How do psychological characteristics of family members affected by substance use influence quality of life?

Expectations of Patients and Their Families After the Treatment of Substance Use Disorder

BACKGROUND

Substance use disorders are economically and socially devastating to families and societies. Expectations of the patients and their families during the posttreatment phase of substance use disorder need to be emphasized to maintain a patient's sobriety and prevent relapse.

AIM

The aim of this study was to examine the prediction power of personal and sociodemographic factors of patients and their families to treatment outcomes.

METHODS

A descriptive, correlational, cross-sectional design was used. Data were collected from 80 patients treated for substance use disorders from a major psychiatric hospital and their family members regarding social, health, and psychological expectations. A three-step multiple hierarchical regression analysis was used to predict the power of personal and sociodemographic characteristics of patients' and their families' expectations to treatment outcomes.

RESULTS

Heroin use, codeine use, family education, and family support were significant predictors of rehabilitation expectation ( p < .05). Level of education and heroin use were predictors for lower levels of rehabilitation expectation, whereas family support and codeine use were indicators for higher scores of rehabilitation expectation.

CONCLUSION

Emphasis should be given to expectations of the patient and their family through appropriate psychoeducation and enhanced understanding and partnership.

Caregiving burden of family caregivers of substance-addicted people in Turkey

PURPOSE

The purpose of this exploratory study was to examine the caregiving burden (CB) and the determinants of burden among family members of substance-addicted people.

DESIGN AND METHODS

The sample of this cross-sectional research was 128 informal family caregivers of substance-addicted people. We collected data by using the Zarit Burden Interview (ZBI) assessing subjective burden.

FINDINGS

Mean ZBI score was 52.2. The regression analysis showed that ZBI mean score was higher in female caregivers and caregivers with lower education, poor economic status, and longer caregiving duration. There was an inverse relationship between the addict's age and the CB.

PRACTICE IMPLICATIONS

The predictors of CB may assist in setting caregivers at greater risk of CB as targets for the intervention.

Correlation Between Post-operative Sense of Coherence and Family Function in Patients With Type A Aortic Dissection

Objective

To analyze the relationship between post-operative sense of coherence and family function in patients with type A aortic dissection (AD).

Methods

Ninety patients with AD treated from January 2019 to December 2020 were selected as the research subjects. All patients received surgical treatments. Two weeks after the operation, the Sense of Coherence Scale (SOC-13) and Family APGAR index scale (APGAR) were used to evaluate the patients' sense of coherence and family function. Baseline data of all patients were collected, the SOC-13 scores of patients with type A AD with different demographic characteristics were compared, and the relationship between family function and patients' sense of coherence was analyzed.

Results

The ninety patients with type A AD had a low level of psychological consistency, and the average SOC-13 score was 49.84 ± 3.89 points. The SOC-13 score of patients with type A AD with family monthly incomes <5,000 yuan and moderate and severe family dysfunction was lower than that of patients with family monthly incomes ≥5,000 yuan and good family function. The difference was statistically significant (P < 0.05). There was no statistically significant difference in the SOC-13 scores of patients with type A AD with different demographic characteristics (P > 0.05). The results of multiple linear regression analysis showed that family monthly income <5,000 yuan and moderate and severe family dysfunction might be general influencing factors of sense of coherence among patients with type A AD (P < 0.05). Y = 43.333 + 6.667X₁ + 16.730X₂ was obtained.

Conclusion

The post-operative sense of coherence of patients with type A AD may be affected by family function.

Cultural adaptation and Rasch psychometrics of the Substance Addiction Consequences scale

This study aims to adapt and evaluate the validity of the Substance Addiction Consequences scale for the Brazilian community-based addiction setting. This is a psychometric study, conducted in two stages: (1) cultural adaptation and (2) validation using the psychometric Rasch model. The Substance Addiction Consequences derived from the Nursing Outcome Classification comprises 16 items and four domains in the original instrument. We applied the original scale with 200 outpatients at two Psychosocial Care Centers for Alcohol and Drugs in São Paulo, Brazil. The four subscales are suitable for the Rasch model. In 13 of the 16 items, infits and outfits are between 0.5 and 1.5, corresponding to the model's optimal parameters. In addition, we removed one item that distorted the measurement. The psychometrics suggested that the SAC scale is valid with its 15 items and four domains. Therefore, it can be considered appropriate to use in the Brazilian community-based addiction setting.

