Hỗ trợ tâm lý và kĩ năng cho người cai nghiện các chất dạng thuốc phiện bằng methadone trên địa bàn thành phố hải phòng

HO TRd TAM LY VA KY NANG CHO NGtfCJl CAI NGHIEN
CAC CHAT DANG THUOC PHIEN BANG METHADONE
TREN DIA BAN THANH PHO H A I PHONG
Vu Thi Hanh
Khoa Tdm ly - Gido due hgc
Email: hanhvt@dhhp edu.vn
Ngdy nhgn bdi: 04/12/2017
Ngdy PB ddnh gid: 28/2/2018
Ngdy duyet ddng: 03/3/2018
TOM TAT
Chuong trmh hd frg dieu tri phuc bdi cho benh nhdn cai nghien cac chdt dang thudc phidn
bdng Methadone tren dia bdn Thanh phd da trien khai thye hien duge 02 ndra. Trong do hd tara ly
va ky ndng cho benh nhan da va dang dugc diyc hidn diu dan vd budc ddu thu dugc kit qua khd
quan. Benh nhan da ddn dn dinh tdm ly, Idy Iai niem tin vdi chinh ban than, gia dinh, cdng ddng va
xa hgi. Tuy nhien, benh nhan vdn gap mdt sd khd khdn chua ty gidi quyet dugc, hg van can nhan
dugc su hd trg vd tdra Iy vd ky ndng frong mdt qua trinh lau dai, lien tuc, kien tri va ben bi de ty tin
hon nfta kbi tham gia vao cac boat dgng ttong cgng ddng, xa bdi. Ddc bidt, chinh quyin dia
phuong can ed sy chi dao ey thi ban ddi vdi boat ddng hd frg dilu tn phyc hdi; Cdc Sd, Ban,
Ngdnh, CO quan chuydn mdn cd lien quan can tidp tuc phdi hgp chat che nhdm hd trg cho benh
nhan gdp phdn dam bao trat ty xa hgi va an sinh xa hgi trdn dia ban thanh phd.
Tu khda: hd trg, didu tri phyc hdi chue nang, thude Methadone, benh nhan Methadone.
PSYCHOLOGICAL AND SKILL SUPPORTS FOR DRUG ADDICTS TREATED
WITH METHADONE MEDICINE AT HAI PHONG CITY
ABSTRACT
The program supporting dmg addicted patients freated with methadone withdrawal drug m the
city has been implemented for 2 years. The psychological and skill supports for them have been and
are being carried out regularly and mitially they have obtamed positive effects. Patients have
gradually stabiUzed psychology, regam trust with themselves, family, community and society.
However, they still face sorae diiticulties that are not solved themselves. They still need the
psychological and technical support in a long, persistent process m order to participate into tiie
activities of the community and society more confidendy. Particularly, flie local authorities should

have more specific guidance on rehabilitation freatment. Different units such as the relevant
departments, sections and agencies should continue to work closely together to support those
patients, which helps to ensure the social order and social security in the city.
Keyword:
methadone.

support, rehabilitation freatment. Methadone medicine. Patients with

T^P CHi KHOA HQC, So 27, thang 3/2018

I

45


1. DAT VAN DE
Theo Chi tiii sd 32/CT-TTg 31/10/2014
ciia Thu tudng Chinh Phu vd day manh didu
tri nghidn cac chdt dang thudc phidn bang
thudc thay thi ddng vai trd quan frgng frong
phdng, chong HIV/AIDS, lara giara nhu cdu
su dung ma tiiy vd hdnh vi pham phap luat
lien quan den ma tuy, gdp phdn dam bao an
ninh, frat tu xa hdi, phdt triin kinh te - xd hdi
cua cdc dia phucmg va ca nude. Hidn nay,
khdng it ngudi nghien cac chat dang thudc
phien da cai nghien bdng Methadone. Nhirng
benh nhdn den udng thudc tai cac ca sd dieu
tri Methadone thudng da ed radt thdi gian dai
sii dung cac chat gay nghien nen hg thudng

