Mothers Caring for Adult Children With Substance Use Disorder: Understanding Lived Experience

2021 ◽  
pp. 084456212110374
Author(s):  
Oona St-Amant ◽  
Jasna K. Schwind
Keyword(s):  
Substance Use ◽  
Lived Experience ◽  
Family Involvement ◽  
Substance Use Disorder ◽  
Adult Children ◽  
Service Provision ◽  
Health Care Systems ◽  
Anticipatory Grief ◽  
Care Systems ◽  
Mothers Experiences

Background Most persons with substance use disorder (SUD) live in family settings. In the absence of adequate mental health services, mothers are often called upon to provide care for their adult children with SUD. Despite positive outcomes such as decreased rates of hospitalization associated with family involvement, mothers are often stigmatized within the health care systems as contributors to trauma and/or family dysfunction. Purpose The purpose of this study is to explore mothers’ lived experience of caring for adult children with SUD. Method Guided by critical feminist theory, this study used interpretive descriptive qualitative research design to identify patterns within mothers’ experiences for practical relevance and application to service provision. Results The findings yielded in this study identified mothers’ experiences as: longing for wellness, identity as loving mother, loss, anticipatory grief, shame and blame and feeling excluded from services. Ultimately, the findings from this study extend the limited research to date on mothers’ experiences of stigma, especially when they are blamed for their child’s illness. Conclusions Findings from this study advocate for family-centered approaches that attend to mothers’ unique experience, from their standpoint, and offer recommendations for change to service provision.

Representative Bureaucracy Through Staff With Lived Experience: Peer Coproduction in the Field of Substance Use Disorder Treatment

2020 ◽  
Vol 50 (8) ◽  
pp. 880-897
Author(s):  
Sunggeun (Ethan) Park
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Lived Experience ◽  
Substance Use Disorder ◽  
The United States ◽  
Descriptive Representation ◽  
Representative Bureaucracy ◽  
Organizational Decision Making ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

This study extends the representative bureaucracy literature by theorizing and empirically testing how staff sharing lived experience with service users can serve as user representatives in service provision processes (i.e., the peer coproduction mechanism). Using survey data from a representative sample of substance use disorder treatment clinics in the United States, we explore factors associated with descriptive representation (the presence of staff with firsthand experience of a substance use disorder in both frontline treatment and senior positions) and directors’ perceptions of recovering staff’s potential to serve as user representatives in individual care and organizational decision-making processes. Recovering staff accounted for a third of the field’s workforce, but the majority of the clinics did not employ them in senior staff positions. Regression results suggest that organizational leaders’ recognition of recovering staff’s unique representation capacities may facilitate greater descriptive representation and grant meaningful organizational decision-making authority to recovering staff. Multiple research and practice implications are discussed.

Dancing With Death in the Dust of Coronavirus: The Lived Experience of Iranian Nurses

2020 ◽  
Vol 26 (4) ◽  
pp. e82-e89
Author(s):  
Fatemeh Bahramnezhad ◽  
Parvaneh Asgari
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Phenomenological Approach ◽  
Care Providers ◽  
Care Systems ◽  
Interpretative Phenomenological Approach ◽  
Communication Challenges ◽  
Novel Coronavirus

The novel coronavirus disease (COVID-19) pandemic as a public health emergency poses dramatic challenges for health-care systems. The experiences of health-care workers are important in planning for future outbreaks of infectious diseases. This study explored the lived experiences of 14 nurses in Tehran, Iran caring for coronavirus patients using an interpretative phenomenological approach as described by Van Manen. In-depth interviews were audio-recorded between March 10 and May 5, 2020. The essence of the nurses' experiences caring for patients with COVID-19 was categorized as three themes and eight subthemes: (a) Strong pressure because of coronavirus: initial fear, loneliness, communication challenges, exhaustion. (b) Turn threats into opportunities: improvement of nursing image, professional development. (c) Nurses' expectations: expectations of people, expectations of government. The findings of this study showed that identifying the challenges and needs of health-care providers is necessary to create a safe health-care system and to prepare nurses and expand their knowledge and attitudes to care for patients in new crises in the future.

scholarly journals Depression, anxiety, and stress from substance-use disorder among family members in Iceland

