@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2015;1(4):22-31

Background
While the world's population is passing the seven billion people, more than 230 million people are suffering from substance abuse and more than 200 thousand people a year die because of drug abuse in the world [1].
Previous Studies
…[2-6]. Addiction treatment requires the use of a variety of behavioral and pharmacological approaches [7].…[8-17].People are in different levels of readiness and motivation to change behavior. Model of stages of changing behavior raises five distinct stages to change the behavior including pre-contemplation, contemplation, preparation, action and maintenance [18, 21, 22, 24]. …[ 25, 26].
Aim(s)
This study aimed to determine the factors related to addiction and compliance with various constructs in health education models.
Research type
This study is a qualitative research of inductive content analysis by Graneheim and Lundman methods [27].
Research society, place and time
Research society consisted of 8 drug rehabilitation clinics in Bojnourd.Participants in this study included of 21 persons from three groups of patients, doctors and experts, including 8 patients, 6 doctors (three psychiatrists and three GP) and 7 experts who were psychologists employed at drug rehabilitation clinics. This study was done in 2014.
Sampling method and number
Sampling to selecting participants was purposive until data saturation.Patients participating in the study in 2014 were selected through referrals to addiction treatment clinics. Doctors and experts Selection criteria included having experience working in the addiction treatment clinics.
Used devices&materials
The method of collecting data was semi-structured and open interviews with each of the participant.As well as open and clear questions, in order to more explanation, fully concentrate on the issue, active participation of participants was used to increase the reliability of the findings. Participants were asked about the cause of referring to clinic and effective factors at the beginning of rehabilitation of addicted person. To deepen the statements of the participants, it was necessary to ask them more questions and explanation. Every interview lasted about 40 minutes. The time of interview was set in coordination with the participants. The interviews continued until the extraction of new data, and data saturation. Statistical Analysis: For content analysis of qualitative data, the following steps suggested by Granhaym and Landman were used [27]. A) Transcription of the entire interview after interview B)Reading the text for general understanding C)Determining the meaning units and primary codes D)And determining the similar primary codes in the more comprehensive categories Then, the underlying content in the classified data was determined based on previous studies and related theories.The initial codes were exchanged by some of the participants, and the relevance of them were compared. The results were controlled with the people who had quality experience and information in the field of drug rehabilitation research.
Findings by Text
Participants included 8 patients referred to rehab clinics with a history of drug use between 2 and 15 years, and under treatment, six doctors (three psychiatrist and three GP) with 2 to 12 years of experience in the field of addiction treatment and 7 experts in psychology with at least one year and a maximum of 10 year experience in the addiction clinics. Participants aged between 25 and 50 years. In terms of gender,four patients were female; four patients were males;of doctors, five were male and one was female; three experts were men and four were women. The participants' level of education was different from primary school to PhD. Four main themes were identified as factors related to drug rehabilitation that are applicable by the constructs of perceived threat, perceived barriers to consumption persistence, attitude to the behavior and subjective norms. The first two constructs have been considered in Health Belief Model.Attitude and subjective norms have been emphasized in the Theory of Planned Behavior and the Theory of Reasoned Action. Each of these themes has different and diverse classes. The details and results of the data analysis have been shown in Table 1. Perceived barriers to Continuous Consumption: This theme has two classes and several sub-classes that included economic problems and concerns arising from the drugs. Perceived threat: This theme had three classes of personal, family and society complications. Subjective norms: a person in him/his social network is affected by numerous people. Some of these references are confirming and some are inhibitors of performing the desired behavior. Subjective norms are related to belief and thinking about how the important people in life tend the person to act and this attention to their request will lead to certain outcomes [22, 28]. If a person believes that the most important people confirm his/her desired behavior, he/she is more likely to have behavioral plans. .Two classes are important in this theme: attention to family`s expectations and considering social status. Attitude toward a behavior: Doing or not doing behavior is directed toward personal judgment. Therefore, beliefs are effective in the formation of attitudes as well as the outcomes and their evaluation. If a person considers a behavior useful, he or she will do it, and if deems it harmful behavior, refuses to fulfill it 29]. In fact, the attitude toward the behavior depends on positive or negative assessment of the individual behavior [23]. Individual beliefs toward addiction and giving values to rehabilitation are the two main classes of this theme.
Main comparison to the similar studies
… [29]. Tavakoli has pointed out to financial problems in case of preparing drugs,economic and social problems as the barriers to persistence the addiction, in favor of drug rehabilitation.[15,30]…[31,32]. Perceived threat in addition to the individuals’and their family’s perception of the person’s vulnerability refers to personal beliefs about the extent of the damages that threats a person [18, 22, 23, 28]. Several studies express that the factors that lead people to drug rehabilitation way include: knowledge of the consequences of consumption, and its negative impact on self and others,fear of legal problems,fear of losing face,the loose of job and drawn into illegal acts,fear of jail,problems for marriage and employment.…[33-36].
Suggestions
It is suggested that in the future studies, relating factors to persistence of abandon and related constructs be studied.
Limitations
The most important limitation of the study was limited time of attendees, especially patients in the clinic, because the participants were attending the clinic for medical affairs, and it was difficult to adjust the time of the interview.
Conclusions
Various factors related to beginning of drug rehabilitation are compatible with some health education models constructs Including the perceived threat, perceived barriers to consumption persistence, subjective norms, attitudes and behavior
Acknowledgments
Thanks to the cooperation of all those who participated in this research.
Conflict of interest
Non-declared
Ethical Permissions
Participating was voluntary. The participants were explained about the purpose of the study and confidentiality of data. For recording the voices and note taking, the participants’ oral permission was taken.
Funding Sources
This study is part of the doctoral thesis on health education named “The design and evaluation training package affecting the persistence of drug rehabilitation”approved by Tarbiat Modares University on 3/23/2014with the number D/52/4470.

TABLES and CHARTS

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