The Impact of an Inpatient Treatment on the Psychodynamic and Symptomatology in Couples Concordant for Substance Use: An Exploratory Study

2020 ◽  
Author(s):  
Aksel Hansen ◽  
Stefan Brokatzky ◽  
Benjamin Kraus ◽  
Kai Thomas ◽  
Christina Sternbauer ◽  
...  
Keyword(s):  
Substance Use ◽  
Exploratory Study ◽  
Research Question ◽  
Healthcare Services ◽  
Structured Interview ◽  
Brief Symptom Inventory ◽  
The Body ◽  
Inpatient Setting ◽  
Individual Level ◽  
The Impact

Abstract Background: Much literature deals with patients who use drugs and have partners who are drug-free. However, concordant couples, in which both partners are consuming drugs, are sparsely examined in the literature. This might be due to the fact, that couples are rarely treated together in healthcare services. Despite that fact we propose that it is feasible and clinically meaningful to treat concordant couples in the same ward. Consequently, this study pursues the goal to expand the body of knowledge in the treatment of concordant couples investigating the research question: is it feasible, clinically and prognostically meaningful to treat these patients in the same ward? Method: This exploratory study included five concordant couples (ten patients), which were simultaneously treated between August 2013 and November 2014 in a specialised substance use ward at the Psychiatric Hospital Münsterlingen, Switzerland. All patients passed through a psychodynamic characterisation based on the OPD-II interview and the Structured Interview for Personality Organization. Symptom load was measured with the Brief Symptom Inventory at admission and termination of treatment. We calculated comparisons at the individual level using t-tests for paired samples. Results: We showed that it is feasible and clinically meaningful to treat couples concordant for substance use in the same ward. The psychodynamic characterization of the five concordant couples revealed recurring patterns of collusion, involving divided roles between dependence and independence, caregiving and neediness, activity and passivity, control and submission, strength and deficiency as well as superiority and inferiority. The patients didn´t change significantly on the BSI between pre- to post-treatment, although men (d = 1.64) benefited to a greater extent than women (d = 0.10). Conclusion: Treating concordant couples together in the same inpatient setting is unusual, but feasible and clinically useful, because it makes it possible to take into account the couples dynamics in the treatment.

scholarly journals The Impact of an Inpatient Treatment on the Psychodynamic and Symptomatology in Couples Concordant for Substance Use: A Qualitative Study

2020 ◽  
Author(s):  
Aksel Hansen ◽  
Stefan Brokatzky ◽  
Kai Thomas ◽  
Christina Sternbauer ◽  
Myriam Rudaz ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Couples Therapy ◽  
Inpatient Treatment ◽  
Brief Symptom Inventory ◽  
Inpatient Setting ◽  
Drug Rehabilitation ◽  
Psychosocial Situation ◽  
The Impact

Abstract Background: Much literature is devoted to describing the psychosocial situation of patients with a substance use disorder and the course of their families and healthy partners. Couples where both partners have a substance use disorder are less well described and even less often studied. Method: This study described the psychodynamic and symptomatology, as measured by the Brief Symptom Inventory (BSI), of five concordant couples treated simultaneously as inpatients at the same specialized substance use disorder ward. Results: The psychodynamic characterization of the couples revealed that the female was often the organizer, whereas the male was either the motivator or the lackey. In addition, the female was often emotionally dependent on the male. Most individuals showed symptom reductions from pre- to post-treatment, although the men seemed to benefit to a greater extent than the women. Moreover, the patients did not necessarily desire couples therapy. Conclusion: Treating couples concordant for substance use together in the same inpatient setting is unusual, but possible. The dynamics of couples in drug rehabilitation should be further investigated taking into account possible gender differences.

scholarly journals Driving Factors for the Utilisation of Healthcare Services by People with Osteoarthritis: Results from A Nationwide Population-Based study

2021 ◽  
Author(s):  
Daniela Costa ◽  
Ana M Rodrigues ◽  
Eduardo B Cruz ◽  
Helena Canhão ◽  
Jaime da Cunha Branco ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Multinomial Logistic Regression ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Structured Interview ◽  
Population Based ◽  
Enabling Factors ◽  
Population Based Study ◽  
The Impact

