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Siljeholm O, Eckerström J, Molander O, Sundbye J, Hammarberg A. 'Before, we ended up in conflicts, now we can provide support'-Experiences of Community Reinforcement and Family Training (CRAFT) for parents of young adults with hazardous substance use. BMC Psychiatry 2024; 24:464. [PMID: 38907237 PMCID: PMC11191224 DOI: 10.1186/s12888-024-05913-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/14/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND The prevalence of hazardous substance use is highest in the age between 18 and 25, but few young adults enter treatment. Community Reinforcement and Family Training (CRAFT) is a support program for concerned significant others (CSOs) of individuals with diverse substance use disorders and is proven efficacious in promoting treatment entry. The aim of the current study was to investigate the experiences of CRAFT among parents of substance using young adults. METHODS We used a qualitative design conducting semi-structured interviews with 10 parents of young adults (18-24 years) with hazardous substance use. The participants were recruited from a randomized controlled trial of the CRAFT program. The transcribed interviews were analyzed using thematic analysis. RESULTS We divided the results into three overall domains-Reasons for entering the CRAFT program, Strengths of the CRAFT program and Limitations of the CRAFT program - with three to four themes under each domain. The parents appreciated the accessible support at a time when they needed it due to feelings of shock and powerlessness, and they described communication strategies together with positive reinforcement as the two most helpful CRAFT-sessions. Regarding limitations of CRAFT in the current population, the parents wanted more accessible support for the young adults when they were ready to enter treatment, and described difficulties to practice CRAFT-components due to changing life-circumstances and fear of aggravated health for their young adults. CONCLUSION The results provide arguments for the health care system to implement support programs to parents of young adults with hazardous substance use. The results show that CRAFT is suitable for the current population, but with some possible additions due to changing circumstances that are common in the young adult developmental phase emerging adulthood. TRIAL REGISTRATION The trial was pre-registered at isrctn.com, reference number ISRCTN12212515 date: November 7, 2018.
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Affiliation(s)
- Ola Siljeholm
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Joachim Eckerström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Olof Molander
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Jennie Sundbye
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anders Hammarberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Cucciare MA, Han X, Yousef S, Timko C. Predictors of concerned others' mental health and quality of life over 12 months following adults' entry into treatment for an alcohol use disorder. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 164:209434. [PMID: 38866140 DOI: 10.1016/j.josat.2024.209434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/10/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION People in treatment for alcohol use disorders (AUDs) can negatively impact their Concerned Others (COs). This longitudinal study examined patient and CO characteristics associated with CO outcomes. METHOD Participants were 279 dyads of patients entering residential treatment and their CO. Outcomes were COs' mental health and quality of life. The study collected patient and CO predictors and CO outcomes at baseline and 3-, 6-, and 12-month follow-ups as part of a randomized controlled trial. In the first set of models, the analytic approach identified baseline patient predictors associated with COs' outcomes measured at baseline and follow-ups. In the second set of models, we examined whether those effects remained after adding baseline CO characteristics. RESULTS In the first set of models, COs of older age and whose patient reported less CO-patient relationship stress had better mental health. Also, married COs and those with higher income and whose patient reported no violence in the CO-patient relationship had better quality of life. In the second set of models, COs whose patient entered treatment due to criminal justice involvement, with more social support, less reported stigma, and less use of avoidance coping had better mental health. Also, married COs, those with higher income, and less reported discrimination stigma had better quality of life. CONCLUSIONS Understanding patient and CO characteristics that are associated with COs' outcomes may inform AUD treatment programs' efforts to help COs. Identifying modifiable determinants of CO outcomes is important to clinical practice regardless of whether the patient chooses to obtain treatment.
