동서간호학연구지 (Journal of East-West Nursing Research)

  • 제29권2호
  • /
  • Pages.172-184
  • /
  • 2023
  • /
  • 1226-4938(pISSN)
  • /
  • 2671-8448(eISSN)
경희대학교 동서간호학연구소 (East-west Nursing Research Institute, Kyung Hee University)
권호 표지
DOI QR코드

DOI QR Code

알코올 사용 장애 환자의 재발경험: Q 방법론적 접근

Relapse Experience of Patients with Alcohol Use Disorder: Q Methodological Approach

  • 김진주 (국제대학교 간호학과) ;
  • 현명선 (아주대학교 간호대학.간호과학연구소)
  • Kim, Jin Ju (Department of Nursing, Kookje University) ;
  • Hyun, Myung Sun (College of Nursing.Research Institute of Nursing Science, Ajou University)
  • 투고 : 2023.09.01
  • 심사 : 2023.11.13
  • 발행 : 2023.11.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The purpose of this study was to identify the subjective relapse experiences of patients with alcohol use disorder in one's life context. Methods: A Q methodology was used to analyze the subjectivity of relapse experiences among 55 participants with alcohol use disorder. Fifty-five Q-statement were derived from interviews and literature review. Q-statements were classified into normally distributed shapes using a 9-point scale. Data were analyzed using the QUANL program. Results: Four types of relapse experiences were identified: failure to self-regulation drinking cravings, fear of relapse and awareness of the need for treatment, drinking as a coping mechanism and defensive coping, and lack of motivation to change drinking behavior. Conclusion: The results of this study suggest that patients with alcohol use disorder need a differential approach based on four types of relapse experiences in the recovery process.

