Predicting Hazardous Alcohol Drinking Behaviors in Family Members of Hazardous Alcohol-Drinker Patients
Abstract
:1. Introduction
2. Methods
2.1. Design
2.2. Sample and Setting
2.3. Ethical Approval
2.4. Measures
2.4.1. Assessment of Alcohol Use
2.4.2. Assessment of Perceived General Stress
2.4.3. Assessment of Perceived Stress from the Hazardous-Drinker Patient
2.4.4. Assessment of General Coping Mechanisms
2.4.5. Assessment of Strategies for Coping with Patients’ Drinking-Related Behavior
2.4.6. Assessment of Social Support
2.4.7. Assessment of Mental Health
2.4.8. Assessment of Quality of Life
2.4.9. Assessment of Protective Factors against Hazardous Alcohol Drinking
2.4.10. Assessment of Facilitative Factors for Hazardous Alcohol Drinking
2.4.11. Assessment of Demographic Information
2.5. Procedure
2.6. Data Analysis
3. Results
3.1. Family Members’ Characteristics
3.2. Related Factors
3.3. Predictors of Family Members’ Hazardous Alcohol Drinking Behaviors
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- World Health Organization. Data and Statistics. Facts Sheet-Alcohol. 2017. Available online: https://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/data-and-statistics/fact-sheet-alcohol-2017 (accessed on 26 April 2022).
- Rojas, J.I.; Nisbet, R.B. Detecting alcohol use disorders in primary care settings. J. Okla. State Med. Assoc. 2011, 104, 23–27. [Google Scholar] [PubMed]
- Rossow, I.; Felix, L.; Keating, P.; McCambridge, J. Parental drinking and adverse outcomes in children: A scoping review of cohort studies. Drug Alcohol Rev. 2016, 35, 397–405. [Google Scholar] [CrossRef] [PubMed]
- Copello, A.; Templeton, L.; Orford, J.; Velleman, R.; Patel, A.; Moore, L.; MacLeod, J.; Godfrey, C. The relative efficacy of two levels of a primary care intervention for family members affected by the addiction problem of a close relative: A randomized trial. Addiction 2009, 104, 49–58. [Google Scholar] [CrossRef] [PubMed]
- Orford, J.; Copello, A.; Velleman, R.; Templeton, L. Family members affected by a close relative’s addiction: The stress-strain-coping-support model. Drugs Educ. Prev. Policy 2010, 17, 36–43. [Google Scholar] [CrossRef] [Green Version]
- Weisner, C.; Parthasarathy, S.; Moore, C.; Mertens, J.R. Individuals receiving addiction treatment: Are medical costs of their family members reduced? Addiction 2010, 105, 1226–1234. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bartel, S.J.; Sherry, S.B.; Molnar, D.S.; Mushquash, A.R.; Leonard, K.E.; Flett, G.L.; Stewart, S.H. Do romantic partners influence each other’s heavy episodic drinking? Support for the partner influence hypothesis in a three-year longitudinal study. Addict. Behav. 2017, 69, 55–58. [Google Scholar] [CrossRef]
- Lin, C.-C.; Tsai, Y.-F.; Yeh, W.-L.; Kao, J.-T.; Chen, C.-Y. Perceptions of problem-drinker patients’ family members about their own hazardous-drinking behaviours in Chinese general hospitals: A qualitative study. BMC Psychiatry 2017, 17, 189. [Google Scholar] [CrossRef]
- Babor, T.F.; Higgins-Biddle, J.C. Brief Intervention for Hazardous and Harmful Drinking: A Manual for Use in Primary Care; World Health Organization: Geneva, Switzerland, 2001. [Google Scholar]
- Orford, J.; Velleman, R.; Natera, G.; Templeton, L.; Copello, A. Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Soc. Sci. Med. 2013, 78, 70–77. [Google Scholar] [CrossRef] [Green Version]
- Meyers, R.J.; Miller, W.R.; Smith, J.E.; Tonigan, J.S. A randomized trial of two methods for engaging treatment-refusing drug users through concerned significant others. J. Consult. Clin. Psychol. 2002, 70, 1182–1185. [Google Scholar] [CrossRef]