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Affiliation(s)
- Michael A Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72205, USA; Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72205, USA.
| | - Xiaotong Han
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72205, USA; Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72205, USA.
| | - Sara Yousef
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Christine Timko
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Johannessen A, Helvik AS, Tevik K, Tjelta T, Thorsen K. The elephant in the room: Metaphors in women's accounts of life with a family member with problematic substance use. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:346-363. [PMID: 38903891 PMCID: PMC11186450 DOI: 10.1177/14550725241230744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/22/2024] [Indexed: 06/22/2024] Open
Abstract
Background: Research has shown that a family member's problematic substance use has significant deleterious mental and physical health impacts on other members of the family. Women are more often affected than men. These negative health effects persist as the person with problematic substance use ages, and they vary according to the relationship status. Aim: The aim of this study was to gain a deeper understanding of how women experience and are affected by their family member's substance use problems. Method: A metaphorical analysis of narrative interviews with 11 daughters and five wives of older adults (>65 years) with problematic substance use. Results: We identified four areas of signification in which metaphors were employed: (1) experiences (chaos and crash and walking on eggshells); (2) strategies (complicity and silencing); (3) dilemmas (deceit or a disease and open or closed dilemmas); and (4) consequences (obtaining or retaining an identity, health and different types of help). Conclusion: Family life with a parent or spouse with a substance use problem was described as chaotic, unsafe, uncertain and with no prospects of change. The study illustrates how metaphors are used to mediate experiences and worldviews pertaining to existential matters founded in deep negative emotions, deceit, shame and stigma. Metaphors make up a crucial material for communicating emotions and themes that are difficult to convey due to shame and stigma.
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Affiliation(s)
- Aud Johannessen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne-Sofie Helvik
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; and Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kjerstin Tevik
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; and Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Thomas Tjelta
- Faculty of Health and Social Sciences, University of South-Eastern Norway USN, Porsgrunn, Norway
| | - Kirsten Thorsen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Monari EN, Booth R, Forchuk C, Csiernik R. Experience of Family Members of Relatives With Substance Use Disorders: An Integrative Literature Review. Creat Nurs 2024:10784535241252169. [PMID: 38758032 DOI: 10.1177/10784535241252169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Background: Substance use disorders (SUDs) present substantial challenges for family members living with or supporting relatives with SUDs. This review explores existing literature on family members' experiences with relatives with SUDs and their support needs. Method: An integrative review was conducted by searching literature in the Cumulative Index of Nursing and Allied Health, PubMed, PsycINFO, ProQuest, and Scopus databases. Results: Five themes were generated based on analysis of 26 empirical studies: (a) family members' and caregivers' experiences of SUDs; (b) impact of SUDs-related aggressive/violent behaviors on families; (c) dilemmas faced by family members; (d) culture and family stigma related to SUDs; and (e) factors contributing to SUDs, challenges, and support needs. The review highlighted barriers to seeking support due to stigma and guilt, underscoring the need for structured support programs. Conclusions: This review sheds light on the challenges faced by family members with relatives suffering from SUDs and emphasizes the crucial need for structured support programs. The findings provide insights for developing initiatives to address the social and trauma-induced needs of family members and to establish support resources for them.
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Affiliation(s)
- Esther N Monari
- School of Nursing, Memorial University of Newfoundland, Canada
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Mardani M, Alipour F, Rafiey H, Fallahi-Khoshknab M, Arshi M. Challenges in addiction-affected families: a systematic review of qualitative studies. BMC Psychiatry 2023; 23:439. [PMID: 37328763 PMCID: PMC10273571 DOI: 10.1186/s12888-023-04927-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 06/05/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND The relative paucity of research on Addiction-Affected Families' (AAF) issues and the lack of attention given to their difficulties and treatment in interventions and clinical practices indicate that the primary focus consistently revolves around individuals with addictive disorders, even when the treatment process involves their families. However, it is believed that family members endure significant pressures that result in extensive negative consequences on the personal, familial, and social aspects of their lives. Aiming for a better understanding of the challenges and issues that AAF's experience, this systematic review explored qualitative studies with a focus on the impact of addiction on different aspects of families. METHODS We searched Research Gate, Scopus, Web of Science, ProQuest, Elsevier, and Google Scholar Databases. We included studies of qualitative design which have investigated the effects of addiction on families. Non-English language studies, medical views, and quantitative approaches were excluded. Participants in the selected studies included parents, children, couples, sisters/brothers, relatives, drug users and specialists. The data from the selected studies were extracted using a standard format for the systematic review of qualitative research (the National Institute of Health and Care Excellence [NICE] 2102a). RESULTS A thematic analysis of the findings of the studies identified 5 main themes: 1) initial shock (family encounter, searching for why), 2) family in the fog (social isolation, stigma and label), 3) sequence of disorders (emotional decline, negative behavioral experiences, mental disturbance, physical degeneration, family burden), 4) internal family chaos (instability of relationships, shadow people, erosive confrontation with the drug-using member, a newly emerging member, collapsing system, financial collapse), and 5) self-protection (attracting information, support, and protective sources, coping and adjusting the effects, the emergence of spirituality). CONCLUSION This systematic review of qualitative research highlights the various and complex issues which addiction-affected families go through in terms of financial, social, cultural, mental and physical health problems, as a result of which experts of the field are needed to investigate and take measures. The findings can inform policy and practice and the development of interventions aimed to lighten the burdens which addiction-affected families carry.
