scholarly journals Qualitative study: learning from recovery: what do people who have recovered from alcohol dependence have to teach those who are still struggling?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S292-S292
Author(s):  
Anju Soni ◽  
Ian Treasaden
Keyword(s):  
Alcohol Dependence ◽  
Alcoholics Anonymous ◽  
Treatment Programs ◽  
Age Group ◽  
Icd 10 ◽  
The Uk ◽  
The Relationship ◽  
Effective Service ◽  
Eventual Outcome

AimsThe aim is to tap into user experience in the UK and to analyse what lessons can be learnt from those who have recovered from alcohol dependence to help those who are struggling including to inform the delivery of alcohol services.MethodThe study was conducted in London, UK. 20 males in the age group 30–45 years were recruited. 10 of these participants had recovered from alcohol dependence and the other 10 were in treatment for alcohol dependency and diagnosed as dependent according to ICD-10 or DSM 5 criteria. In the former group, each participant had at least 2 years of complete sobriety. A semi structured questionnaire was developed and used to interview all the subjects.Males 30-45 years were eligible as alcohol dependence is more common in this age group and purposive sampling drove the selection (i.e. if early analysis suggests the importance of a particular factor, subjects likely not to show that factor would be sampled for comparison).Grounded analysis was the qualitative analysis method of choice and constant comparison was used, i.e., data were collected and analysed concurrently.ResultThe main “families” that arose grouped around relationships in both the recovered alcoholics (RA) and continued alcoholics (CA). A successful shift required a change in the relationship to self, from feeling empty or critical towards acceptance and this shift was facilitated by being accepted and respected by others.Relationship as motivator to stop drinking24% people had the insight to self-refer to voluntary organisations such as AA but 76% did so because of fear of losing either their relationship or their job.Although 80% of recovered alcoholics had been ambivalent about coming off alcohol, the shift happened when they had a nurturing relationship elsewhere such as a key worker at the Alcoholics Anonymous.Insight and PerceptionAwareness of alcohol as an obstacle rather than a solution was key for change to occur. Although 75% people with insight into their difficulties were more successful in maintaining sobriety, insight alone without action was insufficient. Moreover, action was possible without insight. Fear of death alone was a sufficient motivator.ConclusionDifference between support systemsAs a result of comparing those patients with alcohol dependence who responded well to treatment compared to those who were very recalcitrant to treatment important characteristics of an effective service have been identified. It was clear that the quality of services offered to those with alcohol dependence who attended A&E departments could be improved by offering more time for the initial assessments and adopting a more individualistic approach for each patient.Training sessions to the A&E staff about the differences required in management between those with alcohol dependence who are motivated to abstain compared to those who will only be able to reduce consumption should be offered rather than mere blanket exhortations to abstain from alcohol consumption. The importance of behavioural avoidance of situations where alcohol is excessively consumed is more helpful in terms of eventual outcome.The A&E staff should be encouraged to employ individuals from Alcoholics Anonymous in their department as early involvement with AA improves engagement and outcome can greatly improve engagement with treatment programs subsequently and lead to significantly better outcomes.

Mapping the contours of fairness

2014 ◽  
Vol 1 (2) ◽  
pp. 191-204 ◽  
Author(s):  
Lilian Otaye ◽  
Wilson Wong
Keyword(s):  
Job Satisfaction ◽  
Factor Analysis ◽  
Regression Analysis ◽  
Turnover Intention ◽  
Content Type ◽  
Mediating Role ◽  
The Uk ◽  
The Relationship

Purpose – The purpose of this paper is to explore the contours of fairness by showing how different facets of fairness impact three important employee outcomes (job satisfaction, turnover intention and employer advocacy) and examining the mediating role of quality of management and leadership (through perceptions of both senior management and the quality of exchange with immediate supervisors) in attenuating negative impacts of unfairness on these outcomes. The study extends the concept of fairness beyond the traditional focus on organizational justice and models the mediating role of leadership on the relationship between (un)fairness and the three employee-level outcomes in a sample of employees representative of the UK workforce. Design/methodology/approach – Data were obtained from a nationally representative sample of 2,067 employees in the UK. Exploratory factor analysis and then confirmatory factor analysis is used to refine three unfairness factors and address their dimensionality of the unfairness scale and then multiple regression analysis is used to test a fairness-leadership-employee performance outcome model. Findings – Results of multiple regression analysis revealed that both trust in leadership and leader-member exchange partially mediate the relationship between organizational (un)fairness and job satisfaction, advocacy and turnover intention, respectively. Practical implications – The findings highlight the important role that leaders play in influencing the relationship between perception of unfairness and employee outcomes. This has implications for both theory and practice as it suggests that the pattern of inclusion that leaders create through the relationships that they develop with their followers has a significant impact on the relationship between unfairness and the work outcomes. They not only must manage traditional perceptions of justice, but also the assessments employees make about trust in management judgements and the perceived consequences of such judgements. Originality/value – In an environment where perceptions of unfairness are becoming both more endemic but also more complex, the study shows that both senior leaders and immediate supervisors have important agency in managing negative consequences. Through the measurement of satisfaction, turnover intention and employer advocacy it also provides potential links to link fairness into the engagement literature.