- Fals-Stewart, W.; Birchler, G.R.; O’Farrell, T.J. Behavioral couples therapy for male substance-abusing patients: Effects on relationship adjustment and drug-using behavior. J. Consult. Clin. Psychol. 1996, 64, 959–972. [Google Scholar] [CrossRef]
- Winters, J.; Fals-Stewart, W.; O’Farrell, T.J.; Birchler, G.R.; Kelley, M.L. Behavioral couples therapy for female substance-abusing patients: Effects on substance use and relationship adjustment. J. Consult. Clin. Psychol. 2002, 70, 344–355. [Google Scholar] [CrossRef] [PubMed]
- Kirby, K.C.; Benishek, L.A.; Kerwin, M.E.; Dugosh, K.L.; Carpenedo, C.M.; Bresani, E.; Haugh, J.; Washio, Y.; Meyers, R.J. Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient? Psychol. Addict. Behav. 2017, 31, 818–827. [Google Scholar] [CrossRef] [PubMed]
- Roche, A.M.; Freeman, T.; Skinner, N. From data to evidence, to action: Findings from a systematic review of hospital screening studies for high risk alcohol consumption. Drug Alcohol Depend. 2006, 83, 1–14. [Google Scholar] [CrossRef] [PubMed]
- Rosón, B.; Monte, R.; Gamallo, R.; Puerta, R.; Zapatero, A.; Fernández-Solá, J.; Pastor, I.; Girón, J.A.; Laso, J. Prevalence and routine assessment of unhealthy alcohol use in hospitalized patients. Eur. J. Intern. Med. 2010, 21, 458–464. [Google Scholar] [CrossRef]
- Hsu, K.-Y.; Tsai, Y.-F.; Huang, C.-C.; Yeh, W.-L.; Chang, K.-P.; Lin, C.-C.; Chen, C.-Y.; Lee, H.-L. Tobacco-smoking, alcohol-drinking, and betel-quid-chewing behaviors: Development and use of a web-based survey system. JMIR mHealth uHealth 2018, 6, e142. [Google Scholar] [CrossRef] [Green Version]
- Tsai, Y.-F.; Tsai, M.-C.; Lin, Y.-P.; Chen, C.-Y. Brief intervention for problem drinkers in a Chinese population: A randomized controlled trial in a hospital setting. Alcohol. Clin. Exp. Res. 2009, 33, 95–101. [Google Scholar] [CrossRef]
- Tsai, Y.-F.; Lin, Y.-P.; Tsai, M.-C.; Weng, C.-E.; Chen, C.-Y. Hazardous alcohol-drinking problems among a Chinese hospital patient population. J. Adv. Nurs. 2013, 69, 1819–1828. [Google Scholar] [CrossRef]
- Tsai, Y.-F.; Chen, C.-Y.; Lin, Y.-P.; Tsai, M.-C.; Weng, C.-E. Hazardous drinking problems in family members of problem-drinker patients in Chinese general hospitals. Gen. Hosp. Psychiatry 2012, 34, 633–638. [Google Scholar] [CrossRef]
- Beck, A.T. Thinking and depression. I. Idiosyncratic content and cognitive distortions. Arch. Gen. Psychiatry 1963, 9, 324–333. [Google Scholar] [CrossRef]
- Moos, R.H.; Finney, J.W.; Cronkite, R.C. Alcoholism Treatment: Context, Process, and Outcome; Oxford University Press: Oxford, UK, 1990. [Google Scholar]
- Orford, J.; Natera, G.; Davies, J.; Nava, A.; Mora, J.; Rigby, K.; Bradbury, C.; Bowie, N.; Copello, A.; Velleman, R. Tolerate, engage or withdraw: A study of the structure of families coping with alcohol and drug problems in South West England and Mexico City. Addiction 1998, 93, 1799–1813. [Google Scholar] [CrossRef]
- Von Elm, E.; Altman, D.G.; Egger, M.; Pocock, S.J.; Gøtzsche, P.C.; Vandenbroucke, J.P. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Lancet 2007, 370, 1453–1457. [Google Scholar] [CrossRef]
- Tsai, M.-C.; Tsai, Y.-F.; Chen, C.-Y.; Liu, C.-Y. Alcohol use disorders identification test (AUDIT): Establishment of cut-off scores in a hospitalized Chinese population. Alcohol. Clin. Exp. Res. 2005, 29, 53–57. [Google Scholar] [CrossRef] [PubMed]
- Wampold, B.E.; Freund, R.D. Use of multiple regression in counseling psychology research: A flexible data-analytic strategy. J. Couns. Psychol. 1987, 34, 372–382. [Google Scholar] [CrossRef]
- Chu, L.C.; Kao, H.S.R. The moderation of meditation experience and emotional intelligence on the relationship between perceived stress and negative mental health. Chin. J. Psych. 2005, 47, 157–179. [Google Scholar]