bi suy nhugc ve the chat, nao bg tdn thuong
nang, tam ly tieu cyc, ty danh mat di nhieu
gia tn sdng vd ky ndng sdng... Viec duy fri
udng lieu Methadone deu ddn giiip benh nhan
nhanh chdng cat con va cd mdt sd bieu hien
phuc hdi ve mat the chat, sue khde. Tuy
nhien, de giiip benh nhan hda nhdp gia dinh,
edng ddng, xa hdi hg edn cd su hd trg td cac
ehuyen gia nhdm khdi phyc ve mat tam ly,
hinh thanh Iai cac gia fri sdng va ky nang
sdng da bi mat. Viec hd frg tdm ly va ky ndng
cho benh nhan cai nghidn bang Methadone
bude ddu cho thay nhung bieu hidn phuc
hdi: benh nhan khdng ty ky thi vd giam ky thi
cua gia dinh, cgng ddng xa hdi; hda nhdp
dugc vdi mgt sd boat dgng trong cdng ddng;
gay dung lai nidm tin vdi gia dinh va xa hdi...
2. CAC KHAI NIEM
2.1. Methadone
Theo Nghi dinh sd 82/2013/ND - CP
ngay 19/7/2013, Methadone cd frong danh
muc cac chat ma tuy dugc dung ban chd
frong vide phan tich, kidm nghiem, nghien
ctm khoa hgc, dieu fra tgi pham hoac frong

46

TRirdNG DAI HQC HAI PHONG

linh vyc y tl theo quy dinh cua ca quan cd

thdm quyin. Theo Vdn ban quy pham cua Bg
Y tl. Methadone dugc ggi chat dang thudc
phien tdng hgp, ed tac dung duge ly tuong tir
nhu cdc chat dang thudc phien khde (ddng
van) nhung khdng gay nhiera dgc he than
kinh tnmg uong vd khdng gay khoai cam 6
lidu dieu tri, cd thdi gian ban buy ddi (trung
binh la 24 gid) ndn ehi su dung 1 lan frong
ngay la du de khdng xudt hidn hgi chung cai.
Methadone cd do dung nap dn dinh ndn it
phai tdng lidu khi dieu frj Idu dai [5.5]. Hidn
nay, thudc Methadone dugc Bg Y te quan ly
chat che va phdn phdi cho cac co sd dilu tri
benh nhan eai nghien cac chat dang thudc
phidn dugc thuc hidn theo mgt quy trinh
nghiem ngat. Qua nghien cuu, cdc nhd khoa
hge da chi ra dieu fri nghien cac chat dang
thudc phidn bdng Methadone cd the giup
ngudi nghidn: giam cam giac them ma tiiy,
gidm tan sudt su dyng cac dang thudc phi^n,
giam cac hanh vi nguy co lay nhiem HIV,
viem gan B, C, cai thidn tinh trang sftc khde,
dinh duong, dimg cac hanh vi pham phap de
kiem tien mua heroin, giiip dn dinh eudc
sdng, cd CO hgi tai hda nhdp vdi gia dinh va
cgng ddng.
2.2. Ngu&i cai nghien cdc ch&t dgng
thuoc phien bang Methadone
Trudc day, nhimg ngudi cai nghien
cac chat dang thudc phien thudng bi gia dinh,

cgng ddng xa hdi ky thi, xa lanh. Tbdi gian
gdn day, vdi sy ra ddi cua nhiing Van ban
phap quy cd lien quan den nhirng ngudi cai
nghien cac chat dang thude phidn vd qua cac
kdnh tmyen thdng, xa hgi da cd nhimg thay
ddi frong nhin nhan ddi vdi ngudi cai nghien,
Theo Nghi dinh sd 90/2016/ND - CP vl Quy
dinh dieu frj nghidn eac chat dang thuoc
phien bdng thudc thay the thi nghien eac chat


dgng thudc phien la mdt benh man tinh cdn
dugc didu tri ldu dai. Cung frong Nghi dinh
nay quy dinh cu tbi ngudi nghien chdt dang
thude phien duge quyen lya chgn tham gia
dieu tri nghien chdt dang thudc phidn tai eo
sd didu tri bode ty cai nghien tai gia dinh,
edng ddng vd vide dilu tri nghidn chdt dang
thudc phidn chi dugc thyc hidn khi ngudi
nghien ty nguydn tham gia dieu tri. Nhu vay,
ngudi cai nghien cac chdt dang thudc phien
bdng Methadone (benh nhdn cai nghien eac
chat dang thudc phien bang Methadone) Id
nhftng ngudi Id thudc vdo cdc chdt dang
thudc phien (cd ngudn gdc ty nhidn, tdng hgp
vd ban tdng hgp cd tac dung gidng thudc
phidn) dugc dieu fri su dyng thudc
Methadone thay tbi, dam bao an toan va sd
dung Idu ddi giiip ngudi benh gidra hoac
ngung su dung chat dang thudc phien.