Socioeconomic Determinants of Health-Related Quality of Life of Entrepreneurs. A Cross-Sectional Study

Background: Quality of life is one of the most important conceptual categories in many scientific fields and socio-economic practices. In the authors’ opinion, the assessment of the overall quality of life and the health-related quality of life of private entrepreneurs deserves particular attention. Until now, quality of life and its determinants in entrepreneurs have been investigated by few authors. The aim of this study was to identify and assess the key determinants of quality of life and its health-related aspects in entrepreneurs from Wroclaw, Poland. Methods: A questionnaire survey was carried out in a group of 616 entrepreneurs selected from among 4332 individuals (2276 women, 2056 men) who had participated in a study on the socioeconomic determinants of quality of life and physical activity of Wrocław residents of working age. The main research method was a diagnostic survey using S-ES and WHOQOL BREF questionnaires. Information was obtained on respondents’ quality of life and perceived health condition, as well as sex, age, education, marital status, number of people in the household, income per capita, savings, and indebtedness. The collected data were subjected to statistical analysis using numerical distribution, medians, and quartile deviation. Crude and adjusted odds ratios were used to assess relationships between entrepreneurs’ quality of life and socioeconomic status. Results: Over 66% of Wroclaw entrepreneurs rated their overall quality of life as average or above average and about 34% as below average. An average or above assessment of perceived health condition was provided by 71% of respondents, and below average by 29% of respondents. Health-related quality of life was assessed as average or above average in the environmental domain by 79%, physical domain by 77%, social domain by 65%, and psychological domain by 58% of the entrepreneurs. Among the respondents significant correlations were found between quality of life and perceived health condition; family status, i.e., marital status; number of persons in the household; and financial status, i.e., per capita income, savings, and debt. Conclusions: The results of this study can be used for managing the quality of life of entrepreneurs. Quality of life determinants should be constantly updated, as they may change along with further economic development and Poland’s economic convergence with better developed EU countries.

“He is lovely and awful”: The challenges of being close to an individual with alcohol problems

Introduction: In the last 20 years, there has been growing evidence that heavy drinking causes serious harm not only to the person who drinks but also to the person's relations and concerned significant others (CSOs). A relationship with a heavy drinker is often full of conflicts, and CSOs are frequently exposed to aggression, psychological, and sometimes physical violence from the heavy drinker. Despite their struggles, CSOs often feel it is difficult to seek professional help for these problems. The aim of this study was to investigate what problems CSOs of people with alcohol problems experience prior to seeking professional help to handle these issues. Moreover, to investigate what led to seeking professional help at all. Methods: This is a qualitative study with 12 female help-seeking CSOs of persons with alcohol problems. The participants were recruited from a randomised controlled trial (RCT) on Community Reinforcement and Family Training (CRAFT). Semi-structured interviews were conducted, audio-recorded, and transcribed. The analysis was based on interpretative phenomenological analysis. Results: Three overall themes and one sub-theme emerged from the analysis: (1) The CSO’s feelings and experiences of the situation prior to help-seeking, (2) The relationship with the drinker, (3) Reasons for help-seeking and its trajectory; and the sub-theme, What the CSOs hoped to gain from help-seeking. Conclusion: The present study showed that female CSOs of people with alcohol problems had suffered for a long time before seeking professional help. They felt their daily lives were unpredictable and stressful. They were often exposed to verbal and mental abuse and their relationships with the drinking relative were often characterised by frequent rowing. The CSOs had tried to cope for a long time using a number of different strategies; seeking help seemed to be the last option considered. Despite all the struggles and pain, the CSOs also felt a lot of love for their drinking relative and hoped for the return of their once sober relative. Our findings can be viewed as a support to the stress-strain-coping-support (SSCS) model proposed by Orford and colleagues.

Perceived family cohesion, social support, and quality of life in patients undergoing treatment for substance use disorders compared with patients with mental and physical disorders

Purpose

Support from family and other social network elements can be important in helping patients to cope with practical and emotional consequences of diseases. The aim of the study was to examine perception of family and social support and quality of life (QoL) in patients undergoing treatment for substance use disorders (SUDs). We compared them with patients in treatment for mental disorders (MDs) and physical disorders (PDs).

Methods

We used data from a national multicenter study that recruited patients (N  =  518) from three treatment domains; SUD treatment units, MD treatment units, and PD treatment units (severe neurological conditions or cancer). Data on family cohesion, social support, and QoL were compared across patient groups. In addition, data on health variables was collected. We used a multiple linear regression procedure to examine how health and support variables were associated with QoL.

Results

Family cohesion and social support in the SUD and MD groups were rated at similarly low levels, substantially lower than in the PD group. The SUD group exhibited a somewhat lower QoL than did the PD group, but their QoL was still in the near-to-normal range. In contrast, the MD group had markedly low QoL. When examining factors associated with QoL, we found that greater family cohesion and social support were positively associated with QoL. Mental distress was the strongest factor, and was negatively associated with QoL (beta − 0.15, 95% CI  =  − 0.17/− 0.14, p  <  0.001).

Conclusion

Service providers need to be aware of the weaker networks and less regulatory family and/or social support available to patients with SUDs. Providers should focus consistently on the social networks of patients and include patients’ families in treatment processes.