- Chen, C.H. A Case-Control Study of Colorectal Cancer, Stress and Its Related Risk Factors. Master’s Thesis, Chung Shan Medical, Taichung, Taiwan, 2010, unpublished. [Google Scholar]
- Chen, J.P. A Case-Control Study on Stress and Lifestyle Factors in Relation to Coronary Heart Disease. Master’s Thesis, Chung Shan Medical, Taichung, Taiwan, 2011, unpublished. [Google Scholar]
- Chang, L.Y. Coping Strategies and Functional Status of Patients with Chronic Obstructive Pulmonary Disease. Master’s Thesis, National Yang Ming University, Taipei, Taiwan, 1996, unpublished. [Google Scholar]
- Wang, S.M. The Relationships of Symptom Distress, Social Support and Self-Care Behaviors in Heart Transplant Recipients. Master’s Thesis, National Defense Medical Center, Taipei, Taiwan, 1997, unpublished. [Google Scholar]
- Cheng, T.A.; Wu, J.-T.; Chong, M.Y.; Williams, P. Internal consistency and factor structure of the Chinese Health Questionnaire. Acta Psychiatr. Scand. 1990, 82, 304–308. [Google Scholar] [CrossRef]
- Tseng, H.-M.; Lu, J.-F.R.; Gandek, B. Cultural issues in using the SF-36 Health Survey in Asia: Results from Taiwan. Health Qual. Life Outcomes 2003, 1, 72. [Google Scholar] [CrossRef] [Green Version]
- Nolen-Hoeksema, S. Gender differences in risk factors and consequences for alcohol use and problems. Clin. Psychol. Rev. 2004, 24, 981–1010. [Google Scholar] [CrossRef]
- Garnett, C.; Kastaun, S.; Brown, J.; Kotz, D. Alcohol consumption and associations with sociodemographic and health-related characteristics in Germany: A population survey. Addict. Behav. 2021, 125, 107159. [Google Scholar] [CrossRef]
- Sanchez-Ramirez, D.C.; Franklin, R.; Voaklander, N. Hazardous Alcohol Use in 2 Countries: A Comparison Between Alberta, Canada and Queensland, Australia. J. Prev. Med. Public Health 2017, 50, 311–319. [Google Scholar] [CrossRef] [Green Version]
- Hobden, B.; Bryant, J.; Forshaw, K.; Oldmeadow, C.; Evans, T.-J.; Sanson-Fisher, R. Prevalence and characteristics associated with concurrent smoking and alcohol misuse within Australian general practice patients. Aust. Health Rev. 2020, 44, 125. [Google Scholar] [CrossRef]
- Ko, Y.-C.; Chiang, T.-A.; Chang, S.-J.; Hsieh, S.-F. Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors. J. Oral Pathol. Med. 1992, 21, 261–264. [Google Scholar] [CrossRef] [PubMed]
- Tsai, K.-Y.; Su, C.-C.; Lin, Y.-Y.; Chung, J.-A.; Lian, I.-B. Quantification of betel quid chewing and cigarette smoking in oral cancer patients. Community Dent. Oral Epidemiol. 2009, 37, 555–561. [Google Scholar] [CrossRef] [PubMed]
- Worakhajit, P.; Fuangtharnthip, P.; Khovidhunkit, S.-O.P.; Chiewwit, P.; Klongnoi, B. The Relationship of Tobacco, Alcohol, and Betel Quid with the Formation of Oral Potentially Malignant Disorders: A Community-Based Study from Northeastern Thailand. Int. J. Environ. Res. Public Health 2021, 18, 8738. [Google Scholar] [CrossRef] [PubMed]
- Garcia, T.A.; Fairlie, A.M.; Litt, D.M.; Waldron, K.A.; Lewis, M.A. Perceived vulnerability moderates the relations between the use of protective behavioral strategies and alcohol use and consequences among high-risk young adults. Addict. Behav. 2018, 81, 150–156. [Google Scholar] [CrossRef] [PubMed]
- McCann, T.V.; Lubman, D.I. Adaptive coping strategies of affected family members of a relative with substance misuse: A qualitative study. J. Adv. Nurs. 2017, 74, 100–109. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Non-Hazardous Alcohol Drinkers | Hazardous Alcohol Drinkers | ||
---|---|---|---|
Variable | (n = 256) | (n = 62) | t/χ2 (p) |
Age, years (mean, SD) | 49.69 (13.13) | 45.03 (12.03) | 2.55 (0.01) a |
Gender (n, %) | 71.28 (<0.01) b | ||
Male | 33 (12.89) | 39 (62.90) | |
Female | 223 (87.11) | 23 (37.10) | |
Education level (n, %) | 32.00 (<0.01) b | ||
≤Primary school | 65 (25.39) | 5 (8.06) | |