The changing landscape of local authority commissioning

2020 ◽  
pp. 177-196
Author(s):  
Dave Ayre
Keyword(s):  
Academic Research ◽  
The European Union ◽  
Public And Private ◽  
The United Kingdom ◽  
Health And Social Care ◽  
History Of ◽  
The Uk ◽  
Relationship Of ◽  
The Relationship

This chapter assesses the history of the relationship between public and private sectors and the extent to which the political and regulatory environment of governments and institutions such as the European Union (EU) can help or hinder the efforts of public bodies in seeking to deliver services that determine the health and quality of life for communities. The relationship of public and private sectors in the United Kingdom (UK) and the commissioning, procurement, and development of public–private partnerships is driven by the prevailing political and economic environment. However, rigorous academic research on the benefits of partnering to organisations, societies and between countries is limited. Evidence is needed to fill the policy vacuum. A bolder approach is necessary to work with public and private sectors to develop and implement successful partnering alternatives to the outsourcing of public services. The growing catalogue of outsourcing failures in construction, probation, rail franchising, health, and social care is creating an appetite for change, and the exit of the UK from the EU provides the opportunity.

scholarly journals Spouse Burden in Patients with Alcohol Dependence Syndrome

2019 ◽  
Vol 16 (3) ◽  
pp. 27-33
Author(s):  
Sanjeev Chandra Gautam ◽  
Yash Bhattarai
Keyword(s):  
Alcohol Dependence ◽  
Primary Alcohol ◽  
Age Group ◽  
Physical And Mental Health ◽  
Physical Strain ◽  
Alcohol Abusers ◽  
Cross Sectional ◽  
Icd 10 ◽  
Alcohol Dependence Syndrome ◽  
The Cost

Use of alcohol has been one of the major source of recreation and stress relievers to date and it is one of the most abused substances in the world due to its free availability. The cost that a spouses incur in terms of economic hardships, social isolation and physical strain can be referred to as Spouse Burden. Spouses play an important role inpatient’s support and treatment and with a study like this there might be a better understanding of the problem. A descriptive, cross-Sectional hospital based study was done in 62 patients who met the diagnostic criteria for Alcohol Dependence Syndrome (ICD-10 DCR) and consents were taken from required personnel. Most of the patients examined were in the age group 40 to 60 years of age (72.6%) followed by the age group up to 40 (22.6%). 72.5% of the spouses were up to 40 years of age, followed by spouses of the age group 40-60 (27.5%).Males were the primary alcohol abusers(87%).51.6% of the patients were unemployed and the rest 48.4% was still employed whereas 51.6%of the spouses were employed and the rest48.4% unemployed. 51.6% of the patients were illiterate whereas majority of the spouses were literate(67.7%). There is a significant severity of burden of alcohol dependence syndrome in spouses and these verity of dependence is positively correlated with spouse burden. Financial, spouse routine, spouse interaction, physical and mental health of other members of the family were significantly affected with increase in dependence.

Depression in heart failure

2019 ◽  
Vol 14 (6) ◽  
pp. 1-11 ◽  
Author(s):  
John Sharp ◽  
Monica McCowat
Keyword(s):  
Heart Failure ◽  
Epidemiological Studies ◽  
Life Outcomes ◽  
Cardiac Health ◽  
Prevalence Of Depression ◽  
The Uk ◽  
The Impact ◽  
The Relationship

Heart failure is one of the most prevalent long-term physical health conditions. It is suggested that up to 26 million people are living with it worldwide including approximately 920 000 people in the UK. Evidence has consistently demonstrated the links between cardiac health and mental health; therefore, this article will explain depression and its presentation in heart failure, as these two conditions have been strongly and consistently linked. The prevalence of depression in heart failure will be reviewed from epidemiological studies and an overview of the impact of comorbid depression in heart failure will be provided, with a particular focus on mortality, morbidity and quality of life outcomes. The relationship between depression and heart failure will be discussed by examining pathophysiological and behavioural mechanisms, as well as evidence regarding the appropriate identification and subsequent management of heart failure depression will be reviewed.

