vdi tru'dc can thiep (42,7% so vdi 69,4%) vdi P<0,001 va thap hdn so vdi ddi chiing (42,7% so vdi 69,0%) vdi P<0,001, hieu qua can thiep dat 26,5%.
V. K i T LUiBbN
- Ty le hpc vien tu" danh gia s i i t khoe tdt hdn mot chiit va t5t hdn nhieu t§ng, hieu qua can t h i i p dat 42,7 va 23,9%.
- S6 rSn 6m dau trung binh trong thang tru'dc dieu tra thap hdn tru'dc can thiep (0,5 lan so vdi 0,8 lan) va thap hdn ddi chiitig (0,5 lan so vdi 0,9 lan).
- Ty le mac benh qua kham benh ngoai t n i giam: 42,7% so vdi 69,4% tru'dc can t h i | p va 42,7% so vdi 69,0% so vdi doi chiiYig, hieu qua can thiep dat 26,5%.
TAI UEU T H A M K H A O
1. Le' Bach Hong (2008), 7/nh hinh ma OJ^ va cong tac cai nghien phuc hoi dio ngu&i nghien ma tuy d Viet Nam, Hoi nghi chuyen de_ can thi^p giam tac hai trong di/ phong lay nhiem HIV va dieu tn nghien die chat dang thuoc phien.
2. PhCing Quang Thu'c (2004), Thut trang va glal phap nang cao siit khoe ngu'di cai nghien ma tuy bSt huge tai Trung tam Giao due - Lao dgng - Xa hdi so Vf thanh phd Ha Ngi, Luan vSn thac sy y hoc, chuyen nganh Y te cong dong, Hpc vien Quan y, nSm 2004.
3. My H^nh (2009), "Cong tac cai nghien ma tuy tai Trung tam 05 - 05 Lam Dong", Tap chi Phong chong ma tuy, so 8/2009.
