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Chang C, Wang TJ, Chen MJ, Liang SY, Wu SF, Bai MJ. Factors influencing readiness to change in patients with alcoholic liver disease: A cross-sectional study. J Psychiatr Ment Health Nurs 2021; 28:344-355. [PMID: 32667735 DOI: 10.1111/jpm.12677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 06/19/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Readiness to change has been documented as a factor affecting alcohol treatment attendance, engagement and outcome. Knowledge regarding readiness to change and its influencing factors in patients with alcoholic liver diseases will inform the development of relevant interventions to help these patients to successfully stop drinking. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The scores in all three dimensions of readiness, recognition, ambivalence and taking steps, were low. For the recognition stage, age, drinking severity and stigma are important factors to be considered. For the ambivalence stage, age and drinking severity are important influencing factors. For the taking steps stage, drinking refusal self-efficacy and depression should be the focus. Instead of negative associations, we found that age and drinking severity, self-stigma and depression were positively associated with readiness to change. Patients who are younger and have higher drinking severity, higher self-stigma, higher self-efficacy and severe depression are more likely to change alcohol use. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Age, drinking severity, self-stigma, drinking refusal self-efficacy and depression are important factors to be considered when mental health nurses try to increase psychological preparedness for changing alcohol use in patients with alcoholic liver diseases. Different factors must be considered for patients in different stages of readiness to change. Different alcohol treatments are needed for different patient populations. ABSTRACT: Introduction Readiness to change (RC) refers to the willingness or psychological preparedness for changing alcohol use. Knowledge regarding factors influencing RC is crucial for developing alcohol treatment plans. Aims The study's purpose was to investigate RC and its influencing factors in patients with alcoholic liver disease (ALD). The factors explored include demographics, disease characteristics, drinking severity, self-stigma, depression, social support and self-efficacy. Method This is a cross-sectional study using self-reported questionnaires. Results Eighty-seven patients with ALD were recruited. Their scores in all three dimensions of readiness, recognition, ambivalence and taking steps, were low. Self-stigma, age and drinking severity explained 32.3% variation in recognition. Drinking severity and age explained 21.5% variation in ambivalence. Self-efficacy, depression and age explained 19.3% variation in taking steps. Discussion Instead of negative associations, we found that age, drinking severity, self-stigma and depression were positively associated with RC. Younger patients with higher drinking severity, higher self-stigma, higher self-efficacy and severe depression are more likely to change alcohol use. Implications for practice Mental health nurses should consider factors such as age, drinking severity, self-stigma, self-efficacy and depression, while trying to increase patients' RC. More specifically, strategies to increase self-efficacy and interventions to support coping are needed. Relevance statement Many ALD patients needing treatment for problematic alcohol use can be effectively managed in primary care with appropriate specialist support. An experienced specialist mental health nurse can play this role. Mental health nurses are important members of alcohol addiction treatment teams. Traditionally, most nurses working in alcohol therapy services have been mental health specialists and work in a partnership model with physicians and other healthcare professionals. The influencing factors found in this study can further inform mental health nurses to recognize and work more effectively with ALD patients' alcohol problems.