2.3, Ho trgr t&m /jJ vd ky nang cho
ngu&i cai nghiin cdc chdt dgng thuocphi^n
bang Methadone
Nhimg ngudi radi tham gia cai
nghien bdng Methadone thudng cd tinh trang
sdc khde suy sup, nao bg bi tdn thuong ndng.
Hdu bet nhirng ngudi cai nghien deu cd tam
ly khdng dn dinh, hoang raang, dao ddng.
Ben eanh do, trong thdi gian sd dung chat
gay nghien, de thda mdn can them mudn hg
dd tira raoi cdch de cd tidn mua thudc nen
danh mdt nhiiu gid tri sdng, nhdn each meo
md. Sau mgt thdi gian cai nghien, nlu tudn
thu quy trinh dilu tri nghiem ngat (dd lidu,
dilu chinh liiu, lilu duy fri) ngudi cai nghien
dugc phyc hdi vd thi chdt, giam lidu
Methadone. Tuy nhien, nhiing tbdi quen xdu,
hanh vi lech chudn chua mdt ban Idra eho hg
chua du ty tin dl hda nhdp gia dinh, cdng
ddng xa hdi. Hd frg tdra ly va ky ndng cho
ngudi eai nghien eac chdt dang thudc phien

bdng Methadone la sy ttg giup ky thudt tu
eac chuyen gia tam ly giup ngudi cai nghidn
ty hinh thdnh Iai nhiing ky nang sdng, gia tri
sdng da mat, dan dn dinh tdm ly, bd ty ky thi
ban thdn, tham gia vdo eae boat ddng tai gia
dinh, cdng ddng, xa hgi, ty tin hda nhap ben
vftng khdng tdi su dyng chdt gdy nghidn.
Hd ttg tam ly vd ky ndng cho ngudi

cai nghidn cdn dugc thuc hien lien tuc, deu
dan, ben bi, lau dai. Bdi ddy la qua trinh frg
giup ngudi cai nghien phat huy ngudn lye
cua chinh ban thdn (y thftc mudn thay ddi
ban thdn, khdng mudn Id thudc vdo chdt gay
nghidn, da sd ngudi mac nghien tudi ddi edn
fre...) ty frang bi nhiing hiiu bidt vd cdc
chuan myc xd hgi va gia fri sdng ca ban cua
con ngudi. Tir do, ngudi cai nghidn tin tudng
vao chmh ban thdn cd thi thuc hien dugc
nhiing hdnh vi, vide lam phu hgp vdi nhimg
chudn muc xa hgi thi hidn gia frj sdng tdt
dep. Nhd sy ldng nghe, cam thdng, chia se,
thdu cam cua cac chuyen gia tam ly, nhiing
ngudi cai nghien dugc hoc Id suy nghT, tdm
tu giup hg cam thay ty tin, thoai mdi ddn bd
di thai do ty ky thi ban thdn. Qua cac boat
dgng do chuydn gia tam ly thiit kd vd td
chftc, ngudi cai nghien duge trai nghigm cae
cam xuc tich cyc, dilu nay giup hg cd ddng
lyc mudn the hien hdnh vi, thai do dung ddn
vdi nhiing ngudi xung quanh. Vide hd frg
tdm ly va ky ndng cho ngudi cai nghien edn
thyc hien nhiing boat dgng kit ndi benh nhdn
vdi mdt sd td chftc, ca nhan frong cdng ddng,
xd hdi nhdm phat huy nhftng kiln thftc va ky
nang da khdi phuc hoac hinh thanh ky ndng
mdi d hg. Qua dd, benh nhan thyc hanh cdc
boat dgng giao tidp, tmyen thdng, vdn hda,
van nghd, thd due, thd thao... hg ddn bgc Id

tdm ly tich eye, pha vd thdi quen tmdc day,
ddu franh ban thdn dl vugt qua nhftng khd