Abstract Background: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods: We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt . Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables.Results: In our sample, a high proportion of participants are overweight or obese (82,6%, n=748) and physically inactive (20,6%, n=201) and a small proportion had physiotherapy management (14,4%, n=141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. "GPUsers" represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations ( p <0,05) with the higher utilisation of healthcare services profiles. Conclusions: Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.

scholarly journals Household food insecurity is independently associated with poor utilization of maternal healthcare services in Bangladesh

FACETS ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 969-983 ◽  
Author(s):  
Ghose Bishwajit ◽  
Sanni Yaya
Keyword(s):  
Food Insecurity ◽  
Wealth Index ◽  
Healthcare Services ◽  
Sociodemographic Factors ◽  
Outcome Variable ◽  
Household Food Insecurity ◽  
Maternal Healthcare ◽  
Individual Level ◽  
Household Food ◽  
The Impact

Introduction: Food insecurity at the individual level has been shown to be associated with the adoption of risky behavior and poor healthcare-seeking behavior. However, the impact of household food insecurity (HFI) on the utilization of maternal healthcare services (MHS) remains unexplored. In this study, we aimed to investigate whether or not household food insecurity was associated with non/inadequate utilization of MHS. Methods: Participants consisted of 3562 mothers aged between 15 and 49 years and with at least one child. The outcome variable was the utilization of MHS, e.g., institutional delivery, attendance ante-, and pre-natal visits. The explanatory variables included various sociodemographic factors (e.g., age, residence, education, wealth) apart from HFI. HFI was measured using the Household Food Insecurity Access Scale (HFIAS). Result: The prevalence of non- and under-utilization of MHS was 5.3 and 36.5, respectively. In the multivariate analysis, HFI, wealth index, and educational level were independently associated with MHS status. The odds of non- and under-utilization of MHS were 3.467 (CI = 1.058–11.354) and 4.104 (CI = 1.794–9.388) times higher, respectively, among women from households reporting severe food insecurity. Conclusion: Severe HFI was significantly associated with both under- and non-utilization of MHS. Interventions programs that address HFI and the empowerment of women can potentially contribute to an increased utilization of MHS.

Perceptions of the Significant Other of the Effects of Psychodynamic Psychotherapy

1996 ◽  
Vol 168 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Jane Roberts
Keyword(s):  
Family Relationships ◽  
Exploratory Study ◽  
Psychodynamic Psychotherapy ◽  
Extended Family ◽  
Structured Interview ◽  
Emotional Impact ◽  
Individual Psychotherapy ◽  
Significant Other ◽  
The Impact ◽  
The Relationship

BackgroundClinical practice suggests that partners of psychotherapy patients often have powerful feelings about the therapy and therapist. The repercussions of psychotherapy on those close to the patient are rarely considered. A small exploratory study was therefore conducted.MethodAll patients who had completed at least two months of weekly psychodynamic psychotherapy in 1990 at an out-patient unit of a psychiatric hospital (n = 35) and had a partner with whom they were living at the time of starting therapy (n = 23) were contacted. Eight gave permission for their partner to be contacted directly. All eight partners agreed to participate in a semi-structured interview exploring their perceptions of the effects of the therapy on a number of family relationships. The impact of the process of the study was also investigated by means of a questionnaire sent to all partners some weeks after the interview.ResultsConsiderable changes were perceived to have taken place in association with therapy affecting not only the relationship between the couple but also their parenting relationship, the children, and at times members of the extended family. Partners' views about the direction of such changes seemed to influence other perceptions about the therapy.ConclusionsThe repercussions of individual psychotherapy may well spread extensively within a family. This further blurs the boundary between individual and family therapy, both theoretically and clinically. Research procedures are themselves a major intervention and may have a considerable emotional impact on participants.

scholarly journals Driving factors for the utilisation of healthcare services by people with osteoarthritis in Portugal: results from a nationwide population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniela Costa ◽  
Ana M. Rodrigues ◽  
Eduardo B. Cruz ◽  
Helena Canhão ◽  
Jaime Branco ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Multinomial Logistic Regression ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Structured Interview ◽  
Population Based ◽  
Enabling Factors ◽  
Population Based Study ◽  
The Impact

Abstract Background Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt, in Portugal. Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables. Results In our sample, a high proportion of participants are overweight or obese (82,6%, n = 748) and physically inactive (20,6%, n = 201) and a small proportion had physiotherapy management (14,4%, n = 141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. “GPUsers” represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations (p < 0,05) with the higher utilisation of healthcare services profiles. Conclusions Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.

