Examination of Quality of Life among Patients with Alcohol or Substance Use Disorder in Outpatient Rehabilitation Center
Year 2024,
Volume: 25 Issue: 4, 410 - 420, 30.12.2024
Başak Ünübol
,
Gizem Akülker
,
Rabia Bilici
,
Selim Arpacıoğlu
Abstract
Objective: The study aimed to examine the change in the quality of life levels of patients followed at the BAHAR Center with a diagnosis of Alcohol or Substance Use Disorder and to investigate the factors effective in this change.
Method: Patients followed up at Erenköy BAHAR Center with a diagnosis of Alcohol/Substance Use Disorder between January 2022 and June 2023 were consecutively included in the study. The Sociodemographic Data Form and the Quality of Life Scale Short Form (WHOQOL-BREF) were administered to the patients who were followed up at the rehabilitation center as a pre-test at the first interview and as a post-test at the 6th month of treatment.
Results: 82% of the participants were men, 18% were women, 44% were high school graduates, 38% were single, 48% were unemployed, and 76% were living with their families. Physical Quality of Life Sub-Dimension, Psychological Sub-Dimension, Social Sub-Dimension, Environment Sub-Dimension and Total "Post-Test" score averages of the WHOQOL-BREF Scale were all found to be significantly different and greater than the "Pre-Test" score averages.
Conclusion: This study can play a role as a guide in clinical intervention strategies in terms of including more interventions aimed at improving the quality of life when structuring the programs of patients in the rehabilitation process..
References
- McLellan AT, Thomas McLellan A, Lewis DC, et al. Drug dependence, a chronic medical illness. JAMA 2000; 284(13): 1689-1695
- Feelemyer JP, Jarlais DCD, Arasteh K, et al. Changes in quality of life (WHOQOL-BREF) and addiction severity index (ASI) among participants in opioid substitution treatment (OST) in low and middle income countries: an international systematic review. Drug Alcohol Depend 2014; 134: 251–258.
- Reis B. Tasavvufî sosyal hizmet/sûfîlerin manevî terapi yöntemleri (Ali SEYYAR). Dergiabant 2015; 3(6): 165-170.
- WHO. International Standards of Drug Use Disorders. Revised Edition. Geneva: WHO, 2020.
- Abay AR, Çölgeçen Y. Psikiyatrik sosyal hizmet- koruyucu, tedavi edici ve rehabilite edici ruh sağlığı alanında sosyal çalışmacıların rolü. Opus Uluslararası Toplum Araştırmaları Dergisi 2018; 9(16): 2147–2185.
- NIDA. Principles of Drug Addiction Treatment: A Research-based Guide. Bethesda, MD: National Institute on Drug Abuse, 2000.
- Laudet AB, White WL. Recovery capital as prospective predictor of sustained recovery, life satisfaction, and stress among former poly-substance users. Subst Use Misuse 2008; 43(1): 27–54.
- Fleming AR, Fairweather JS, Leahy MJ. Quality of life as a potential rehabilitation service outcome: the relationship between employment, quality of life, and other life areas. Rehabil Couns Bull 2013; 57(1): 9–22.
- The WHOQOL Group. What quality of life? World Health Organization Quality of Life Assessment. World Health Forum 1996; 17: 354–346.
- Volk RJ, Cantor SB, Steinbauer JR, Cass AR. Alcohol use disorders, consumption patterns, and health‐Related Quality of Life of primary care patients. Alcohol Clin Exp Res 1997; 21(5): 899–905.
- Foster JH, Powell JE, Marshall EJ, Peters TJ. Quality of life in alcohol-dependent subjects: a review. Qual Life Res 1999; 8(3): 255–261.
- De Maeyer J, Vanderplasschen W, Broekaert E. Quality of life among opiate-dependent individuals: A review of the literature. Int J Drug Policy 2010; 21(5): 364–380.
- Flores PJ. Group Psychotherapy with Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory, Third Edition. London, UK: Routledge, 2013.
- Malachy B, Chapin MH, Miller S. Quality of life assessment in the measurement of rehabilitation outcome. J Rehabil 2008; 74(2): 45-55.
- Yaghmaian R, Smedema SM, Thompson K. Core self-evaluations as personal factors in the world health organization's international classification of functioning, disability and health model: an application in persons with spinal cord injury. Rehabil Res Policy Educ 2017; 31(2): 89-104.
- Working Group on Drugs Rehabilitation. National Drugs Strategy 2001-2008: Rehabilitation: Report of the Working Group on Drugs Rehabilitation, May 2007. Dublin: Department of Community, Rural and Gaeltacht Affairs, 2007..