TAP CHI KHOA HQC, S6 27, thang 3/2018

4?


khan, khdng hi anh hudng bdi nhirng tdc
ddng xau.
Kdt qud eua qua frinh hd trg ve tam
ly va ky nang eho benh nhdn cai nghidn bdng
Methadone khdng nhin thdy ngay ma nd
dugc thi hien qua su chuyen biln tu nhdn
thuc dung ddn vl cac chuan myc, gia tri xa
hdi din vide ddn khdi phuc lai nhftng xuc
cam, tinh cam tich eye d bdnh nhan. Tft viec
hdi long vl nhiing gia tri sdng vd ky nang
sdng dugc frang bj gdp phdn tao cho benh
nhdn cd ddng luc mudn thay ddi ban thdn, cd
nhu cau tbi hien nhftng hanh ddng tdt dep
vdi gia dinh, cgng ddng, xd hdi. Bidu hien
phuc hdi eua bdnh nhdn khi da tham gia ho
trg dieu tri dugc do bang cdc boat ddng cu
thd d benh nhdn nhu cd viec lam dn dinh vdi
mdc thu nhdp tmng binh khd (so vdi muc
luong tdi thidu cua lao ddng phd thdng trong
xd hdi), tu tin giao tiep, manh dan chia se ve
ban than cimg vdi kiln thuc, ky ndng va cam
xiie khi dugc phuc hdi, khdng ne franh nhiing

vdn de lien quan den chat gay nghien... Dd
cung chinh la ket qua tich cyc cua qua trinh
hd frg tam ly va ky ndng cho benh nhdn eai
nghidn cdc chdt dgng thudc phien bang
Methadone.
3. Hoat dong ho t r o tam ly va ky
nang cho benh nhan cai nghien cac chdt
dang thuoc phien bang Methdone tai
thdnh ph^ Hai Phdng
Chuang frinh didu tri nghidn cac chdt
dang thudc phien bdng thudc methadone
dugc chinh thuc tridn khai thi didm tai Viet
Nam ttr tbdng 4/2008 tai thanh phd Hai
Phdng va Thanh phd Hd Chi Minh. Vdi
nhung thanh cdng ban dau tai 2 thdnh phd, tir
nam 2011 ddn nay, chuong frinh lien tuc
dugc nhan rdng ra nhieu dia phuang tren ea
48

TRirONG D^I HQC HAI PHONG

nudc. Dudi sy chi dao cua Chinh phu, Hai
phdng va nhiiu dia phuong frong cd nudc da
md rgng thera cae co sd dilu tri Methadone,
cimg vdi ddra bao lilu udng Methadone,
ngudi cai nghien cdn dugc hd trg ve tam Iy
vd ky nang. Tft ndra 2015, chuang trinh hd
frg didu tri phyc hdi da duge tidn hanh thi
didm tai co sd dilu tri Methadone Thiiy
Nguyen va ca sd didu frj Methadone Kien

An. Vdi hieu qua budc dau, Uy Ban nhan
dan thanh phd da giao cho Lien Hiep Hoi
Khoa hgc Ky thudt thanh phd Hai Phdng
quan ly Chuong trinh bd ttg dieu tri phue hdi
ddi vdi bdnh nhdn eai nghien tai mgt sd co sd
dilu tri Methdone. Vdi sy quydt tdm cua TS.
Hoang Vdn Kd (Nguyen Phd Chit tich Uy
ban nhdn dan thanh phd Hdi Phdng) va Ban
didu phdi Chuong trinh hd ttg dieu tri phuc
hdi eho ngudi cai nghien cac chdt dang thudc
phien bang Methadone, ndra 2016 Hai Phdng
da cd thdm 4 co sd dieu tri cai nghidn bang
Methadone tai Hdi Phong cd chuang trinh ho
ttg didu tri phuc hdi cho ngudi cai nghien. Tii
thang 4 ndm 2017, Hdi Phdng cd tdng sd 8 cu
sd didu tti eai nghien bang Methadone thuc
hien ehuong trinh hd ttg tam ly va ky nang
cho ngudi cai nghien (Thanh Xuan, Hai An,
Kien An, An Lao, Tien Lang, Ld Chan, An
Hung, Thuy Nguyen).
Qua qud trinh phoi kit hgp vdi Lien
Hiep eae Hgi Khoa bgc va Ky thudt Hai
Phdng, ndm bdt ddc diem va nhu cdu cita
ngudi cai nghidn tai cac co sd dieu tri
Methadone, khoa Tdm ly - Giao due hgc
trudng Dai hgc Hai Phdng da xdy dung
nhiing chuydn dd vdi rauc tidu hudng den
hinh thanh, cung cd eho bdnh nhdn nhung ky
ndng sdng va gid fri sdng ca ban, tren ca sd
dd tilp tuc trang bi cho bdnh nhdn nhiing kJ