scholarly journals The Association Between Adverse Child Health, Psychological, Educational and Social Outcomes, and Nondependent Parental Substance: A Rapid Evidence Assessment

2018 ◽  
Vol 21 (3) ◽  
pp. 470-483 ◽  
Author(s):  
Ruth McGovern ◽  
Eilish Gilvarry ◽  
Michelle Addison ◽  
Hayley Alderson ◽  
Emma Geijer-Simpson ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Misuse ◽  
Adverse Outcomes ◽  
The Body ◽  
Social Outcomes ◽  
Cross Sectional ◽  
Adverse Health Outcomes ◽  
Psychological Educational ◽  
The Impact ◽  
Parental Alcohol

Background: Between 5% and 30% of children in high-income countries live with a substance misusing parent, the majority of which is below dependent levels. However, little is understood about the impact of nondependent parental substance misuse upon children. Methods: We searched the international literature using rigorous systematic methods to identify studies examining parental substance misuse and adverse outcomes in children. The inclusion criteria were cross-sectional, longitudinal, case-control, and cohort studies; of children aged 0–18 years whose parents are high-risk substance misusers; reporting on their health, psychological, substance use, educational, and social outcomes. Results: We identified 36 papers (from 33 unique studies), most of which were assessed as being of medium to high methodological quality ( N= 28). Parental nondependent substance misuse was found to be associated with adversity in children, with strong evidence of an association with externalizing difficulties ( N = 7 papers, all finding an association) and substance use ( N = 23 papers, all finding an association) in adolescents and some evidence of adverse health outcomes in early childhood ( N = 6/8 papers finding an association). There is less evidence of an association between parental substance misuse and adverse educational and social outcomes. The body of evidence was largest for parental alcohol misuse, with research examining the impact of parental illicit drug use being limited. Conclusion: Methodological limitations restrict our ability to make causal inference. Nonetheless, the prevalence of adverse outcomes in children whose parents are nondependent substance misusers highlights the need for practitioners to intervene with this population before a parent has developed substance dependency.

scholarly journals THE EFFECT OF CULTURE ON PERFORMANCE EXPECTANCY, INTENTION AND TRUST IN MOBILE PAYMENT ADOPTION

2022 ◽  
Vol 14 (1) ◽  
pp. 0-0
Keyword(s):  
Technology Adoption ◽  
The Body ◽  
Cultural Dimensions ◽  
Behavioural Intention ◽  
Consumer Trust ◽  
Mobile Payment ◽  
Individual Level ◽  
Performance Expectancy ◽  
Cultural Variables ◽  
The Impact

This study aims to investigate the role of culture at an individual level in the context of m-payment adoption. Specifically, it examines the effect of uncertainty avoidance and collectivism based on the Hofstede cultural dimensions on three important constructs in technology adoption as well as m-payment adoption which are performance expectancy, behavioural intention and consumer trust. The data was collected in Vietnam which ranked first in m-payment development worldwide in 2019 to test the hypotheses. The findings confirmed the significant impact of cultural variables in the context of mobile payment adoption. The positive and significant impacts of performance expectancy on behavioural intention and consumer trust, and consumer trust on behavioural intention are also confirmed which are aligned to previous studies. This research contributes to the body of literature of not only m-payment adoption, but also the impact of culture in m-payment adoption in particular and technology adoption in general.

scholarly journals THE EFFECT OF CULTURE ON PERFORMANCE EXPECTANCY, INTENTION AND TRUST IN MOBILE PAYMENT ADOPTION

2022 ◽  
Vol 14 (1) ◽  
pp. 0-0
Keyword(s):  
Technology Adoption ◽  
The Body ◽  
Cultural Dimensions ◽  
Behavioural Intention ◽  
Consumer Trust ◽  
Mobile Payment ◽  
Individual Level ◽  
Performance Expectancy ◽  
Cultural Variables ◽  
The Impact