2018 ◽  
Vol 35 (3) ◽  
pp. 165-178 ◽  
Author(s):  
Jóna Ólafsdóttir ◽  
Steinunn Hrafnsdóttir ◽  
Tarja Orjasniemi
Keyword(s):  
Substance Use ◽  
General Population ◽  
Family Member ◽  
Substance Use Disorder ◽  
Adult Children ◽  
Addiction Treatment ◽  
Substance Abusers ◽  
Family Members ◽  
Mental States ◽  
Depression Anxiety Stress Scale

Aims: This research was designed to explore the extent to which the use of alcohol or drugs by one member of a family affects the psychosocial state of other family members. The study asks whether family members of substance abusers are more likely to report increased depression, anxiety and stress then the general population in Iceland? Are there significant differences between family members; e.g., spouses, parents, adult children and siblings by gender, age, education and income? Data and methods: The instrument used for this purpose is the Depression Anxiety Stress Scale (DASS), which is designed to measure those three related mental states. It was administered to 143 participants (111 women and 32 men) with ages ranging from 19–70 years on the first day of a four-week group therapy programme for relatives of substance use disorder (SUD) at The Icelandic National Centre for Addiction Treatment (SÁÁ) from August 2015 to April 2016. Thirty participants are adult children of a parent with SUD, 47 are a spouse, 56 are parents of a child with SUD and 10 are siblings. The subscales of the DASS for depression, anxiety, and stress were utilised to examine which family member – parent, child, partner, or sibling – presented the behaviour associated with SUD. Results: 36% or more of the respondents in all three subscales had average, serious, or very serious depression, anxiety, and/or stress. This is higher than in DASS studies of the general population in Iceland. However, the analysis indicates that it made little difference to the family’s wellbeing which family member was affected by SUD.

Back to Europe: Back to Bismarck?

1996 ◽  
Vol 26 (4) ◽  
pp. 777-802 ◽  
Author(s):  
Hans-Ulrich Deppe ◽  
Stjepan Oreskovic
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Service Provision ◽  
Health Care Systems ◽  
Insurance Companies ◽  
Central State ◽  
German Health Care System ◽  
German Health ◽  
Care Systems ◽  
Care System

Since 1989 there have been enormous changes in all aspects of health policy, and the Former Socialist Economies (FSEs) are facing similar challenges. The general restructuring of politics and economies has resulted in two leading orientations in the transformation of health care systems: the separation of funding and service provision from the state, and the separation of funding and service provision from each other. Many FSEs have already passed legislation establishing a sickness insurance system under a single national funding institution, or a combination of compulsory and voluntary insurance, or a system involving private sector insurance companies in generating compulsory or voluntary health care funding. Due to the peculiarities and specific features of the German health care system, the uncritical intention to implement the “Bismarck model” in the FSEs faces several problems. These can be summarized in one main point: the relative stability of the German health care system, which may be attractive to the FSEs, is based on economic prosperity and on a strong ability to assert the will of the central state institutions; these preconditions are not present in the FSEs.

scholarly journals (In)Visible illness: A photovoice study of the lived experience of self-managing rheumatoid arthritis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248151
Author(s):  
Susie Donnelly ◽  
Anthony G. Wilson ◽  
Hasheem Mannan ◽  
Claire Dix ◽  
Laura Whitehill ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lived Experience ◽  
Sense Of Self ◽  
Health Care Systems ◽  
Analysis Data ◽  
Situational Factors ◽  
Self Management ◽  
Management Support ◽  
Structured Interviews ◽  
Care Systems