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Affiliation(s)
- Chi Chang
- Department of Nursing, Mackay Memorial Hospital, Taipei, Taiwan.,School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ming-Jen Chen
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Fang Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ming-Jong Bai
- Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan
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Lucht M, Quellmalz A, Mende M, Broda A, Schmiedeknecht A, Brosteanu O, Höppner-Buchmann J, Langosch J, Stuppe M, Schomerus G, Klauer T, Grabe HJ, Freyberger HJ, John U, Meyer C. Effect of a 1-year short message service in detoxified alcohol-dependent patients: a multi-center, open-label randomized controlled trial. Addiction 2021; 116:1431-1442. [PMID: 33155711 DOI: 10.1111/add.15313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/11/2020] [Accepted: 10/27/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Existing evidence suggests that text message interventions can help people to reduce their alcohol consumption. However, studies with alcohol-dependent patients are lacking. In this study a 1-year automatic mobile phone-based short messaging service (SMS) intervention on alcohol consumption in patients after alcohol detoxification in hospital was compared with treatment as usual. DESIGN Multi-center, randomized, controlled, two parallel-group, observer-blinded trial. SETTING AND PARTICIPANTS Primary and secondary care: four hospitals and community (1 million residents, 7600 km2 area in Germany). A total of 462 patients with alcohol dependence (ICD-10) were included during inpatient detoxification treatment. Patients were randomly assigned (1 : 1) to an SMS intervention and treatment as usual (SMS + TAU; n = 230; mean age: 45.4 years; 22.6% women) or TAU alone (n = 232 mean age: 44.5 years; 22.8% women). Planned, automated messages were sent to patients over 1 year to record assistance needs. A 'yes' or missing response triggered a telephone call from a hospital therapist. Outcome was assessed by an independent survey center. MEASUREMENTS The primary end-point was a three-category alcohol consumption measure covering months 10-12 after discharge: abstinence, non-heavy drinking, heavy drinking [men > 60 g/day; women > 40 g/day equal to World Health Organization (WHO) criteria: high risk and very high risk, mean consumption]. Secondary end-points were number of abstinent days over 12 months and frequency of abstinence. RESULTS The arms differed primarily in the heavy drinking category (intervention group 22.2%, TAU-only group 32.3%) in months 9-12. This is reflected by an odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.11-2.54, P = 0.015 for heavy drinking versus non-heavy drinking/abstinence. No difference between treatments was found with respect to any drinking versus abstinence (OR = 1.13). These results were confirmed by models adjusting for randomization strata. CONCLUSIONS In Germany, a 12-month mobile phone short messaging service-based intervention enhanced the reduction in heavy drinking for 1 year in routine care among adults with alcohol dependence discharged from inpatient alcohol detoxification.
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Affiliation(s)
- Michael Lucht
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany.,Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Anne Quellmalz
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany
| | - Meinhard Mende
- Clinical Trial Center (CTC) Leipzig, University of Leipzig, Leipzig, Germany
| | - Anja Broda
- Clinical Trial Center (CTC) Leipzig, University of Leipzig, Leipzig, Germany
| | | | - Oana Brosteanu
- Clinical Trial Center (CTC) Leipzig, University of Leipzig, Leipzig, Germany
| | - Jacqueline Höppner-Buchmann
- Hospital of Geriatric Psychiatry; Helios Hospital Schwerin, Schwerin, Germany and Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Jens Langosch
- Bethanien Hospital for Psychiatry, Psychosomatics, and Psychotherapy, Greifswald, Germany
| | - Markus Stuppe
- Hospital of Addiction Medicine; Helios Hospital Schwerin, Schwerin, Germany
| | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Thomas Klauer
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Harald J Freyberger
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany.,Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Ulrich John
- Institute of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Greifswald, Germany
| | - Christian Meyer
- Institute of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Greifswald, Germany
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Kilian C, Manthey J, Carr S, Hanschmidt F, Rehm J, Speerforck S, Schomerus G. Stigmatization of people with alcohol use disorders: An updated systematic review of population studies. Alcohol Clin Exp Res 2021; 45:899-911. [PMID: 33970504 DOI: 10.1111/acer.14598] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND We summarize research on the public stigmatization of persons with alcohol use disorder (AUD) in comparison with other mental health conditions and embed the results into a conceptual framework of the stigma process. METHODS We conducted a systematic search using Embase, MEDLINE, PubMed and PsycINFO (via Ovid), and Web of Science for population-based studies on the public stigma in AUD and at least 1 other mental health condition, published between October 1, 2010 and December 20, 2020, thus including all studies published since the last systematic review on this topic. The study is registered with PROSPERO (registration number: CRD42020173054). RESULTS We identified 20,561 records, of which 24 met the inclusion criteria, reporting results from 16 unique studies conducted in 9 different countries. Compared to substance-unrelated mental disorders, persons with AUD were generally less likely to be considered mentally ill, while they were perceived as being more dangerous and responsible for their condition. Further, the public desire for social distance was consistently higher for people with AUD. We found no consistent differences in the public stigma toward persons with AUD in comparison with other substance use disorders. CONCLUSION The stigmatization of persons with AUD remains comparatively high and is distinct from that of other substance-unrelated disorders.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Sinclair Carr
- Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Franz Hanschmidt
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Sven Speerforck
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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Listabarth S, Gmeiner A, Pruckner N, Vyssoki S, Wippel A, König D. When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2020; 34:157-163. [PMID: 33141424 PMCID: PMC7732788 DOI: 10.1007/s40211-020-00364-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/06/2020] [Indexed: 12/17/2022]
Abstract
Background Alcohol use disorder (AUD) is associated with a high prevalence rate and causes a significant burden on health systems globally. The most severe condition associated with AUD is end-stage alcohol-related liver disease (ARLD), for which liver transplantation (LTX) is the only curative therapy. However, the determination of key epidemiologic figures of both conditions is limited by several difficulties and challenges. Therefore, the goal of this paper is to discuss different epidemiological models to estimate AUD and ARLD prevalence, and compare the results of these models with LTX data. Methods A literature search for epidemiological models estimating the prevalence of AUD and associated secondary diseases was conducted. Identified approaches are discussed and recalculated, applying the newest available data for Austria. The thus estimated numbers were, in a further step, set in relation to the national LTX statistics. Results Besides health survey-based estimations and models based on economic data, estimations based on the mortality of ARLD (Jellinek formula) were identified. Depending on the prediction scenario, the calculated rates of prevalence of AUD ranged between 4.1% and 10.1% for the population aged older than 15 years. Furthermore, while the prevalence of secondary diseases due to AUD is high, only a marginal proportion (about 4%) of end-stage ARLD patients receive a new organ. Conclusion These results suggest that the prevalence of AUD and associated diseases remain underestimated. Furthermore, a pronounced discrepancy between the number of ARLD deaths and the number of LTXs due to ARLD, and distinct regional differences in the supply of LTXs, were found.
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Affiliation(s)
- Stephan Listabarth
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Andrea Gmeiner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Nathalie Pruckner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Sandra Vyssoki
- Department of Health Sciences, St. Pölten University of Applied Sciences, Sankt Pölten, Austria
| | - Andreas Wippel
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Daniel König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Doganis D, Katsimpris A, Panagopoulou P, Bouka P, Bouka E, Moschovi M, Polychronopoulou S, Papakonstantinou E, Tragiannidis A, Katzilakis N, Dana H, Antoniadi K, Stefanaki K, Strantzia K, Dessypris N, Schüz J, Petridou ET. Maternal lifestyle characteristics and Wilms tumor risk in the offspring: A systematic review and meta-analysis. Cancer Epidemiol 2020; 67:101769. [PMID: 32659726 DOI: 10.1016/j.canep.2020.101769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/06/2020] [Accepted: 06/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little is known about the etiology of childhood Wilms tumor (WT) and potentially modifiable maternal risk factors, in particular. METHODS Unpublished data derived from the hospital-based, case-control study of the Greek Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST) were included in an ad hoc conducted systematic literature review and meta-analyses examining the association between modifiable maternal lifestyle risk factors and WT. Eligible data were meta-analysed in separate strands regarding the associations of WT with (a) maternal folic acid and/or vitamins supplementation, (b) alcohol consumption and (c) smoking during pregnancy. The quality of eligible studies was evaluated using the Newcastle-Ottawa Scale. RESULTS Effect estimates from 72 cases and 72 age- and sex-matched controls contributed by NARECHEM-ST were meta-analysed together with those of another 17, mainly medium size, studies of ecological, case-control and cohort design. Maternal intake of folic acid and/or other vitamins supplements during pregnancy was inversely associated with WT risk (6 studies, OR: 0.78; 95 %CI: 0.69-0.89, I2 = 5.4 %); of similar size was the association for folic acid intake alone (4 studies, OR: 0.79; 95 %CI: 0.69-0.91, I2 = 0.0 %), derived mainly from ecological studies. In the Greek study a positive association (OR: 5.31; 95 %CI: 2.00-14.10) was found for mothers who consumed alcohol only before pregnancy vs. never drinkers whereas in the meta-analysis of the four homogeneous studies examining the effect of alcohol consumption during pregnancy the respective overall result showed an OR: 1.60 (4 studies, 95 %CI: 1.28-2.01, I2 = 0.0 %). Lastly, no association was seen with maternal smoking during pregnancy (14 studies, OR: 0.93; 95 %CI: 0.80-1.09, I2 = 0.0 %). CONCLUSIONS In the largest to-date meta-analysis, there was an inverse association of maternal folic acid or vitamins supplementation with WT risk in the offspring, derived mainly from ecological studies. The association with maternal alcohol consumption found in our study needs to be further explored whereas no association with maternal smoking was detected. Given the proven benefits for other health conditions, recommendations regarding folic acid supplementation as well as smoking and alcohol cessation should apply. The maternal alcohol consumption associations, however, should be further explored given the inherent limitations in the assessment of exposures of the published studies.