This study aims to investigate the role of culture at an individual level in the context of m-payment adoption. Specifically, it examines the effect of uncertainty avoidance and collectivism based on the Hofstede cultural dimensions on three important constructs in technology adoption as well as m-payment adoption which are performance expectancy, behavioural intention and consumer trust. The data was collected in Vietnam which ranked first in m-payment development worldwide in 2019 to test the hypotheses. The findings confirmed the significant impact of cultural variables in the context of mobile payment adoption. The positive and significant impacts of performance expectancy on behavioural intention and consumer trust, and consumer trust on behavioural intention are also confirmed which are aligned to previous studies. This research contributes to the body of literature of not only m-payment adoption, but also the impact of culture in m-payment adoption in particular and technology adoption in general.

scholarly journals Access to Health Care Services by Individuals Who Are Deaf or Hard of Hearing (Dhh) in Botswana: Francistown and Tati

2020 ◽  
Author(s):  
Gorgeous Sarah Chinkonono ◽  
Vivian Namuli ◽  
Catherine Atuhaire ◽  
Hamida Massaquoi ◽  
Sourav Mukhopadhyay ◽  
...  
Keyword(s):  
Health Care ◽  
Hard Of Hearing ◽  
Access To Health Care ◽  
Health Care Services ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
Structured Interview ◽  
Care Services ◽  
Main Challenge ◽  
The Impact

Abstract Background: Individuals who are Deaf or hard of hearing (DHH) face a lot of challenges when accessing health care services. The main barrier that they face is communication. Despite this, not much research had been carried out in Africa to understand how individuals who are DHH access healthcare services. This study sought to explore experiences of individuals who are DHH in Botswana when accessing healthcare services to propose recommendations towards improving their situation.Methods: This is a qualitative research study using phenomenological approach. Participants were observed at one point in time. Face-to-face in-depth interviews were conducted with 22 DHH individuals living in Francistown and Tati, using a semi-structured interview guide and an interpreter. Participants age range was between 18years to 40years. Purposive sampling and snowballing sampling techniques were used to select the participants.Results: The main challenge that individuals who are DHH in Botswana face is communication barrier which has culminated in their reception of poor healthcare services as the healthcare professionals fail to effectively attain to their health needs. This is evident through wrong prescriptions and treatment; poor counselling services, lack of confidentiality; poor maternal health services especially during child delivery; and limited health information. However, individuals who are DHH in Botswana continues to utilise healthcare services.Conclusion: Poor communication between healthcare professionals and individuals who are DHH act as an impediment to acquiring proper healthcare services by individuals who are DHH. This can lead to poor health outcomes for the DHH population as they are not well informed about health issues that they are at risk of and at times do not know where to seek specific healthcare services pertaining to the health problems they are experiencing. Therefore, there is a need to provide sign language interpreters in the healthcare centres to reduce the impact of this problem.

scholarly journals Towards a Comprehensive Understanding of Fertility: The Model of Dyadic Pathways

2019 ◽  
Vol 44 ◽  
Author(s):  
Uta Brehm ◽  
Norbert F. Schneider
Keyword(s):  
Theory Of Planned Behaviour ◽  
Research Question ◽  
Real Life ◽  
The Body ◽  
Theoretical Contribution ◽  
Future Fertility ◽  
Self Reports ◽  
Individual Self ◽  
The Impact ◽  
Relevant Factors

In this theoretical contribution, we propose a comprehensive and integrative heuristic model to explain fertility, the Model of Dyadic Pathways (MDP). We show how existing models such as the Theory of Planned Behaviour often do not withstand empirical challenges, especially not individual self-reports in qualitative studies. Furthermore, existing models vary in their premises and foci, resulting in a collection of models which do not necessarily align with or supplement one another. For these reasons, these heuristic models have been widely criticised and, in practice, pieced together according to the research question and tradition of the researcher. Against this backdrop, we establish the MDP to reconnect theory with reality and to unify a variety of approaches. The MDP is grounded on the dyad of partners as the prevalent basis of fertility. It integrates reasoned and unreasoned fertility behaviour, the impact of individual- and couple-level life course, soci(et)al conditions, and the body as an “actor”. The model explicitly accounts for the variety of different real-life pathways that lead to fertility. It thereby encourages researchers to, first, consider all potentially relevant factors and their mechanisms and, second, think of fertility and its measurement as a multilinear process. Based on the presented elements a comprehensive model of fertility must cover, we suggest ways to improve surveys accordingly. Furthermore, we elaborate on the contributions and challenges the MDP presents to future fertility research.

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