Junior high school | 42 (16.41) | 4 (6.45) | |
Senior high school | 70 (27.34) | 10 (16.13) | |
≥College or above | 79 (30.86) | 43 (69.35) | |
Marital status (n, %) | 1.86 (0.40) b | ||
Single | 39 (15.23) | 11 (17.74) | |
Married | 206 (80.47) | 46 (74.19) | |
Other | 11 (4.30) | 5 (8.06) | |
Religious belief (n, %) | 48.32 (<0.01) b | ||
Buddhism | 35 (13.67) | 9 (14.52) | |
Taoism | 37 (14.45) | 30 (48.39) | |
Belief in God but no specific religion | 165 (64.45) | 13 (20.97) | |
Other | 19 (7.42) | 10 (16.13) | |
Living with patient (n, %) | 31.12 (<0.01) b | ||
Yes | 244 (95.31) | 45 (72.58) | |
No | 12 (4.69) | 17 (27.42) | |
Relation to the patient (n, %) | 20.07 (<0.01) b | ||
Parent | 23 (8.98) | 4 (6.45) | |
Sibling | 13 (5.08) | 12 (19.35) | |
Child/Daughter-in-law | 47 (18.36) | 18 (29.03) | |
Partner | 173 (67.58) | 28 (45.16) | |
Smoking (n, %) | 48.76 (<0.01) b | ||
Yes | 29 (11.33) | 31 (50.00) | |
No | 227 (88.67) | 31 (50.00) | |
Chewing betel quid (n, %) | 7.62 (0.01) b | ||
Yes | 231 (90.23) | 48 (77.42) | |
No | 25 (9.77) | 14 (22.58) | |
Chronic diseases (n, %) | 0.45 (0.81) | 0.81 (0.99) | −2.97 (<0.01) a |
Non-Hazardous Alcohol Drinkers (n = 256) | Hazardous Alcohol Drinkers (n = 62) | ||
---|---|---|---|
Variable | Mean (SD) | Mean (SD) | t (p) |
Perceived general stress | 30.40 (3.12) | 30.37 (2.54) | 0.06 (0.95) |
Perceived stress from hazardous-drinker patient | 16.20 (9.79) | 5.27 (8.07) | 8.14 (<0.01) |
Frequency of using general coping strategies | 43.83 (4.03) | 45.61 (3.80) | −3.17 (<0.01) |
Frequency of using strategies to cope with patient’s drinking-related behavior | 18.79 (10.10) | 4.89 (7.26) | 10.21 (<0.01) |
Social support-informal | 20.78 (4.46) | 20.10 (4.49) | 1.08 (0.28) |
Social support- professional | 24.69 (4.50) | 26.21 (4.76) | −2.36 (0.02) |
Mental health | 17.36 (4.00) | 18.45 (4.50) | −1.88 (0.06) |
Quality of life | 82.97 (6.09) | 82.08 (6.21) | 1.03 (0.31) |
Physical aspect | 46.27 (4.49) | 46.70 (4.57) | −0.68 (0.50) |
Psychological aspect | 36.70 (3.51) | 35.38 (3.27) | 2.69 (0.01) |
Factors protecting against hazardous alcohol drinking | 70.73 (7.32) | 57.63 (5.80) | 13.13 (<0.01) |
Factors facilitating hazardous alcohol drinking | 35.94 (4.75) | 43.63 (4.52) | −11.55 (<0.01) |
95% CI for OR | |||||||
---|---|---|---|---|---|---|---|
Variable | B | SE | Wald | p | OR | Lower | Upper |
Frequency of using general coping strategies | 0.25 | 0.07 | 12.60 | <0.01 | 1.29 | 1.12 | 1.48 |
Frequency of using strategies to cope with patient’s drinking-related behavior | −0.12 | 0.04 | 9.88 | <0.01 | 0.89 | 0.82 | 0.96 |
Factors protecting against hazardous alcohol drinking | −0.28 | 0.05 | 28.60 | <0.01 | 0.76 | 0.69 | 0.84 |
Factors facilitating hazardous alcohol drinking | 0.42 | 0.09 | 21.30 | <0.01 | 1.52 | 1.27 | 1.81 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Chen, C.-Y.; Lin, C.-C.; Kao, J.-T.; Yeh, W.-L.; Lin, C.-Y.; Tsai, Y.-F. Predicting Hazardous Alcohol Drinking Behaviors in Family Members of Hazardous Alcohol-Drinker Patients. Int. J. Environ. Res. Public Health 2022, 19, 5497. https://doi.org/10.3390/ijerph19095497
Chen C-Y, Lin C-C, Kao J-T, Yeh W-L, Lin C-Y, Tsai Y-F. Predicting Hazardous Alcohol Drinking Behaviors in Family Members of Hazardous Alcohol-Drinker Patients. International Journal of Environmental Research and Public Health. 2022; 19(9):5497. https://doi.org/10.3390/ijerph19095497
Chicago/Turabian StyleChen, Ching-Yen, Chen-Chun Lin, Jung-Ta Kao, Wen-Ling Yeh, Chiao-Yun Lin, and Yun-Fang Tsai. 2022. "Predicting Hazardous Alcohol Drinking Behaviors in Family Members of Hazardous Alcohol-Drinker Patients" International Journal of Environmental Research and Public Health 19, no. 9: 5497. https://doi.org/10.3390/ijerph19095497