Quality of Life and Life Satisfaction among Persons with Alcohol Dependence Syndrome

2020 ◽  
Vol 21 (1) ◽  
pp. 50
Author(s):  
Bijayalaxmi Dash ◽  
Mamta Rani Swain
Keyword(s):  
Quality Of Life ◽  
Life Satisfaction ◽  
Alcohol Dependence ◽  
Sampling Technique ◽  
Poor Quality ◽  
Vital Role ◽  
Satisfaction Scale ◽  
Alcohol Dependence Syndrome ◽  
The Relationship

Background: Quality of life plays a vital role to improve the life satisfaction of an individual. The increase in quality of life is related to the increase of subjective life satisfaction. There is an existing relationship between quality of life and life satisfaction for persons with alcohol dependence (Frisch et al., 2000). Aim: The aims of the present study was to assess and examine the relationship between Quality of life and life satisfaction among persons with alcohol dependence. Methodology: A total number 30 respondents with alcohol dependence syndrome were taken by using a purposive sampling technique. The samples were collected from MHI (COE), SCBMCH, Cuttack IPD and OPD. The scales such as WHOQOL-BREF questionnaire and Life Satisfaction were administered. Result: In this present study it was found that the persons with alcohol dependence scored the poor quality of life in all domains of WHO QOL, as well as life satisfaction scale and also statistically positive significant co-relationbetween quality of life and life satisfaction among persons with alcoholdependence.

scholarly journals Quality of Life and Stigma among Women with Epilepsy during Their Reproductive Years

2021 ◽  
Vol 11 (1) ◽  
pp. 63-71
Author(s):  
Pallerla Srikanth ◽  
Mysore Narasimha Vranda ◽  
Priya Treesa Thomas ◽  
Kenchaiah Raghvendra
Keyword(s):  
Quality Of Life ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Care Hospital ◽  
Age Group ◽  
Stigma Scale ◽  
The Impact ◽  
The Relationship ◽  
Reproductive Age Group

Background and Purpose: The purpose of this study was to understand the relationship between quality of life and stigma among reproductive age group women with epilepsy.Methods: A cross-sectional descriptive study was conducted to assess the data from the 49 women with epilepsy from a tertiary care hospital in India. Quality of life was evaluated with the quality of life in epilepsy-31 questionnaire and stigma was evaluated with the stigma scale of epilepsy. Data also included socio-demographic and clinical characteristics.Results: The mean age of the participants was 24.67±3.72 years. Quality of life total score (r=-0.485**) and seizure worry domain (r=-0.427**) were significantly negatively correlated with stigma total score at p<0.01 level. Being uneducated, married, unemployed, having children, having generalized tonic-clonic seizures, duration of illness (˃10 years), and consuming levetiracetam, anti-epileptic drug (AED), were the significant contributing factors for low quality of life among women with epilepsy during the reproductive age group. Belonging to lower socio-economic status and taking more than two AEDs were also associated with lower quality of life among women with epilepsy, which are trending towards significance.Conclusions: The study assessed the relationship between the quality of life and the Stigma scale of epilepsy and demonstrated the impact of stigma and quality of life on socio-demographic and clinical variables of women with epilepsy under the reproductive age group. To enhance the quality of life and reduce the stigma levels among women with epilepsy, some of the modifiable parameters can be considered by the multidisciplinary health care professionals from the findings of the current research.

scholarly journals Anxiety, depression and quality of life in mothers of intellectually disabled children

2018 ◽  
Vol 6 (2) ◽  
pp. 28-35
Author(s):  
N Sapkota ◽  
A K Pandey ◽  
BK Deo ◽  
MK Shrivastava
Keyword(s):  
Quality Of Life ◽  
Intellectual Disability ◽  
Poor Quality ◽  
Anxiety And Depression ◽  
Disabled Children ◽  
Intellectually Disabled ◽  
Icd 10 ◽  
Anxiety Depression ◽  
The Relationship