Background Chronic illnesses, such as Rheumatoid Arthritis (RA), are a growing burden on health care systems worldwide. Self-management emphasises the patient’s central role in managing their illness. This is pertinent given the majority of care is provided by the individual themselves; yet how individuals make sense of self-management in everyday life is largely unseen. Objective The purpose of this study was to capture the strengths and concerns of individuals with RA in self-managing their illness, raise awareness of their lived experience and spark a dialogue among stakeholders. Methods A community-based participatory approach, Photovoice, was adopted. A purposive sample of participants were tasked with taking photographs to represent the challenges and solutions to living with RA. Group workshops and semi-structured interviews were conducted to facilitate reflection, dialogue and analysis. Data analysis followed Braun and Clarke’s thematic analysis. Public exhibitions were held throughout the Autumn of 2019. Results Eight women and three men (n = 11) across suburban and urban regions of Ireland were recruited (mean age 57 years, disease duration 4–21 years). Participants identified four main themes which reflected the lived experience of self-managing RA: (i) I’m Here but I’m Not, (ii) Visible Illness, (iii) Medicine in All its Forms, (iv) Mind Yourself. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness. Solutions focused on improving psychological and emotional resilience, particularly through personal reflection and increased agency. Conclusions Our findings suggest that RA is experienced as a fluid relationship between states of masking and surfacing of illness shaped by contextual and situational factors. Photovoice was a highly effective tool to capture and communicate this complexity. Supporting increased agency among individuals with RA to control the (in)visibility of illness and disability can inform the development of future self-management support.

scholarly journals Service and Policy implication of substance use disorders among adolescents in juvenile correctional facilities in Lagos, Nigeria

2016 ◽  
Vol 3 ◽  
Author(s):  
O. Atilola ◽  
B. Ola ◽  
G. Abiri
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Juvenile Justice ◽  
Lived Experience ◽  
Substance Use Disorder ◽  
Prevalence Rate ◽  
Juvenile Justice System ◽  
Care Plan ◽  
Street Child ◽  
Correctional Facilities

Background.Lack of relevant data has continued to militate against the development of policy and practice toward identification and treatment of alcohol/substance abuse among adolescents coming in contact with the juvenile justice system in Nigeria. This study aims to provide such data, including its policy/practice implications.Methods.One hundred and seventy eight (178) adolescents, who are representative of adolescents within the youth correctional services of Lagos jurisdiction, were interviewed using the alcohol and substance abuse section of the Kiddies’ Schedule for Affective Disorders and Schizophrenia.Results.The lifetime prevalence rate of abuse of/dependence on any of alcohol or other substances was 22.5% (alcohol, 12.3%; illicit substance, 17.9%). Males were overrepresented among those with any substance use disorder, with gendered prevalence rate as high as 35%. Having had a lived-experience of being a street-child was the single most significant independent factor (Odds ratio (OR), 8.4;p= 0.007) associated with lifetime alcohol substance use disorder.Conclusions.Substance use disorder is highly prevalent among adolescents within the juvenile justice systems in Lagos Nigeria. There is need for deliberate incorporation of alcohol and substance abuse screening and intervention as part of individual care plan in youth correctional facilities in Nigeria. Practical steps toward achieving this were drawn from local reality and international best practices.

Using Mismatch Negativity to Investigate the Pathophysiology of Substance Use Disorders and Comorbid Psychosis

2018 ◽  
Vol 49 (4) ◽  
pp. 226-237 ◽  
Author(s):  
Jessica U. Ramlakhan ◽  
Reza Zomorrodi ◽  
Jonathan Downar ◽  
Daniel M. Blumberger ◽  
Zafiris J. Daskalakis ◽  
...  
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Mismatch Negativity ◽  
Health Care Systems ◽  
Event Related Potential ◽  
Cannabis Use ◽  
Chronic Alcohol ◽  
Care Systems ◽  
Heavy Burden

Substance use disorders (SUDs) have a devastating impact on society and place a heavy burden on health care systems. Given that alcohol, tobacco, and cannabis use have the highest prevalence, further understanding of the underlying pathophysiology of these SUDs is crucial. Electroencephalography is an inexpensive, temporally superior, and translatable technique which enables investigation of the pathobiology of SUDs through the evaluation of various event-related potential components, including mismatch negativity (MMN). The goals of this review were to investigate the effects of acute and chronic alcohol, tobacco, and cannabis use on MMN among nonpsychiatric populations and patients with comorbid psychosis. A literature search was performed using the database PubMed, and 36 articles met our inclusion and exclusion criteria. We found a pattern of attenuation of MMN amplitude among patients with alcoholism across acute and chronic alcohol use, and this dysregulation was not heritable. Reports were limited, and results were mixed on the effects of acute and chronic tobacco and cannabis use on MMN. Reports on comorbid SUDs and psychosis were even fewer, and also presented mixed findings. These preliminary results suggest that MMN deficits may be associated with SUDs, specifically alcohol use disorder, and serve as a possible biomarker for treating these common disorders.

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