- Petrova HA, Zavarzina OO, Kytianova IP, Kozyakov RV. Social and personal factors of stable remission for people with drug addictions. Psychol Russ 2015; 8(4): 126–138.
- Şamar B, Buz S. Bağımlılık rehabilitasyonunda sosyal hizmet uygulamaları: Erenköy BAHAR modeli. Bağımlılık Dergisi 2022; 23(2): 221–232.
- Ünübol B, Çinka E, Mayi M, et al. Rehabilitation for Addicted Patients: Erenköy BAHAR Model. Psikiyatride Güncel Yaklaşımlar 2021; 13(3): 412–427.
- Ackerley SJ, Gordon HJ, Elston AF, et al. Assessment of quality of life and participation within an outpatient rehabilitation setting. Disabil Rehabil 2009; 31(11): 906-913.
- Gupta A, Deepika S, Taly AB, et al. Quality of life and psychological problems in patients undergoing neurological rehabilitation. Ann Indian Acad Neurol. 2008; 11(4): 225-230.
- George D, Mallery M. IBM SPSS Statistics 27 Step by Step: A Simple Guide and Reference. Boston: Allyn Bacon, 2010.
- Eser E, Fidaner H, Fidaner C, et al. WHOQOL-100 ve WHOQOL-BREF’in psikometrik özellikleri. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi 1999; 7(Suppl 1): 23–40.
- Ünübol B, Çinka E, Bilici R, Hıdıroğlu S. Bağımlı kadınların ruhsal, ailesel ve çevresel sorunlarının incelenmesi. KADEM Kadın Araştırmaları Dergisi 2019; 5(1): 99–131.
- Ünübol B, Ünübol H, Bilici R. Kadın bağımlılarda içselleştirilmiş damgalanmanın bağımlılık özelliklerine ve algılanan sosyal desteğe olan etkisinin incelenmesi. Anadolu Psikiyatri Dergisi 2019; 20(4): 377-384.
- National Institute on Alcohol Abuse and Alcoholism. The basics: Defining how much alcohol is too much. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/basics-defining-how-much-alcohol-too-much (Accessed 28.12.2023).
- Moos RH, Moos BS. Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction 2006; 101(2): 212-222.
- Termorshuizen F, Krol A, Prins, M, et al. Prediction of relapse to frequent heroin use and the role of methadone prescription: an analysis of the Amsterdam Cohort Study among drug users. Drug Alcohol Depend 2005; 79(2): 231-240.
- Ates N, Unubol B, Bestepe EE, Bilici R. The effect of perceived social support on quality of life in Turkish men with alcohol, opiate and cannabis use disorder. J Ethn Subst Abuse 2023; 22(2): 316–336.
- Morales-Manrique CC, Palepu A, Castellano-Gomez M, et al. Quality of life, needs, and interest among cocaine users: differences by cocaine use intensity and lifetime severity of addiction to cocaine. Subst Use Misuse 2011; 46(4): 390–397.
- Ünübol B, İzci F, İzci S. Electrocardiographic abnormalities during and after withdrawal in patients diagnosed with opioid use disorder. Noro Psikiyatr Ars 2023; 60(4): 304–309.
- The Development of the World Health Organization Quality of Life Assessment Instrument (the WHOQOL). Quality of Life Assessment: International Perspectives. Berlin: Springer, 1994: 41–57.
- Muller AE, Skurtveit S, Clausen T. Many correlates of poor quality of life among substance users entering treatment are not addiction-specific. Health Qual Life Outcomes 2016; 14: 39.
- Dişsiz M. Alkol bağımlılığı ve yaşam kalitesi. JAREN/Hemşirelik Akademik Araştırma Dergisi 2015; 1(2): 91-95.
- Bell J, Shanahan M, Mutch C, et al. A randomized trial of effectiveness and cost-effectiveness of observed versus unobserved administration of buprenorphine-naloxone for heroin dependence. Addiction 2007; 102(12): 1899–1907.
- Tracy EM, Laudet AB, Min MO, et al. Prospective patterns and correlates of quality of life among women in substance abuse treatment. Drug Alcohol Depend 2012; 124(3): 242–249.
- Brown S, Jun MK, Min MO, Tracy EM. Impact of dual disorders, trauma, and social support on quality of life among women in treatment for substance dependence. J Dual Diagn 2013; 9(1): 61–71.
- Kakko J, Svanborg KD, Kreek MJ, Heilig M. 1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomised, placebo-controlled trial. Lancet 2003; 361(9358): 662–668.