Introduction: Studies have shown that there is an association between Anxiety, Depression in mothers of children having Intellectual disability with poor quality of life (QOL) in mothers of such children. This study was carried with the objectives to describe the clinico-socio-demographic profile of mothers of intellectually disabled children and to investigate the relationship among anxiety and depression with quality of life in mothers with intellectually disabled children.Material And Method: Mothers (N=31), whose children's IQ score was below 70, were enrolled in to the study with their informed consent. Depression and Anxiety disorders were diagnosed as per ICD 10. Severity of depression was measured with BDI and Anxiety symptoms with STAI. WHOQOL-BREF was used to assess Quality of life. The relationship among anxiety, depression and QOL were analysed using diagonal matrix, ANOVA and Pearson correlation test.Results: The mean age of participants was 50.23 (S.D= 6.11), BDI score was 13.65(S.D= 11.301), STAI score was 53.90 (SD= 15.821), WHOQOL- BREF in all four domains was 290.90 (S.D=49.42). There was significant correlation between BDI and STAI (P=0.01, r:0.651 ) and the three domains of WHOQOL- BREF(P=0.01, r:0.821, 0.843, 0.635 respectively) scale except Environment domain. Among the participants, 48.4% (ICD 10) had depression of varying degree along with 54.8% depression as per BDI cut off score. Anxiety disorder was seen in 22.6% as per ICD 10 but as per STAI it was 53.90(SD=15.821) which was statistically significant (p:0.01, r: -0.507). Depression when compared with no diagnosis persons has poor quality of life in WHOQOL-BREF physical domain (p:0.002) but with compared to Anxiety or both it was not statistically significant.Conclusion: The findings of this study revealed that mothers of children having Intellectual disability have high level of Anxiety and Depression which indeed had impact in quality of life. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017 Page: 28-35

Completed cases of provision of medical care and lethal outcomes in insured individuals with respiratory diseases in the Ryazan region

2021 ◽  
Vol 29 (2) ◽  
pp. 233-238
Author(s):  
Elena V. Manukhina ◽  
Svetlana V. Yurina ◽  
Sergey I. Gladkih
Keyword(s):  
Medical Care ◽  
Respiratory Diseases ◽  
Circulatory System ◽  
Medical Insurance ◽  
Organizational Level ◽  
Age Group ◽  
Microsoft Excel ◽  
Emergency Situations ◽  
Icd 10

AIM: This study aimed to investigate the dynamics of the volume of medical care (MC) provided to the population within the territorial program of compulsory medical insurance (CMI). This study also aimed to examine the lethal outcomes of insured individuals with respiratory diseases (RD) for 5 months in 2020 and 5 months in 2019 in the Ryazan Region during the COVID-19 pandemic. MATERIALS AND METHODS: Analysis was carried out on the basis of the paid registers of the accounts submitted by medical organizations to medical insurance organizations. These accounts were grouped in accordance with the order of the Federal CMI Fund No 104 On Establishment of the Form and Procedure for Reporting on Cases of Providing MC and the Results of Expertise of the Quality of MC dated June 04, 2018. In this study, all the completed cases of the treatment of the insured individuals with RD (ICD-10 codes: J00-J99) in the medical organizations of the Ryazan Region in 20192020 within the compulsory medical insurance were selected. The obtained data were statistically analyzed using the Microsoft Excel application package (Microsoft, USA) and descriptive statistics. RESULTS: The completed treatment cases of the insured individuals with RD in 2020 were categorized according to the age of patients, nosological form, and conditions for the provision of MC. They had different dynamics of growth/decline relative to the same period in 2019. In the structure of the cases of the MC provision, RD accounted for 13.2% (third place). This tendency was observed in the group of patients aged 60 years (7.8%). In patients aged 1860 years, the proportions of RD (18.0%) and diseases of the digestive system (18.1%) were higher than those of the diseases of the circulatory system (14.2%). The total number of cases of the MC provision to patients with this pathology for 5 months in 2020 decreased by 12.9% compared with that for 5 months in 2019 (11.3% in the age group of 1860 years and 16.6% in individuals aged 60 years). Despite the 38.3% decrease in the number of hospitalizations, the number of the completed cases of specialized MC for pneumonia increased by 27.7% (43.9% in the age group of 1860 years and 11.4% in the age group of 60 years). The comparative analysis of 5 months in 2020 and 2019 showed a 57.1% increase in deaths among patients aged 60 years in the provision of specialized MC and a 20.0% reduction among individuals aged 1860 years. CONCLUSION: The number of insured individuals seeking MC for RD increased during the COVID-19 pandemic, and the level of hospital lethality was low. Therefore, the organizational level of MC in the region was high, and medical organizations were adequately prepared for emergency situations with the preserved provision of high-quality MC.

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