Investigation of factors associated with low adherence to treatment of codependency in family members of psychoactive substance users

Abstract The aim of this study was to investigate possible factors that prevent adherence to the treatment of codependent family members of problem drug use individuals. A quasi-experimental study was carried out with 133 relatives of psychoactive substances users who called the Brazilian drug hotline (Ligue 132) between 2013 and 2015, from the five regions of Brazil. The following instruments were used: General service protocol; Family assistance protocol; Holyoake Codependency Index; Behavioral Adherence Scale; and Adherence Factor Questionnaire. Univariate analysis of data was performed for categorical variables and Chi-square test for comparison between variables, with p < 0.05. The sample showed a predominance of women (91.7%), especially mothers (82.7%). Among the investigated factors, alcohol as the substance involved in the problem showed a significant association with the non-adherence to treatment through teleintervention of family members.

Social media recruitment for mental health research: A systematic review

BACKGROUND

Social media holds exciting promise for advancing mental health research recruitment, however, the extent and efficacy to which these platforms are currently in use are underexplored.

OBJECTIVE

A systematic review was conducted to characterize the current use and efficacy of social media in recruiting participants for mental health research.

METHOD

A literature review was performed using MEDLINE, EMBASE, and PsychINFO. Only non-duplicative manuscripts written in the English language and published between 1/1/2004-3/31/2019 were selected for further screening. Data extracted included study type and design, participant inclusion criteria, social media platform, advertising strategy, final recruited sample size, recruitment location, year, monetary incentives, comparison to other recruitment methods if performed, and final cost per participant.

RESULTS

A total of 176 unique studies that used social media for mental health research recruitment were reviewed. The majority of studies were cross-sectional (62.5%) in design and recruited adults. Facebook was overwhelmingly the recruitment platform of choice (92.6%), with the use of paid advertisements being the predominant strategy (60.8%). Of the reviewed studies, substance abuse (43.8%) and mood disorders (15.3%) were the primary subjects of investigation. In 68.3% of studies, social media recruitment performed as well as or better than traditional recruitment methods in the number and cost of final enrolled participants. The majority of studies used Facebook for recruitment at a median cost per final recruited study participant of $19.47. In 55.6% of the studies, social media recruitment was the more cost-effective recruitment method when compared to traditional methods (e.g., referrals, mailing).

CONCLUSION

Social media appears to be an effective and economical recruitment tool for mental health research. The platform raises methodological and privacy concerns not covered in current research regulations that warrant additional consideration.

Domestic violence and risk of internalizing and externalizing problems in adolescents living with relatives displaying substance use disorders

ABSTRACT Objective To investigate the association between exposure to domestic violence and increased risk of internalizing and externalizing problems and substance use among adolescents living with relatives with substance use disorder (SUD) at a low-income community of São Paulo, Brazil. Methods A cross-sectional study was conducted with 102 adolescents aged 12-17 years (M = 14.2, SD = 1.7) who were living with relatives suffering from SUD. Outcomes were measured using the Youth Self-Report (YSR), psychosocial stress factors questionnaire, Drug Use Screening Inventory (DUSI) and Phrase Inventory of Intrafamily Child Abuse (PIICA). Results The sample presented high prevalence of emotional/behavioral problems with YSR’s scores in the clinical range for Internalizing Problems (24.5%), Externalizing Problems (21.6%), and Total Problems (26.5%). The presence of mental health problems predicted substance use (PR = 2.22; 95% CI = 1.2-4.13), and substance use predicted increased risk of mental health problems. Alcohol use predicted more than double the risk of emotional/behavioral problems (PR = 2.01; 95% CI = 1.08-3.76), while illicit drug use was associated with an almost threefold increase in the prevalence of Internalizing (PR = 2.87; 95% CI = 1.19-6.89) and Externalizing Problems (PR = 3.3; 95% CI = 1.35-8.04). Conclusion Adolescents of relatives with SUD are at risk of developing emotional and behavioral problems. These findings reinforce the need to develop public mental health policies, which include protective interventions to adolescents living in families affected by substance use disorders.

Functioning of Concerned Others When Adults Enter Treatment for an Alcohol Use Disorder

BACKGROUND

Poor functioning among Concerned Others (COs; family and friends of an individual with an alcohol or other substance use disorder) is a significant public health problem. The purpose of this study was to inform interventions for COs by examining potential correlates of 3 aspects of functioning: quality of life, mental health, and knowledge of how to handle problems related to their drinker.

METHODS

This study collected data from 277 COs when their friend or family member (their "drinker") was entering treatment for an alcohol use disorder. Potential correlates were the drinker's substance use severity, the CO-drinker relationship and communication, and COs' coping and perceived stigma related to involvement with their drinker.

RESULTS

In a summary analysis, only stressors in the CO-drinker relationship (the drinker's criticism, disagreement, anger, and demands) were consistently associated with poorer functioning as indicated by COs' poorer quality of life and mental health. In contrast, only COs' use of approach coping was associated with COs' knowing how to handle problems related to the drinker.

CONCLUSIONS

Because reducing both relationship stressors and the link between stressors and poor functioning can be achieved through CO and drinker education and intervention, these findings inform how to effectively support COs' goals for better functioning.