ndng sdng ve y thuc frach nhidm vdi chinh


ban than, vdi cac thanh vidn frong gia dinh,
cgng ddng noi benh nhan sinh sdng. Dgc bidt,
frang bi cho benh nhan mdt sd ky ndng gdp
phan giai quydt nhftng vdn dl xa hgi. Hoat
ddng cung cd, phat trien ky nang sdng va gid
tri sdng cho bdnh nhan Methadone hudng
vao eac chuydn de: Lam the ndo dd vui sdng;
Hgc each quan tdm; Ban ldra gi d noi rainh
dang sinh sdng; Quan ly cam xuc ban thdn;
Ban va ma tiiy, HIV/AIDS; Ban vdi mdi
tmdng; Ban vdi ban ddng ddng; Ban vdi vdn
de an todn giao thdng...
Vdi nhiJng chuyen de da trien khai,
frong do chuydn dd "Ban va Methadone"

hudng ddn muc tieu: Nang cao cho bdnh
nhan ky ndng tmyen thdng vd Methadone.
Tren co sd do, giup benh nhan tuyen truyen
vd eai nghien raa tuy bdng Methadone;
Cung ed cho benh nhan niem tin vao thdnh
cdng cai nghidn ma tuy bdng Methadone tu
do gay dnh hudng den nhiJng ngudi dang
sft dung ma tiiy chua cai nghien hoac cai
nghidn ehua thdnh cdng. Sau khi thyc hien
chuyen de "Ban va Methadone" cho bdnh
nhdn tham gia hd trg didu tri phyc hdi tai
08 CO sd, ehung tdi tien hanh khao sat va

thu dugc kit qua danh gid vl mftc do hai
ldng cua hg nhu sau:

Bdng 1. Mirc dQ hdi Idng cua ngirdi cai nghien tham gia ho trgr tdm ly va k^ ndng
trong chuydn dl "B^n vd methadone"

Mftc a§(%)
STT

Ten cff s& dieu tri
R^t hai l&ng

H^i long

Khong hai ldng

1

Thanh Xuan

85

15

0

2

An Hung

90

10

0

3

Kien An

90

10

0

4

An Lao

80

20

0

5

Thuy Nguyen

75

25

0

6

Hai An

95

5

0

7

Le Chan

IGO

0

0

8

Tien Lang

80

20

0

(Ngudn • Tdc gid khdo sdt thdng 11 nam 2017)
Qua k a qua khao sat a Bdng 1 cho M y
khi dugic hS tro kiln thiic va ky nang qua
chuyen di "Ban vd Methadone" benh nhan tai
cac CO so tham gia ho trg diSu tri phuc hdi da
th6 hi6n miic do hai long voi chuyen d i Cac
benh nhan dugc khao sat dSu danh gia a m\ic
do rit hai long va hai long voi chuyen de. Tai

bon eg so: An Hung, KiSn An, Hai An, Le
Chan CO 90% dSn 100% bSnh nhan danh gia rit
hai long voi chuyen de. Qua nghien ciiu truong
hgp benh nhan N.T. H tai eg so di^u tri
Methadone Hai An cho thSy chi H la benh
nhan tham gia dieu tri h6 trg phuc hoi dugc 02
nam, tir mpt nguoi danh m4t h8t gia tri ciia ban