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Affiliation(s)
- Dimitrios Doganis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece; Oncology Department, "P & A Kyriakou" Children's Hospital, Athens, Greece
| | - Andreas Katsimpris
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Paraskevi Panagopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece; 4th Department of Pediatrics, Aristotle University of Thessaloniki, Greece
| | - Panagiota Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Maria Moschovi
- Pediatric Hematology-Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Sofia Polychronopoulou
- Department of Pediatric Hematology-Oncology, "Agia Sofia" Children's Hospital, Athens, Greece
| | | | - Athanasios Tragiannidis
- Hematology-Oncology Unit, 2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Nick Katzilakis
- Department of Pediatric Hematology-Oncology, University of Crete, University of Crete General Hospital, Heraklion, Greece
| | - Helen Dana
- Pediatric Hematology-Oncology Department, "Mitera" Children's Hospital, Athens, Greece
| | - Kondilia Antoniadi
- Department of Pediatric Hematology-Oncology, "Agia Sofia" Children's Hospital, Athens, Greece
| | | | - Katerina Strantzia
- Pathology Laboratory, "P & A. Kyriakou" Children's Hospital, Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Section of Environment and Radiation, Lyon, France
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
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Griffin SM, Karia FP, Zimmerman A, Minnig MCC, Swahn M, Makelarski J, T Mmbaga B, Vissoci JRN, A Staton C. A Mixed-Methods Study: Sex Differences in Experiences of Stigma Associated With Alcoholism and Alcohol Use Disorders Among Injury Patients in Tanzania. Alcohol Clin Exp Res 2020; 44:1700-1707. [PMID: 32583874 DOI: 10.1111/acer.14402] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Each year, alcohol use causes 3.3 million deaths globally and accounts for nearly 30% of injuries treated at Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania. Prior research found significant stigma toward patients reporting alcohol use in general and among healthcare providers for this population. METHODS This mixed-methods study aimed to identify sex-based perspectives of stigma among injury patients, family members, and local community advisory board (CAB) members. Injury patients from the emergency room at KCMC were asked to complete surveys capturing consumption of alcohol, perceived stigma, and consequences of drinking. Patients who completed the survey, their family members, and members of a CAB were also recruited to take part in focus groups led by a trained bilingual research nurse. Data were analyzed using multiple linear regression and Wilcoxon rank sum tests with alpha level set at 0.05. RESULTS Results showed that sex was a significant predictor of perceived discrimination (p = 0.037, Standard Error (SE) = 1.71 (0.81)) but not for perceived devaluation (p = 0.667, SE = -0.38 (0.89)). Focus groups revealed there were global negative perceptions of the amount of alcohol consumed as well as negative perceptions toward disclosure of alcohol use to healthcare providers. Sex differences in stigma emerged when participants were specifically asked about women and their alcohol consumption. CONCLUSIONS The findings of this study suggest there is an underlying sex difference, further stigmatizing women for alcohol use among the injury patient population at KCMC. Tanzanian women suffer from unequal access to health care, and the stigmatization of alcohol use likely increases this disparity.
