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Barriers to alcohol addiction treatment in women and men experiencing alcohol addiction in a Thai context: Exploring lived experiences and healthcare providers’ perspectives
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani College of Nursing Changwat Nonthaburi, Thailand.ORCID iD: 0000-0002-0495-9580
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Risky drinking behaviour can strongly influence the lives of individuals and families, including having negative effects on social welfare and health. The low rate of healthcare service use among people experiencing alcohol addiction is an important problem in Thai society.

The overall aim of the study was to explore the barriers to alcohol treatments for people experiencing alcohol addiction. This thesis includes four qualitative studies that employed three different data collection methods. Individual interviews were used in studies I and II and were analysed with descriptive phenomenology. Focus group interviews were conducted in study III, and the Delphi method was applied in study IV. Both of the latter studies employed content analysis. Purposive sampling was applied to identify participants for the four studies, which included 13 men (study I) and 12 women (study II) experiencing alcohol addiction, 32 healthcare providers (study III) and 32 experts in the alcohol treatment field (study IV); the providers and experts were primarily nurses (study III and IV).

The identified barriers at the individual level included the unawareness of alcohol addiction, gender differences in treatment and in society, the experienced stigma related to alcohol addiction and the lack of engagement in alcohol treatment. Barriers at the organizational level were related to healthcare providers’ agencies and engagement, vertical and horizontal collaborative practices within the hospital wards, and the collaboration with patients and their next of kin. Additionally, the struggle of handling the different sexes during treatment and the difficulties of using the required standard methods were described by the healthcare providers. At the structural level, the barriers were related to the patriarchal society, gender equity and the resources and funding from the Ministry of Public Health for improving the well-being and equal healthcare rights of people experiencing alcohol addiction in Thailand.

In order to improve equal rights to health for people experiencing alcohol addiction in Thailand, knowledge of alcohol addiction, stigma and domestic violence related issues needs to be improved in the healthcare service system. Formal training and nurse educational programmes are needed to reach the theoretical and practical potential of nurses and of other healthcare providers working in alcohol addiction.

Key words: alcohol addiction, gender perspective, lived experiences, alcohol dependency, focus- group interviews, Delphi study

Place, publisher, year, edition, pages
Västerås: Mälardalen University , 2016.
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 218
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-33431ISBN: 978-91-7485-297-4OAI: oai:DiVA.org:mdh-33431DiVA: diva2:1038676
Public defence
2016-12-09, Raspen, Mälardalens högskola, Eskilstuna, 13:15 (English)
Opponent
Supervisors
Available from: 2016-10-24 Created: 2016-10-19 Last updated: 2016-11-18Bibliographically approved
List of papers
1. Thai Men’s experiences of Alcohol Addiction and Treatment
Open this publication in new window or tab >>Thai Men’s experiences of Alcohol Addiction and Treatment
2014 (English)In: Global health action, ISSN 1654-9880, Vol. 7, no 1, Article number 23712- p.Article in journal (Refereed) Published
Abstract [en]

Background: Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men's experiences with addiction and alcohol treatment programs in Thailand.Objective: The aim of this study was to explore men's experiences in terms of the 'pros and cons of alcohol consumption' in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking. Design: Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32-49 years) were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology. Results: Through men's descriptions, three clusters of experiences were found that were 'mending the body', 'drinking as payoff and doping related to work', and 'alcohol becoming a best friend' as ways of describing the development of addiction. Conclusions: The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking. © 2014 Kulnaree Hanpatchaiyakul et al.

National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-24885 (URN)10.3402/gha.v7.23712 (DOI)000336451300001 ()2-s2.0-84904400223 (ScopusID)
Available from: 2014-04-24 Created: 2014-04-24 Last updated: 2016-10-24Bibliographically approved
2. Lived experience of Thai women with alcohol addiction
Open this publication in new window or tab >>Lived experience of Thai women with alcohol addiction
2016 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: The high prevalence of alcohol consumption, together with its associated health risk factors, has long-term negative impacts on both society and the economy in Thailand. Aim: The aim of this study was to explore the experiences of healthcare providers working with people experiencing alcohol addiction and the treatment programs in a Thai hospital. Methods: Qualitative study was applied in this study by conducting focus group interviews with 32 interdisciplinary healthcare providers, most of which were nurses. Content analysis was applied to analyze the verbatim-transcribed data. Findings: Two main topics emerged: (1) the collaborative practices related to alcohol treatment, and (2) the fit of the program, including how the treatment program functions. Obstacles were identified and formulated from several sub-categories. Conclusions: The findings included obstacles linked to the imported (Western) program and the patriarchal structure in Thai culture, which seem to intersect and reinforce each other.

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-33451 (URN)
Available from: 2016-10-24 Created: 2016-10-24 Last updated: 2016-10-24
3. Healthcare providers' experiences of working with alcohol addiction treatment in Thailand
Open this publication in new window or tab >>Healthcare providers' experiences of working with alcohol addiction treatment in Thailand
2016 (English)In: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, 59-73 p.Article in journal (Refereed) Published
Abstract [en]

Background: The high prevalence of alcohol consumption, together with its associated health risk factors, has long-term negative impacts on both society and the economy in Thailand. Aim: The aim of this study was to explore the experiences of healthcare providers working with people experiencing alcohol addiction and the treatment programs in a Thai hospital. Methods: Qualitative study was applied in this study by conducting focus group interviews with 32 interdisciplinary healthcare providers, most of which were nurses. Content analysis was applied to analyze the verbatim-transcribed data. Findings: Two main topics emerged: (1) the collaborative practices related to alcohol treatment, and (2) the fit of the program, including how the treatment program functions. Obstacles were identified and formulated from several sub-categories. Conclusions: The findings included obstacles linked to the imported (Western) program and the patriarchal structure in Thai culture, which seem to intersect and reinforce each other.

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-33188 (URN)10.1080/10376178.2016.1183461 (DOI)000381017500005 ()2-s2.0-84966698953 (ScopusID)
Available from: 2016-09-16 Created: 2016-09-16 Last updated: 2016-10-31Bibliographically approved
4. Barriers to successful treatment of alcohol addiction perceived by healthcare professionals in Thailand: a Delphi study about obstacles and improvement suggestions
Open this publication in new window or tab >>Barriers to successful treatment of alcohol addiction perceived by healthcare professionals in Thailand: a Delphi study about obstacles and improvement suggestions
2016 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9Article in journal (Refereed) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-33453 (URN)10.3402 /gha.v9.31738 (DOI)
Available from: 2016-10-24 Created: 2016-10-24 Last updated: 2016-10-24Bibliographically approved

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