TAP CHI KHOA HQC, Si 27, thang 3/2018

49


tiidn, mdt niem tin vao chinh minh, den nay chi
H da ty tin hon rdt nhiiu, ty tao viec lam va cd

tiiu nhap dn dinh, cd tinh yeu va xdy dyng gia
dmh vdi ban ddng ddng. Trong cae budi thara
gia hd frg dilu tri phuc hdi chi H thudng xuyen
chia sd suy nghi vd cam xuc tich cyc. Khi dugc
hdi diem vl chuyen dl "Ban vd Methadone"
ehi H cho biit sd di chi rdt hdi long vd chuydn
dl bdi qua budi sinh boat, chi va cac ban ddng
ddng dugc chia se nhirng kien thftc vd
Methadone dd dugc trang bi qua cdc dgt tap
budn, ddng thdi cdn dugc bd sung tiiem kidn
thftc mdi. Dac bidt, ehi va cac thanh vidn tham
du chuyen dl hieu dugc rdng cdc bdnh nhan
dang dieu tri cai nghien bang Methadone cdn
cd nhung hanh dgng thidt thyc vd cu the nhu
truyen thdng, xd hgi cdng ich hay nhan dao, tft
thien... de cdng ddng, xd hdi hieu ban ve
Methadone va nhiing bdnh nhan dang dieu tri
cai nghidn bdng Methadone, do edng la each
giup chi va cac ban ddng dang xda bd khoang
each vdi cae thanh vien frong xa hdi.
Trong sd bdnh nhdn cua eo sd didu tri
Methadone Thuy Nguyen thara gia hd frg
dieu tri phuc hdi cd 25% y kiln ddnh gia hdi
ldng vdi chuyen de. Day la ca sd cd sd y kien
danh gia hai long eao nhdt frong 08 co sd tac
gid khao sdt. Dieu nay cho thay mue do hdi
rat hai long cua bdnh nhdn ddi vdi chuydn dd
la thdp nhdt (chiim ti le 75%). Tim hiiu ki
hem ve ket qua ddnh gid frdn cua nhdm benh
nhdn tham gia hd trg didu tri phuc hdi tai co

sd Methadone Thuy Nguyen tap tnmg vdo
mgt sd yeu td: cd 01 thdnh vien tham gia sinh
boat chuyen de ehua thye sy the hidn ki ndng
lang nghe do tdm li ca nhan chua dn dinh;
mdt thanh vien rdi khdi budi sinh boat khi
chuyen de chua kit thdc do cd cdng viec ca
nhdn ddt xuat; vide thyc bidn nhitiig hoat
dgng thyc hanh cua chuydn dl tai cgng ddng

50

TRircUNG DAI HQC HAI PHONG

thyc sy la vdn dl khd khdn (thdi gian, co sd
vat chdt, kinh phi...) ddi voi nhidu thdnh vien
tham gia hd frg dilu tri phyc hdi; e ngai vi sg
khdng nhdn dugc su hd frg, giup dd cita
ehinh quyin dia phuang va ngudi dan. Tim
hieu them cdc co sd khae vd nguyen nhan
danh gia mftc do hai long vdi chuydn dd cung
cho thdy da sd cae nguyen nhdn gidng nhu y
kien ciia benh nhdn thara gia hd frg dieu tri
phuc hdi tai eo sd didu tri Methadone Thiiy
Nguyen. Qua ddy eho thay mac du bdnh nhan
da cd mdt sd bidu bien phue hdi nhung con
gap nhiJng khd khan khi hg ddc lap thuc bien
nhirng boat dgng vi cgng ddng, dieu nay
cung the hien hg vdn chua thyc su ty tin ma
vdn can cd sy tiep tuc hd frg frg dd hda nhap
cgng ddng sdu hon vd hidu qud ban.