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Affiliation(s)
- S Michelle Griffin
- University of New England, (SMG, JM), Biddeford, Maine.,Division of Emergency Medicine, Duke University Medical Center (SMG, JRNV, CS), Durham, North Carolina
| | - Francis P Karia
- Duke University School of Medicine (FPK), Durham, North Carolina
| | - Armand Zimmerman
- Duke Global Health Institute (SMG, AZ, MCCM, BM, JRNV, CS), Durham, North Carolina
| | | | - Monica Swahn
- Georgia State University School of Public Health (MS), Atlanta, Georgia
| | - Jennifer Makelarski
- University of New England, (SMG, JM), Biddeford, Maine.,Department of Obstetrics and Gynecology (JM), The University of Chicago, Chicago, Illinois
| | - Blandina T Mmbaga
- Duke Global Health Institute (SMG, AZ, MCCM, BM, JRNV, CS), Durham, North Carolina.,Kilimanjaro Christian Medical Center (BM), Moshi, Tanzania.,Kilimanjaro Clinical Research Institute (BM), Moshi, Tanzania.,Kilimanjaro Christian Medical University College (BM), Moshi, Tanzania
| | - João Ricardo Nickenig Vissoci
- Duke Global Health Institute (SMG, AZ, MCCM, BM, JRNV, CS), Durham, North Carolina.,Division of Emergency Medicine, Duke University Medical Center (SMG, JRNV, CS), Durham, North Carolina
| | - Catherine A Staton
- Duke Global Health Institute (SMG, AZ, MCCM, BM, JRNV, CS), Durham, North Carolina.,Division of Emergency Medicine, Duke University Medical Center (SMG, JRNV, CS), Durham, North Carolina
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Moore KE, Stein MD, Kurth ME, Stevens L, Hailemariam M, Schonbrun YC, Johnson JE. Risk Factors for Self-stigma among Incarcerated Women with Alcohol Use Disorder. STIGMA AND HEALTH 2019; 5:158-167. [PMID: 33102697 DOI: 10.1037/sah0000182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Alcohol use disorder (AUD) is a highly stigmatized condition, often associated with negative stereotypes such as being morally weak, incompetent, unpredictable, and aggressive. People with AUD are at risk of experiencing self-stigma, a social-cognitive experience in which people think others hold negative stereotypes about them, expect to be treated unfairly, and/or believe that negative stereotypes are personally accurate. Women in the criminal justice system with AUD in particular are at risk of experiencing self-stigma due to intersecting sources of disadvantage. Given that self-stigma can lead to treatment avoidance and dropout, it is important to understand risk factors for self-stigma to inform prevention and intervention efforts in the justice system. Incarcerated women with AUD (n=185) completed measures of alcohol self-stigma as well as a variety of theoretically relevant risk factors including sociodemographics, baseline levels of stress and depression, and alcohol-related factors (i.e., length of drinking history, frequency/amount of use, consequences of use, physician advice to stop, belief that legal involvement is related to alcohol use, alcohol-related charges, self-efficacy to quit, readiness for treatment, pressures to enter treatment, factors that influence treatment) and other stigmatized conditions (drug use, exchanging sex, and homelessness). Results showed that experiencing more consequences of alcohol use, pressures to enter treatment, and perceived stress were associated with internalized stigma and anticipated/enacted stigma. This study begins to identify which incarcerated women with AUD are most at risk of experiencing self-stigma that may interfere with alcohol treatment.
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Affiliation(s)
- Kelly E Moore
- East Tennessee State University, Department of Psychology, 420 Rogers-Stout Hall P.O. 70649, Johnson City, TN 37614
| | - Michael D Stein
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
- Boston University School of Public Health, Department of Health Law, Policy & Management, 715 Albany Street, Boston, MA 02118
| | - Megan E Kurth
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
| | - Lindsey Stevens
- Brown University Medical School, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906
| | - Maji Hailemariam
- Michigan State University, Division of Public Health, College of Human Medicine, 200 East 1st St., Flint, MI 48502
| | - Yael C Schonbrun
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
- Brown University Medical School, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906
| | - Jennifer E Johnson
- Michigan State University, Division of Public Health, College of Human Medicine, 200 East 1st St., Flint, MI 48502
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8
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Soh KC, Lim WS, Cheang KM, Chan KL. Stigma towards alcohol use disorder: Comparing healthcare workers with the general population. Gen Hosp Psychiatry 2019; 58:39-44. [PMID: 30878697 DOI: 10.1016/j.genhosppsych.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Keng Chuan Soh
- Department of Psychological Medicine, Khoo Teck Puat Hospital, Singapore.