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Affiliation(s)
- Mostafa Mardani
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fardin Alipour
- Department of Social Work, Social Welfare Management Research Center, Social Health Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hassan Rafiey
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Maliheh Arshi
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Silva FMD, Camatta MW, Lachini AJB, Nasi C. Family motivations and expectations in the care for psychoactive substance users. Rev Gaucha Enferm 2023; 44:e20220141. [PMID: 37283434 DOI: 10.1590/1983-1447.2023.20220141.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/12/2022] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE To understand the motivations and expectations of family members for the care of users of psychoactive substances. METHOD This is a qualitative study using Alfred Schutz's phenomenological sociology framework. Data was collected through semi-structured interviews with family members of substance users treated in the inpatient and outpatient clinic of a university hospital in southern Brazil. Data was interpreted through comprehensive phenomenological analysis. RESULTS Five categories of motivation were identified: for fear and insecurity with the situation; for obligation; due to the relationship of love and connection; to stop suffering; to promote independent living. CONCLUSION The motivations of the family members aim to avoid the helplessness of the substance user and to achieve positive changes in the construction of a life without the use of substances, projecting a self-sufficient future for the user.
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Affiliation(s)
- Francine Morais da Silva
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Porto Alegre, Rio Grande do Sul, Brasil
| | - Marcio Wagner Camatta
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Porto Alegre, Rio Grande do Sul, Brasil
| | - Annie Jeanninne Bisso Lachini
- Universidade Federal das Ciências da Saúde de Porto Alegre (UFCSPA). Departamento de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Cintia Nasi
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Porto Alegre, Rio Grande do Sul, Brasil
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van Beek M, Velleman R, de Bruijn T, Velleman G, Goudriaan AE. Helping family members affected by a relative’s substance use or gambling: an evaluation study of the 5-Step Method delivered in the Netherlands. DRUGS: EDUCATION, PREVENTION AND POLICY 2023. [DOI: 10.1080/09687637.2023.2165040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Affiliation(s)
- Max van Beek
- Arkin, Department of Research, Amsterdam, the Netherlands
- Jellinek, TOPGGz department Jacob Obrechtstraat 92, Amsterdam, the Netherlands
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, Meibergdreef 9, the Netherlands
- Amsterdam Institute for Addiction Research (AIAR), Amsterdam, the Netherlands
| | - Richard Velleman
- Department of Psychology, University of Bath, Bath, UK
- Addictions Research Group, Sangath, Goa, India
| | | | | | - Anna E. Goudriaan
- Arkin, Department of Research, Amsterdam, the Netherlands
- Jellinek, TOPGGz department Jacob Obrechtstraat 92, Amsterdam, the Netherlands
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, Meibergdreef 9, the Netherlands
- Amsterdam Institute for Addiction Research (AIAR), Amsterdam, the Netherlands
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Rushton C, Kelly PJ, Raftery D, Beck A, Larance B. The effectiveness of psychosocial interventions for family members impacted by another's substance use: A systematic review and meta-analysis. Drug Alcohol Rev 2023; 42:960-977. [PMID: 36744608 DOI: 10.1111/dar.13607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/27/2022] [Accepted: 12/19/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Family members affected by another's substance use disorder experience physical health problems, breakdowns in relationships and reduced psychological wellbeing. This review examines the effectiveness of psychosocial interventions for improving the wellbeing of family members. METHODS A systematic review of randomised-controlled trials (RCT), non-RCTs and pre-post studies examining group or individual interventions for affected families. Five databases were searched (PubMed, PsycINFO, Medline, Web of Science, Cochrane Library). Outcomes included psychological functioning, quality of life, physical health and substance use, family functioning and coping. Outcomes were analysed by study design and mode of delivery (individual or group). Risk of bias was assessed using the Cochrane tools (RoB2, ROBINS-I). The review followed PRISMA reporting guidelines and was prospectively registered with the PROSPERO database (CRD42020200260). RESULTS Nineteen studies were included (k = 10 included in meta-analyses). In k = 3 RCTs, individually administered interventions significantly reduced depression (standardised mean difference [SMD] 0.50, 95% confidence interval [CI] 0.21, 0.79) and distress (SMD 0.28, 95% CI 0.03, 0.54). In k = 2 pre-post studies, individual interventions improved family functioning (d = 0.51, 95% CI 0.28, 0.73) and coping (d = 0.43, 95% CI 0.24, 0.61). In k = 3 non-RCTs and k = 2 pre-post designs group interventions significantly reduced depression (d = 0.50, 95% CI 0.17, 0.82) and distress (d = 0.44, 95% CI 0.13, 0.75), and improved coping (d = 0.81, 95% CI 0.29, 1.33). DISCUSSION AND CONCLUSIONS This review summarises the contemporary literature evaluating interventions for affected families, with both individual and group interventions demonstrating favourable outcomes. However, small sample sizes and methodologically weak-quality studies limit conclusions.