Nhu vay, de bdnh nhan tham gia hd frg
dilu tri duge phuc bdi ben vftng, ty tin thi
hien ky nang sdng va gia tri sdng da dugc
khdi phue can ket ndi eac ngudn lye xa hgi
vdi benh nhdn gidra bdt nbftng khd khdn, frd
ngai khi benh nhan thyc hdnh cac boat dgng
phyc hdi tai cgng ddng.
Qua viec phdn tich rafte do hai long
cua ngudi cai nghidn vdi chuyen de "Ban va
Methadone" dd phdn nao cho thdy tdm quan
trgng va y nghTa eua boat dgng hd frg tam ly
va ky nang cho benh nhan. Tuy nhien, de
thuc hanh cac boat dgng phuc hdi frdn dia
ban thdnh phd Hai Phdng, nhirng bdnh nhan
cai nghidn cdc chdt dang thudc phidn bdng
Methadone cdn nd lyc nhidu hon nua de
vuon len frong eudc sdng. Ddc bidt, sy chi
dao ciia chinh quyen thanh phd va vide phdi
hgp cua cae Sd, Ban, Ngdnh lien quan ddi
vdi boat dgng hd trg didu tri phuc hdi tai cac
CO sd dieu tri Methadone la vd eung can
thidt; Dilu ndy la radt frong nhiing ca sd


vftng chdc bd frg cho cdc benh nhan khdng
tdi nghidn vd phyc hdi bin vftng.
4. KET L U ^
4.1. Chuang trinh hd frg tdm ly va ky
nang cho ngudi cai nghien bang methadon
fren dia ban thdnh phd Hdi Phdng tmh din

nam 2017 da thu dugc nhiing ket qua tich
cue. Dieu do eho thdy ben canh sy phuc hdi
vl the chat, benh nhan dd ddn dn dinh vd tdm
ly, budc ddu dn dinh cugc sdng, tao dung
niem tin vdi gia dinh, cgng ddng va xa hgi,
4.2. Vdi muc dich giup benh nhdn phuc
hdi bdn viing, frong vai frd la don vi chuyen
mdn tham gia bd frg phuc hdi, khoa Tam ly Giao due bgc trudng Dai hgc Hai Phdng dd
trien khai cac chuyen de ho frg tam ly vd ky
nang cho bdnh nhan. Day la bidn phap quan
frgng, can dugc thye hien ddu dan, kidn tri
ben bi giup benh nhan timg budc thye banh
nhftng kien thftc, ky ndng dd tich luy duge
vdo frong cac mdi quan he vdi bdn thdn,
ngudi thdn, ban be vd duong dau vdi nhiing
thft thdch ludn ndy sinh frong cu0e sdng.
4.3. Bdnh nhdn thara gia hd trg dieu
tri phyc hdi mac du dd ed nhiing chuyen
biln tich cyc vd tam ly, tim lai dugc nidm
tin vao ban than, gia dinh, xa hdi nhung
van cdn nguy co tai nghien bdi van edn
nhiiu khd khan trudc mdt. Mgt trong nhiing
khd khdn ddi vdi nhftng ngudi tham gia hd
trg dilu tri phye bdi va cd benh nhdn do la
hg ehua thuc sy ty tin thyc hanh cac boat
ddng phuc hdi frong cdng ddng, xa hdi.
cdn cd sy quan tam ban nua eiia chinh
quydn, co quan chuyen radn, cdng ddng, xa
hgi nhdm hd trg bdnh nhan phuc hdi ben
vung, gdp phan dam bdo trdt ty xa bdi va

an sinh xa hgi.

5. MQT SO DE XUAT
Qua vide budc dau danh gia ket qua
eua Chuang trinh hd trg didu tri phuc hdi
cho benh nhan cai nghien cdc chat dang
thudc phign bdng Methadone eho thdy da
thu dugc mdt sd kdt qua dang khich Id.
Trong pham vi cua bai viet, tae gia the
hi$n dugc mgt trong nhftng ngi dung cua
Chuong trinh. Trong qud trinh trien khai
thuc hidn, phan tich, ddnh gid vd boat
dgng hd trg tam ly vd k^ ndng cho bdnh
cai nghien cae chat dang thude phidn bdng
Methadone tac gia ed mgt sd y kien de
xudt, cu the:
5.1. Vd phia chinh quyen thanh phd,
tiep tuc ehi dao cy thd hon ddi vdi cac boat
ddng bd trg didu fri phuc hdi nhu viec ra
cac vdn ban hdnh chinh chi dao, hudng dan
eac CO sd eai nghidn cac chat dang thudc
phidn bdng Methadone trdn dja ban thanh
phd phdi ket hgp vdi cac co quan ehuyen
mdn, xdy dyng vd triin khai kd hoach hd
trg dieu tri phuc hdi cho benh nhan dang
dilu fri tai CO sd.
5.2. Lien Hiep eae Hdi Khoa hgc va
Ky thudt thanh phd Hai Phdng tidp tuc phat
huy vai tid la co quan chuyen mdn, phdi ket
hgp vdi cdc co quan, td chue frong va ngoai

