Predictors of Treatment Non-Adherence in an Inpatient Substance Abuse Rehabilitation Programme

The research study aimed to identify the factors contributing to premature termination of treatment for substance addiction. The investigation took the form of a differential research design based on archival data obtained from patient files at an inpatient drug rehabilitation centre in Gauteng. One independent variable (treatment adherence) and five dependent variables (past and present patterns of scheduled medication use; legal history and DSM-IV-TR Axis I and II co-morbidity) were chosen. Eighty-five patient files were drawn; constituting 41 treatment adherent and 44 treatment non-adherent addicts. Extraneous variables of age; age of onset; duration of addiction; previous treatment history; drug of choice; current physical health status; gender; race; and level of education were equivalent in both samples. Univariate analysis indicated that treatment adherent and drop-out groups differed significantly in terms of legal history (Fisher's exact test = 12.369; p = 0.002) and past patterns of use of scheduled medication (Fisher's exact test = 29.131; p = 0.000). A logistic regression indicated that a history of abusing a combination of scheduled psychiatric and other medication prior to treatment is the single most accurate predictor of treatment non-adherence (Wald statistic = 11.1035; p = 0.0009). Although certain combinations of past medication patterns and legal history increase predicted probabilities of treatment non-adherence; legal history on its own failed to explain any further variance that past medication could not explain on its own

The South African Traditional Belief Scale as an Instrument to Aid Culture-Congruent Health Care

Medical and psychological health care professionals are becoming increasingly aware that effective treatment in culturally diverse societies requires sensitivity to the patient's cultural beliefs and customs (Davidhizar et Giger; 2001:2; Foley et Wurmser; 2004:2; Hickson et Christie; 1989:162; Mkize; 2003:4; Narayanasamy; 2003:1). To this end this article introduces the South African Traditional Belief Scale (SATBS) as an instrument to enable culture-congruent care; not only in the medical field; but also in psychotherapy and counselling. This scale measures the extent to which black South Africans adhere to traditional beliefs and customs. To obtain reliability and validity data; 64 second-year students were randomly selected at the East Rand campus of Vista University. The reliability of the SATBS was established by calculating inter-item correlations. A reliability coefficient; or index of internal consistency of 0.91 (Cronbach alpha) was obtained after the first iteration. In order to establish criterion validity; the South African Traditional Belief Scale was validated against the Degree of Enculturation Survey (DES) by using the same random sample. A validity coefficient of 0.7899 was obtained which indicates a high index of criterion validity. The questionnaire therefore measures what it purports to assess