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Affiliation(s)
- Clare Rushton
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Dayle Raftery
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Alison Beck
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Briony Larance
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
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Johannessen A, Tevik K, Engedal K, Tjelta T, Helvik AS. Family' members experiences of their older relative's alcohol and substance misuse. Int J Qual Stud Health Well-being 2022; 17:2094059. [PMID: 35786387 PMCID: PMC9255228 DOI: 10.1080/17482631.2022.2094059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Alcohol consumption in Norway and much of the western world has increased during the past decades, in particular among older adults (> 65 years). Although living with a family member's alcohol misuse has been shown to have a significant deleterious health impact, research on this topic is both lacking and urgently needed to develop targeted health services. AIM To generate knowledge of how family members are affected by their older relatives' alcohol and other substance misuse problems. METHOD In 2020, 17 individual interviews were carried out with the wives and adult children of older adults with alcohol and other substance misuse problems. Data were analysed using content analysis. FINDINGS Analyses revealed two main themes; the impact of living with psychological stress over time, and the impact over time on family relationships and functioning. Both included four subthemes, representing different dimensions of participants' experiences of the impact of their older relative's alcohol and substance misuse. CONCLUSION The challenges family members experienced through ongoing exposure to their relatives' alcohol and/or other substance misuse increased over time. These experiences had significant negative consequences for their health and life situation.
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Affiliation(s)
- Aud Johannessen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,Faculty of Health and Social Science, University of South-Eastern Norway, Kongsberg, Norway,CONTACT Aud Johannessen The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, P.O. Box 2136 NO-3103, Tønsberg, Norway
| | - Kjerstin Tevik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Knut Engedal
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Thomas Tjelta
- Faculty of Health and Social Science, University of South-Eastern Norway, Kongsberg, Norway
| | - Anne-Sofie Helvik
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Kalsås ØR, Dyregrov K, Fadnes LT, Titlestad KB. The social health domain of people bereaved by a drug-related death and associations with professional help: A cross-sectional study. DEATH STUDIES 2022; 47:926-937. [PMID: 36347016 DOI: 10.1080/07481187.2022.2142329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
People bereaved by traumatic deaths are vulnerable to long-lasting impairments in social health, including the quality of social relationships and the capacity to manage their social lives. In this Norwegian study involving 255 participants bereaved by a drug-related death, we aimed to investigate their social health and associations with professional help. The results of a cross-sectional survey showed that participants on average rated their social health as poor, though with large variations within the group. Participants who reported high satisfaction with professional help reported significantly higher scores on most social health-related variables. More research is needed on professional help focusing on the social health of traumatically bereaved people.