| | - Wei Shyan Lim
- Department of Psychological Medicine, Khoo Teck Puat Hospital, Singapore
| | - Ka Man Cheang
- Department of Psychological Medicine, Khoo Teck Puat Hospital, Singapore
| | - Keen Loong Chan
- Department of Psychological Medicine, Khoo Teck Puat Hospital, Singapore
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9
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Stigma and the public health agenda for the opioid crisis in America. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 59:44-49. [DOI: 10.1016/j.drugpo.2018.06.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/02/2018] [Accepted: 06/11/2018] [Indexed: 11/19/2022]
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10
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Manthey J, Imtiaz S, Neufeld M, Rylett M, Rehm J. Quantifying the global contribution of alcohol consumption to cardiomyopathy. Popul Health Metr 2017; 15:20. [PMID: 28545449 PMCID: PMC5445448 DOI: 10.1186/s12963-017-0137-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 05/11/2017] [Indexed: 12/31/2022] Open
Abstract
Background The global impact of alcohol consumption on deaths due to cardiomyopathy (CM) has not been quantified to date, even though CM contains a subcategory for alcoholic CM with an effect of heavy drinking over time as the postulated underlying causal mechanism. In this feasibility study, a model to estimate the alcohol-attributable fraction (AAF) of CM deaths based on alcohol exposure measures is proposed. Methods A two-step model was developed based on aggregate-level data from 95 countries, including the most populous (data from 2013 or last available year). First, the crude mortality rate of alcoholic CM per 1,000,000 adults was predicted using a negative binomial regression based on prevalence of alcohol use disorders (AUD) and adult alcohol per capita consumption (APC) (n = 52 countries). Second, the proportion of alcoholic CM among all CM deaths (i.e., AAF) was predicted using a fractional response probit regression with alcoholic CM crude mortality rate (from Step 1), AUD prevalence, APC per drinker, and Global Burden of Disease region as predictions. Additional models repeated these steps by sex and for the wider Global Burden of Disease study definition of CM. Results There were strong correlations (>0.9) between the crude mortality rate of alcoholic CM and the AAFs, supporting the modeling strategy. In the first step, the population-weighted mean crude mortality rate was estimated at 8.4 alcoholic CM deaths per 1,000,000 (95% CI: 7.4–9.3). In the second step, the global AAFs were estimated at 6.9% (95% CI: 5.4–8.4%). Sex-specific figures suggested a lower AAF among females (2.9%, 95% CI: 2.3–3.4%) as compared to males (8.9%, 95% CI: 7.0–10.7%). Larger deviations between observed and predicted AAFs were found in Eastern Europe and Central Asia. Conclusions The model proposed promises to fill the gap to include AAFs for CM into comparative risk assessments in the future. These predictions likely will be underestimates because of the stigma involved in all fully alcohol-attributable conditions and subsequent problems in coding of alcoholic CM deaths. Electronic supplementary material The online version of this article (doi:10.1186/s12963-017-0137-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Sameer Imtiaz
- Institute for Mental Health Policy Research, CAMH, 33 Russell Street, Toronto, ON, M5S 2S1, Canada.,Institute of Medical Science (IMS), University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.,Institute for Mental Health Policy Research, CAMH, 33 Russell Street, Toronto, ON, M5S 2S1, Canada
| | - Margaret Rylett
- Institute for Mental Health Policy Research, CAMH, 33 Russell Street, Toronto, ON, M5S 2S1, Canada
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.,Institute for Mental Health Policy Research, CAMH, 33 Russell Street, Toronto, ON, M5S 2S1, Canada.,Campbell Family Mental Health Research Institute, 250 College Street, Toronto, ON, M5T 1R8, Canada.,Institute of Medical Science (IMS), University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON, M5T 3M7, Canada.,PAHO/WHO Collaborating Centre for Mental Health and Addiction, 33 Russell Street, Toronto, ON, M5S 2S1, Canada
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11
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Kulesza M, Hunter SB, Shearer AL, Booth M. Relationship between Provider Stigma and Predictors of Staff Turnover among Addiction Treatment Providers. ALCOHOLISM TREATMENT QUARTERLY 2016; 35:63-70. [PMID: 29129956 DOI: 10.1080/07347324.2016.1256716] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To further our knowledge about feasible targets for improving quality of addiction treatment services, the current study provides preliminary assessment of the relationship between provider stigma and indicators of staff turnover. As predicted, results suggest that higher provider stigma was significantly related to lower ratings of job satisfaction and workplace climate. However, provider stigma was not significantly related to burnout. Our preliminary findings, if replicated, suggest the importance of considering provider stigma as a risk factor for future staff turnover and job dissatisfaction. Promising provider stigma interventions do exist and offer viable opportunity for improving quality of addiction treatment.
