Heroin craving and its correlations with clinical outcome indicators in people with heroin dependence receiving methadone maintenance treatment.

BACKGROUND: Craving for substance use has been added as one of the diagnostic criteria of substance use disorders in DSM-5. However, further research is necessary to examine and expand the clinical potential of craving in the assessment and treatment for heroin users. This study aimed to examine the psychometrics of the Desire for Drug Questionnaire-Chinese Mandarin version (DDQ-CM) and its clinical utility of assessing craving for heroin measured among heroin users with methadone maintenance treatment (MMT). METHOD: Self-reported craving for heroin use was measured on the DDQ-CM and visual analog scale among 314 intravenous heroin users receiving MMT. Self-reported heroin dependence, attitude toward heroin use, readiness to change heroin use, and depression were collected. RESULTS: The results found that although the original three-factor model was acceptable for applying the DDQ-CM for heroin users with MMT, only the concurrent validity of the subscales of Desire and Intention and Negative Reinforcement was supported but not that of Control. Meanwhile, the levels of craving on the subscales of Desire and Intention and of Negative Reinforcement on the DDQ-CM were positively associated with the levels of heroin dependence, positive and negative attitudes toward heroin use, and depression, but negatively associated with readiness to change heroin use. CONCLUSIONS: This study supported the application of the subscales of Desire and Intention and Negative Reinforcement on the DDQ-CM to measure heroin craving in Taiwanese-Chinese heroin users and supported the clinical implication of craving in heroin users with MMT.

Development of a Chinese short form of the Prenatal Self-Evaluation Questionnaire.

AIMS: To develop a short-form version of the Chinese Prenatal Self-Evaluation Questionnaire and to examine its reliability and validity. Background. Health professionals are short of screening instruments, especially in Chinese, to assess adaptation of pregnant women. DESIGN: A cross-sectional research design was used. Pregnant women who visited prenatal clinics in southern Taiwan were recruited for this study. This study was conducted in two phases. The first phase was to develop a Chinese short form of the Prenatal Self-Evaluation Questionnaire, using a convenience sample that consisted of 600 pregnant women. The second phase was to examine the reliability and validity of the short-form Chinese Prenatal Self-Evaluation Questionnaire, and used a convenience sample consisting of 225 pregnant women. Internal consistency and split-half reliability were used to assess reliability. Construct, convergent and discriminate validities were conducted to assess the validity. RESULTS: Item, correlation, factor and cluster analyses were used to eliminate 35 items from the questionnaire and to retain 44 items in phase one. The correlation coefficient between the short-form Chinese Prenatal Self-Evaluation Questionnaire and the original Chinese Prenatal Self-Evaluation Questionnaire was 0.95, indicating that the short-form Chinese Prenatal Self-Evaluation Questionnaire was acceptable. In phase two, 35 items were eventually retained and divided into six factors: concern for well-being of self and baby (seven items), acceptance of pregnancy (six items), identification of a motherhood role (three items), preparation for labour (six items), relationship with own mother (eight items) and relationship with husband (five items), accounting for 50.42% of the total variance. The convergent and discriminant validities were good, because the correlation coefficients between subscales and the total scale as well as between subscales and subscales were 0.57-0.71 and 0.18-0.41 (p < 0.01), respectively. The Cronbach's alpha and split-half reliabilities of the short form were 0.90 and 0.88, respectively. CONCLUSIONS: A 35-item Chinese short form of the Prenatal Self-Evaluation Questionnaire was developed. The results of this study can be used as a measurement tool for widespread, cost-effective clinical assessment and further research. RELEVANCE TO CLINICAL PRACTICE: Use of the new tool may help nurses to understand the adaptation status of pregnant women and thereby provide suitable nursing care for good adaptation to pregnancy as well as enhanced quality of life.