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Affiliation(s)
- Øyvind R Kalsås
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Bergen, Vestland, Norway
| | - Kari Dyregrov
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Bergen, Vestland, Norway
| | - Lars Thore Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kristine B Titlestad
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Bergen, Vestland, Norway
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Maksimovic JM, Sbutega OB, Pavlovic AD, Vlajinac HD, Kavecan II, Vujcic IS, Grujicic Sipetic SB. Characteristics and quality of life of substance users and their caregivers. Medicine (Baltimore) 2022; 101:e29699. [PMID: 35945774 PMCID: PMC9351891 DOI: 10.1097/md.0000000000029699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The correlation between substance use and depression has been emphasized in the literature. Substance use disorders can also adversely affect the caregivers of drug-addicted persons. A cross-sectional study was conducted at the Special Hospital for Addiction Diseases in Belgrade in 2015 to analyze the characteristics, consequences, and health-related quality of life of drug users and their caregivers. The sample comprised 136 users of various substances, and 136 caregivers. A questionnaire on socio-demographic characteristics, the Short Form Health Survey 36 (SF-36), and Beck Depression Inventory were administered to all participants. According to multivariate logistic regression analysis, compared with caregivers, substance users were significantly more frequently male (P < .001), ≤ 39 years old (P < .001), and more frequently reported the use of sedatives (P = .009) and smoking (P < .001). Some level of depression was present in all participants, but severe forms were more frequent in substance users (P = .010). Among substance users, mean scores of SF-36 domains ranged from 56.62‒87.17, and among their caregivers, from 50.37‒75.07; however, the difference was significant only for the health change domain (P = .037), the score for which was lower in caregivers. Substance users suffered from more severe forms of depression compared to their caregivers, who had lower SF-36 scores in the domain of health change.
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Affiliation(s)
- Jadranka M. Maksimovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- *Correspondence: Jadranka M. Maksimovic, Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia (e-mail: )
| | | | - Aleksandar D. Pavlovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Hristina D. Vlajinac
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana I. Kavecan
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Department of Pediatrics, Institute for Children and Youth Health Care of Vojvodina, Novi Sad, Serbia
| | - Isidora S. Vujcic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Hellum R, Bilberg R, Andersen K, Bischof G, Hesse M, Nielsen AS. Primary Outcome from a cluster-randomized trial of three formats for delivering Community Reinforcement and Family Training (CRAFT) to the significant others of problem drinkers. BMC Public Health 2022; 22:928. [PMID: 35538465 PMCID: PMC9087923 DOI: 10.1186/s12889-022-13293-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community Reinforcement and Family Training (CRAFT) is an intervention designed to help the concerned significant others (CSOs) of people with alcohol problems who are reluctant to seek treatment. It aims to improve the well-being of CSOs and teach them how to change their behavior in order to positively influence the "identified patient" (IP) to seek treatment. METHODS The aim of the present pragmatic cluster-randomized trial was to compare the effectiveness of three formats for delivering CRAFT in real life settings: group sessions, individual sessions, and written material only (control group). Eighteen public treatment centers for alcohol use disorders were randomly assigned to deliver CRAFT in one of the three formats as part of their daily clinical routine. CSOs were recruited via pamphlets, general practitioners, and advertisements on social media. Trained clinicians delivered CRAFT in individual and group format, and self-administered CRAFT was limited to handing out a self-help book. The primary outcome was treatment engagement of the IP after three months. RESULTS A total of 249 CSOs were found to be eligible and randomly assigned to receive CRAFT delivered in group, individual, or self-administered format. The three-month follow-up rate was 60%. At three months follow-up, 29% (n = 32) of the CSOs who received group/individual CRAFT reported that their IP had engaged in treatment. The corresponding rate for the CSOs who received self-administered CRAFT was lower (15%; n = 5) but did not differ significantly from the other group of CSOs (Odds ratio (OR) = 2.27 (95% CI: 0.80, 6.41)). CONCLUSION We hypothesized that CSOs receiving CRAFT in a group format would improve the most, but although our findings pointed in this direction, the differences were not statistically significant. TRIAL REGISTRATION Clinical trials.gov ID: NCT03281057 . Registration date:13/09/2017.