키워드

참고문헌

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Kwon JS, translator. Seoul, Hakjisa; 2015. p. 1-1040.
  2. Ministry of Health and Welfare. The survey of mental disorders in 2021 [Internet]. Sejong: Ministry of Health and Welfare; 2021 [cited 2023 Jan 30]. Available from: https://mhs.ncmh.go.kr/skin/doc.html?fn=refer ence_202205310130225743&rs=/result/202301
  3. Lee HK. Epidemiology of alcohol use disorders and alcohol policy. Journal of Korean Neuropsychiatric Association. 2019;58(3):152-8. Available from: https://doi.org/10.4306/jknpa.2019.58.3.152
  4. Statistics Korea. Statistics on causes of death in 2021 [Internet]. Daejeon: Statistics Korea; 2021 [cited 2023 Feb 3]. Available from: https://kosis.kr/ index/index.do
  5. Eun TK, Kim HO, Park SH, Lim JY, Chung JK, Kim EJ, et al. Childhood ADHD features are associated with adulthood alcohol use disorder. Journal of Korean Academy of Addiction Psychiatry. 2017;21(1):30-7. https://doi.org/10.37122/kaap.2017.21.1.30
  6. Lee BH, Lee HK, Jeo KH, Chung S, Oh HS, Chon Y, et al. A study on the estimation of community-based services demands for the management of patients with alcohol use disorder. Journal of Korean Academy of Addiction Psychiatry. 2019;23(1):33-9. https://doi.org/10.37122/kaap.2019.23.1.33
  7. Hendershot CS, Witkiewitz K, George WH, Marlatt GA. Relapse prevention for addictive behaviors. Substance Abuse Treatment, Prevention, and Policy. 2011;6(17):1-17. https://doi.org/10.1186/1747-597X-6-17
  8. Klimas J, Tobin H, Field CA, O'Gorman CSM, Glynn LG, Keenan E, et al. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database of Systematic Reviews. 2014;12:CD009269. https://doi.org/10.1002/14651858.CD009269.pub3
  9. Sliedrecht W, Waart R. Witkiewitz K, Roozen HG. Alcohol use disorder relapse factors: A systematic review. Psychiatry Research. 2019;278:97-115. https://doi.org/10.1016/j.psychres.2019.05.038
  10. DiClemente CC, Crisafulli MA. Relapse on the road to recovery: Learning the lessons of failure on the way to successful behavior change. Journal of Health Service Psychology. 2022;48(2):59-68. https://doi.org/10.1007/s42843-022-00058-5
  11. Bottlender M, Soyka M. Outpatient alcoholism treatment: predictors of outcome after 3 years. Drug and Alcohol Dependence. 2005;80(1):83-9. https://doi.org/10.1016/j.drugalcdep.2005.03.011
  12. Lee HJ, Choi YH. Characteristics of male alcohol-dependent patients based on MMPI-2 Profile typology. Korean Journal of Clinical Psychology. 2016;35(4):723-33. https://doi.org/10.15842/kjcp.2016.35.4.002
  13. Shon DG. A study on the relationship between the factors and frequency of alcoholism relapse focusing on the moderating effect of gender. Mental Health and Social Work. 2014;42(1):61-90.
  14. Lim SB. Effects of withdrawal symptoms and alcohol insight on the alcoholic relapse: Focusing on the mediating effect of alcohol expectancy and self-efficacy. Alcohol and Health Behavior Research. 2013;14(1):1-15.
  15. Whang SM, Choi YS. Psychological inquiry of human subjectivity: Studies of human mind in object manner. Journal of Korean Society for the Scientific Study of Subjectivity. 2010;21:5-18.
  16. Kim HK. Q methodology and theory: P sampling and Q sorting. Journal of Korean Society for the Scientific Study of Subjectivity. 2007;15:5-19.
  17. Sayette MA, Griffin KM. Self-regulatory failure and addiction. In K. D. Vohs & R. F. Baumeister (Eds.), Handbook of self-regulation: Research, theory, and applications. New York, Guilford Press: 2011. p. 505-21.
  18. Schneekloth TD, Biernacka JM, Hall-Flavin DK. Karpyak VM, Frye MA, Loukianova LL, et al. Alcohol craving as a predictor of relapse. American Journal on Addictions. 2012;21:20-6. https://doi.org/10.1111/j.1521-0391.2012.00297.x
  19. Kvamme BO, Asplund K, Bjerke TN. Drinking resumption: Problematic alcohol use relapse after rehabilitation. A phenomenological hermeneutical perspective. Scandinavian Journal of Caring Sciences. 2015;29(4): 716-23. https://doi.org/10.1111/scs.12202
  20. Shin JH. Diagnosis of dementia: Neuropsychological test. Korean Journal of Family Medicine. 2010;31(4):253-66. https://doi.org/10.4082/kjfm.2010.31.4.253
  21. Kim HK. Agreement between the Q block and the Q tool. Journal of Korean Society for the Scientific Study of Subjectivity. 2008;16:5-16.
  22. Fiabane E, Ottonello M, Zavan V, Pistarini C, Giorgi I. Motivation to change and posttreatment temptation to drink: A multicenter study among alcohol-dependent patients. Neuropsychiatric Disease and Treatment. 2017;13:2497-504. https://doi.org/10.2147/NDT.S137766
  23. Ng SM, Rentala S, Chan CLW, Nayak RB. Nurse-led body-mind-spirit based relapse prevention intervention for people with diagnosis of alcohol use disorder at a mental health care setting, India: A pilot study. Journal of Addictions Nursing. 2020;31(4):276-86. https://doi.org/10.1097/JAN.0000000000000368
  24. Kang MS, Kim YH. Development and effectiveness evaluation of mindfulness-cognitive schema therapy program for decreased alcohol craving, increased abstinence self-efficacy, mindfulness and self-compassion of alcohol use patients. Korean Journal of Educational Therapist. 2022;1: 81-98. https://doi.org/10.35185/KJET.14.1.5
  25. Jung JG, Kim JS, Kim GJ, Oh MK, Kim SS. Brief insight-enhancement intervention among patients with alcohol dependence. Journal of Korean Medical Science. 2011;26(1):11-6. https://doi.org/10.3346/jkms.2011.26.1.11
  26. Wlodarczyk O, Schwarze M, Rumpf HJ, Metzner F, Pawils S. Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review. PLoS One. 2017;12(6):1-15. https://doi.org/10.1371/journal.pone.0179140
  27. Sharma M, Atr A. Application of Transtheoretical Model (TTM) to addictive behaviors: Need for fine tuning. Journal of Alcohol and Drug Education, 2006;50(4):3-6. http://www.jstor.org/stable/45091741
  28. Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: Applications to addictive behaviors. American Psychologist. 1992; 47(9):1102-14. https://doi.org/10.1037/0003-066X.47.9.1102
  29. Johansson JA, Holmes D. "Recovery" in mental health services, now and then: A poststructuralist examination of the despotic State machine's effects. Nursing Inquiry. 2023;e12558:1-8. https://doi.org/10.1111/nin.12558