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Affiliation(s)
| | | | - Amy L Shearer
- RAND Corporation, Santa Monica, California, USA.,Portland State University, Psychology Department, Portland, Oregon, USA
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12
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Ta TMT, Zieger A, Schomerus G, Cao TD, Dettling M, Do XT, Mungee A, Diefenbacher A, Angermeyer MC, Hahn E. Influence of urbanity on perception of mental illness stigma: a population based study in urban and rural Hanoi, Vietnam. Int J Soc Psychiatry 2016; 62:685-695. [PMID: 27887028 DOI: 10.1177/0020764016670430] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS To examine, for the first time in Vietnam, whether urbanity of respondents among other socio-demographic factors affects the public perception of stigma attached to persons with mental illness in Hanoi. METHODS A general population-based survey was carried out in 2013 in the greater Hanoi area. The perception of stigma attached to people with mental illness was elicited using Link's perceived discrimination and devaluation scale (PDDS) carried out in Vietnamese language. The survey sample (n = 806) was stratified for gender, urban/rural location, age, household size and marital status, in accordance with the 2013 Vietnamese census. RESULTS Comparing the total score of the PDDS and its single items, we found less perceived stigma and discrimination among the rural population of Hanoi and in respondents who reported religious attainment to either Buddhism or Christianity. Logistic regression analyses found no significant influences of gender, age, household size or marital status regarding the perceived stigma toward persons with mental illness. CONCLUSION Less negative perception of stigma attached to persons with mental illness that was observed among the rural population in the Hanoi area may be interpreted in the light of possibly more demanding living conditions in modern urban Vietnam with less opportunities for mentally ill patients and points toward a dynamic interaction with rapidly changing living conditions in Asian megacities.
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Affiliation(s)
- Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany
| | - Aron Zieger
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany
| | - Georg Schomerus
- Department of Psychiatry, Ernst Moritz Arndt University Greifswald, Germany.,HELIOS Hanseklinikum Stralsund, Germany
| | - Tien Duc Cao
- Department of Psychiatry and Psychological Medicine, Hospital 103, Military Academy of Medicine, Hanoi, Vietnam
| | - Michael Dettling
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany
| | - Xuan Tinh Do
- Department of Psychiatry and Psychological Medicine, Hospital 103, Military Academy of Medicine, Hanoi, Vietnam
| | - Aditya Mungee
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany
| | - Albert Diefenbacher
- Department of Psychiatry, Psychotherapy and Psychosomatic, Ev. Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
| | | | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatic, Ev. Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
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13
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Tamutiene I, Laslett AM. Associative stigma and other harms in a sample of families of heavy drinkers in Lithuania. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.1080/14659891.2016.1232760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ilona Tamutiene
- Department of Public Administration, Vytautas Magnus University, Kaunas, Lithuania
| | - Anne-Marie Laslett
- National Drug Research Institute, Curtin University, Melbourne, Australia
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
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14
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Schomerus G, Van der Auwera S, Matschinger H, Baumeister SE, Angermeyer MC. Do attitudes towards persons with mental illness worsen during the course of life? An age-period-cohort analysis. Acta Psychiatr Scand 2015; 132:357-64. [PMID: 25676686 DOI: 10.1111/acps.12401] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Cross-sectional studies frequently find higher age associated with negative attitudes towards persons with mental illness. We explore whether attitudes worsen over the life span, or follow a cohort pattern. METHOD Using data from three identical population surveys in Germany from 1990, 2001 and 2011 (combined sample n = 7835), we performed age-period-cohort analyses determining the association of age, time period and birth-cohort with social distance from a person with either depression (n = 3910) or schizophrenia (n = 3925), using linear and nonlinear partial least squares regression models. RESULTS Social distance increases with age, independent from cohort and period effects, cumulating to an increase of 2.4 (schizophrenia) and 2.3 (depression) on the 28 point social distance scale over the life span (youngest to oldest participant). We found a cohort effect in depression, but not schizophrenia, with decreasing social distance until 1970 and a slight increase in younger cohorts. Period effects were visible particularly in schizophrenia, with growing social distance over time. CONCLUSION Considering demographic change and the vulnerability of older persons to severe outcomes of mental illness such as suicide, the observed increase of negative attitudes over the life span seems highly relevant. We discuss the role of conservatism and preferences for agreeable social contacts in older age.
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Affiliation(s)
- G Schomerus
- Department of Psychiatry, University of Greifswald, Greifswald, Germany.,HELIOS Hanseklinikum Stralsund, Stralsund, Germany
| | - S Van der Auwera
- Institute of Community Medicine, University of Greifswald, Greifswald, Germany
| | - H Matschinger
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.,Institute of Health Economics and Health Services Research, University of Hamburg, Hamburg, Germany
| | - S E Baumeister
- Institute of Community Medicine, University of Greifswald, Greifswald, Germany
| | - M C Angermeyer
- Department of Public Health, University of Cagliari, Cagliari, Italy.,Center for Public Mental Health, Gösing am Wagram, Austria
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