nudc xdy dyng Chuong trinh hd frg dieu tri
phyc hdi cho bdnh nhan nhdra thu dugc kdt
qua cao nhdt.
5.3. Dudi sy cbl dao cua Uy ban Nhdn
ddn Thdnh Phd, cdc ca sd cai nghien cdc chdt
dang thudc phidn bang Methadone tren dia
ban thdnh phd Hai Phdng cdn xdc dinh viec
hd trg tam ly va ky nang cho benh nhan eai
nghidn la mdt frong nhiing hoat ddng hd frg
quan frgng giiip benh nhan khdng tai nghidn
va phdi hgp chdt che vdi co quan chuyen

TAP CHI KHOA HQC, So 27, thang 3/2018

51


mdn frong boat ddng hd frg phyc hdi cho
bdnh nhan.

phyc hdi tai cdng ddng giup bdnh nhan tai hda
nhap ben vung.

5.4. Vdi tu each la bg phan hd ttg ky
tiiuat, khoa Tdm ly - Giao due hgc Trudng Dai
hgc Hai Phdng cdn tilp tuc phdi kit hgp vdi
Lien Hiep cac Hgi Khoa hgc - Ky thuat Thdnh
phd nghien cuu, tim hieu nhiing khd khan eua
benh nhan dang tham gia bd ttg didu tri phuc
hdi, td chue nhirng ehuyen dd thiit thyc, hidu

qua hd frg bdnh nhan tdt hon nfta ve tdm ly va
ky ndng, dac biet la eac boat dgng thyc hanh

5.5. Ddi vdi benh nhdn dang tham gia h6
frg dieu tr| phue bdi can nd luc hon niia de
khde phuc nhiing khd khan va ty tm khi thuc
hanh nhung boat ddng phyc hdi tai cdng ddng.
Vdi sy dn dinh vl tdra ly, nhiing ky naig budc
dau da duge binh thanh, benh nhdn cdn thudng
xuydn tien hdnh cac hoat dgng cd y nghia frong
cgng ddng, xa hdi dd qua trinh phuc hdi dat ket
qua nhu mong mudn.

TAI LIEU THAM KHAO
1. Ld Chi An (2006), Cdng ldc xa hgi cd nhdn, Trudng Dai hgc Md Thanh phd Hd Chi
Minh, Tp. Hd Chi Minh.
2. Bill Thi Xuan Mai, Nguyen Thi Thai Lan, Lim Shaw Hui (2008), Gido trinh tham vdn,
Trudng Dai hgc Lao ddng - Xd hdi, Nxb Lao dgng - Xa hdi, Ha Ndi.
3. Bui Thj Xudn Mai, Nguydn Td Nhu (2015), Gido trinh tham vdn dieu trj nghien ma tuy.
Nxb Lao ddng - Xa hgi. Ha Ngi.
4. Mdt sd Van ban Quy pham phap ludt cd lien quan
5. Chi thi sd 32/CT-TTg 31/10/2014. Thii tudng Chinh Phu ydu cdu cdc tinh, thdnh phd, cac
bg, nganh day manh viec didu tri eai nghidn bdng thudc Methadone.
6. Nghi dinh sd 82/2013/ND-CP ngay 19/7/2013
7. Nghi dinh sd 90/2016/ND -CP Quy dinh vl dilu fri cai nghidn cdc chdt dang thudc phien
bdngMethadone.
8. Thdng frr sd 14/2015/TT- BYT quan ly tiiudc Methadone.
9. Quyit dinh sd 493/QD-BYT eua Bd frudng Bd y t l ngay 18/12/2016 vd Hudng din dilu
tri Methadone frong cdc co sd cai nghidn raa tuy

52

I TRr6NG DAI HQC HAI PHONG