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Affiliation(s)
- Rikke Hellum
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark
| | - Randi Bilberg
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark.
| | - Kjeld Andersen
- Psychiatric Department, Region of Southern Denmark, Odense, Denmark
| | - Gallus Bischof
- The Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Department of Psychological and Behavioral Sciences, Aarhus University, Artillerivej 90, 2, 2300, Copenhagen S, Denmark
| | - Anette Søgaard Nielsen
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark
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Kumar S, Schess J, Velleman R, Nadkarni A. Stigma towards dependent drinking and its role on caregiving burden: A qualitative study from Goa, India. Drug Alcohol Rev 2022; 41:778-786. [PMID: 35128746 PMCID: PMC9304139 DOI: 10.1111/dar.13438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/30/2022]
Abstract
Introduction Stigma towards alcohol use disorders is prevalent in India and can lead to social exclusion and hamper treatment access and outcomes. Family members of individuals with dependent drinking are often their primary caregivers and play a key role in decisions around help‐seeking, treatment and recovery. The nature and role of stigma in caregiving, and the consequent burden on family caregivers of those with dependent drinking, has not been qualitatively studied in India. Methods We conducted in‐depth interviews with: (i) men with probable alcohol dependence (n = 11); (ii) family caregivers (n = 12); and (iii) doctors with experience of treating alcohol dependence (n = 13) in community settings in Goa. Data were analysed using inductive thematic analysis. Results Two primary themes were identified from the data: (i) stigma in the form of ignorance, prejudice and discrimination; and (ii) the impact of this stigma on caregiving decisions and the mental health of caregivers. Discussion and Conclusions We found that stigma functioned as a barrier to a proper course of treatment and care, as well as a detrimental factor for caregiver's mental health and caregiving decision‐making. Stigma towards dependent drinking in the forms of ignorance, prejudice and discrimination is prevalent within homes, workplaces and health systems and might exacerbate the caregiving burden among female family caregivers. Policies, educational programs and campaigns aimed at preventing stigma in these forms would likely enable access to more inclusive and appropriate health services, benefit the health of family caregivers and improve the treatment outcomes of drinkers.
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Affiliation(s)
- Sonali Kumar
- Addictions Research Group Sangath Community NGO Porvorim India
| | - Jaclyn Schess
- Addictions Research Group Sangath Community NGO Porvorim India
- Ross School of Business University of Michigan Ann Arbor USA
| | - Richard Velleman
- Addictions Research Group Sangath Community NGO Porvorim India
- Department of Psychology University of Bath Bath UK
| | - Abhijit Nadkarni
- Addictions Research Group Sangath Community NGO Porvorim India
- Centre for Global Mental Health, Department of Population Health London School of Hygiene and Tropical Medicine London UK
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Liu Y, Guo X, Yang B. Age at onset of drug use and aggressive behavior: The role of internal and environmental factors. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02013-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Yang F, Jiang Y, Paudel KP. Impact of Work Value Awareness on Self-Rated Physical Health of Rural-to-Urban Migrant Workers in China. Healthcare (Basel) 2021; 9:healthcare9050505. [PMID: 33925693 PMCID: PMC8146592 DOI: 10.3390/healthcare9050505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/07/2021] [Accepted: 04/21/2021] [Indexed: 12/31/2022] Open
Abstract
We used data based on the China Labor-Force Dynamics Survey 2016 to examine the relationship between the work value awareness and the physical health of rural-to-urban migrant workers. The work value awareness was characterized by five dimensions: awareness of the emotional value, social value, respect value, ability value and interest value. Physical health was measured by a self-rated health assessment. The results from an IV-ordered probit model show that the awareness of work value has a statistically significant impact on the self-rated physical health of rural-to-urban migrant workers. The results also show that the impacts of work value awareness on rural-to-urban migrant workers’ physical health are heterogeneous to genders and ages. Mental health plays a mediating role between the awareness of work value and the physical health of rural-to-urban migrant workers. It is beneficial for rural-to-urban migrant workers to improve awareness of the value of work to enhance their physical health. The findings of this paper have policy implications for improving the health and welfare of Chinese rural-to-urban migrant workers as well as temporary migrants to cities in many developing countries.
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Affiliation(s)
- Fan Yang
- Department of Labor and Social Security, School of Public Administration, Sichuan University, Chengdu 610065, China;
| | - Yao Jiang
- Department of Sociology, Zhou Enlai School of Government, Nankai University, Tianjin 300350, China;
| | - Krishna P. Paudel
- Department of Agricultural Economics and Agribusiness, Louisiana State University (LSU) and LSU AgCenter, Baton Rouge, LA 70803, USA
- Correspondence: ; Tel.: +1-225-578-7363
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