- Şamar B, Taş M, Kayın M, Ünübol B. Comprehensive analysis of social stigma of ındividuals with substance use disorder in Turkey in the context of Erving Goffman’s stigma theory. J Ethn Subst Abuse 2023; doi: 10.1080/15332640.2023.2176394.
- Raymond HF, McFarland W. Racial mixing and HIV risk among men who have sex with men. AIDS Behav 2009; 13(4): 630–637.
- McLaughlin D, Long A. An extended literature review of health professionals’ perceptions of illicit drugs and their clients who use them. J Psychiatr Ment Health Nurs 1996; 3(5): 283–288.
- Solomon SS, Celentano DD, Srikrishnan AK, et al. Mortality among injection drug users in Chennai, India (2005-2008). AIDS 2009; 23(8): 997–1004.
Ayaktan Rehabilitasyon Merkezinde Takipli Alkol veya Madde Kullanım Bozukluğu Tanılı Hastalarda Yaşam Kalitesinin İncelenmesi
Year 2024,
Volume: 25 Issue: 4, 410 - 420, 30.12.2024
Başak Ünübol
,
Gizem Akülker
,
Rabia Bilici
,
Selim Arpacıoğlu
Abstract
Amaç: Bu çalışmada Alkol veya Madde Kullanım Bozukluğu tanılarıyla BAHAR Merkezinden takip edilen hastaların yaşam kalitesi düzeylerinin değişiminin incelenmesi ve bu değişimde etkili faktörlerin araştırılması amaçlanmıştır.
Yöntem: Ocak 2022- Haziran 2023 tarihleri arasında Alkol/Madde Kullanım Bozukluğu tanısıyla Erenköy BAHAR Merkezi’nde takipli hastalar ardışık olarak çalışmaya dahil edilmiştir. Rehabilitasyon merkezinde takibine başlanan hastalara Sosyodemografik Veri Formu ile birlikte Yaşam Kalitesi Ölçeği Kısa Formu (WHOQOL-BREF) ilk görüşmede ön- test olarak ve tedavisinin 6. ayında son-test olarak uygulanmıştır.
Bulgular: Katılımcıların %82’si erkek, %18’i kadın, %44 oranında lise mezunu, %38’i bekar, %48’i çalışmıyor ve %76’sı ailesiyle yaşıyordu. WHOQOL-BREF Ölçeğinin Fiziksel Yaşam Kalitesi Alt Boyutu, Psikolojik Alt Boyutu, Sosyal Alt Boyutu Çevre Alt Boyutu ve Toplam “Son-Test” puan ortalamaların tümü “Ön-Test” puan ortalamalarından anlamlı şekilde farklı ve büyük saptandı.
Sonuç: Rehabilitasyon sürecindeki hastaların programlarının yapılandırılması sırasında, yaşam kalitesini artırmaya yönelik müdahalelere daha çok yer verilmesi açısından klinik müdahale stratejilerinde de yol gösterici olabilir.
Supporting Institution
İstanbul Kalkınma Ajansı tarafından desteklenmiştir.
References
- McLellan AT, Thomas McLellan A, Lewis DC, et al. Drug dependence, a chronic medical illness. JAMA 2000; 284(13): 1689-1695
- Feelemyer JP, Jarlais DCD, Arasteh K, et al. Changes in quality of life (WHOQOL-BREF) and addiction severity index (ASI) among participants in opioid substitution treatment (OST) in low and middle income countries: an international systematic review. Drug Alcohol Depend 2014; 134: 251–258.
- Reis B. Tasavvufî sosyal hizmet/sûfîlerin manevî terapi yöntemleri (Ali SEYYAR). Dergiabant 2015; 3(6): 165-170.
- WHO. International Standards of Drug Use Disorders. Revised Edition. Geneva: WHO, 2020.
- Abay AR, Çölgeçen Y. Psikiyatrik sosyal hizmet- koruyucu, tedavi edici ve rehabilite edici ruh sağlığı alanında sosyal çalışmacıların rolü. Opus Uluslararası Toplum Araştırmaları Dergisi 2018; 9(16): 2147–2185.
- NIDA. Principles of Drug Addiction Treatment: A Research-based Guide. Bethesda, MD: National Institute on Drug Abuse, 2000.
- Laudet AB, White WL. Recovery capital as prospective predictor of sustained recovery, life satisfaction, and stress among former poly-substance users. Subst Use Misuse 2008; 43(1): 27–54.
- Fleming AR, Fairweather JS, Leahy MJ. Quality of life as a potential rehabilitation service outcome: the relationship between employment, quality of life, and other life areas. Rehabil Couns Bull 2013; 57(1): 9–22.
- The WHOQOL Group. What quality of life? World Health Organization Quality of Life Assessment. World Health Forum 1996; 17: 354–346.
- Volk RJ, Cantor SB, Steinbauer JR, Cass AR. Alcohol use disorders, consumption patterns, and health‐Related Quality of Life of primary care patients. Alcohol Clin Exp Res 1997; 21(5): 899–905.
- Foster JH, Powell JE, Marshall EJ, Peters TJ. Quality of life in alcohol-dependent subjects: a review. Qual Life Res 1999; 8(3): 255–261.
- De Maeyer J, Vanderplasschen W, Broekaert E. Quality of life among opiate-dependent individuals: A review of the literature. Int J Drug Policy 2010; 21(5): 364–380.
- Flores PJ. Group Psychotherapy with Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory, Third Edition. London, UK: Routledge, 2013.
- Malachy B, Chapin MH, Miller S. Quality of life assessment in the measurement of rehabilitation outcome. J Rehabil 2008; 74(2): 45-55.
- Yaghmaian R, Smedema SM, Thompson K. Core self-evaluations as personal factors in the world health organization's international classification of functioning, disability and health model: an application in persons with spinal cord injury. Rehabil Res Policy Educ 2017; 31(2): 89-104.
- Working Group on Drugs Rehabilitation. National Drugs Strategy 2001-2008: Rehabilitation: Report of the Working Group on Drugs Rehabilitation, May 2007. Dublin: Department of Community, Rural and Gaeltacht Affairs, 2007..
- Petrova HA, Zavarzina OO, Kytianova IP, Kozyakov RV. Social and personal factors of stable remission for people with drug addictions. Psychol Russ 2015; 8(4): 126–138.
- Şamar B, Buz S. Bağımlılık rehabilitasyonunda sosyal hizmet uygulamaları: Erenköy BAHAR modeli. Bağımlılık Dergisi 2022; 23(2): 221–232.
- Ünübol B, Çinka E, Mayi M, et al. Rehabilitation for Addicted Patients: Erenköy BAHAR Model. Psikiyatride Güncel Yaklaşımlar 2021; 13(3): 412–427.
- Ackerley SJ, Gordon HJ, Elston AF, et al. Assessment of quality of life and participation within an outpatient rehabilitation setting. Disabil Rehabil 2009; 31(11): 906-913.
- Gupta A, Deepika S, Taly AB, et al. Quality of life and psychological problems in patients undergoing neurological rehabilitation. Ann Indian Acad Neurol. 2008; 11(4): 225-230.
- George D, Mallery M. IBM SPSS Statistics 27 Step by Step: A Simple Guide and Reference. Boston: Allyn Bacon, 2010.
- Eser E, Fidaner H, Fidaner C, et al. WHOQOL-100 ve WHOQOL-BREF’in psikometrik özellikleri. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi 1999; 7(Suppl 1): 23–40.
- Ünübol B, Çinka E, Bilici R, Hıdıroğlu S. Bağımlı kadınların ruhsal, ailesel ve çevresel sorunlarının incelenmesi. KADEM Kadın Araştırmaları Dergisi 2019; 5(1): 99–131.
- Ünübol B, Ünübol H, Bilici R. Kadın bağımlılarda içselleştirilmiş damgalanmanın bağımlılık özelliklerine ve algılanan sosyal desteğe olan etkisinin incelenmesi. Anadolu Psikiyatri Dergisi 2019; 20(4): 377-384.
- National Institute on Alcohol Abuse and Alcoholism. The basics: Defining how much alcohol is too much. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/basics-defining-how-much-alcohol-too-much (Accessed 28.12.2023).
- Moos RH, Moos BS. Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction 2006; 101(2): 212-222.
- Termorshuizen F, Krol A, Prins, M, et al. Prediction of relapse to frequent heroin use and the role of methadone prescription: an analysis of the Amsterdam Cohort Study among drug users. Drug Alcohol Depend 2005; 79(2): 231-240.
- Ates N, Unubol B, Bestepe EE, Bilici R. The effect of perceived social support on quality of life in Turkish men with alcohol, opiate and cannabis use disorder. J Ethn Subst Abuse 2023; 22(2): 316–336.
- Morales-Manrique CC, Palepu A, Castellano-Gomez M, et al. Quality of life, needs, and interest among cocaine users: differences by cocaine use intensity and lifetime severity of addiction to cocaine. Subst Use Misuse 2011; 46(4): 390–397.
- Ünübol B, İzci F, İzci S. Electrocardiographic abnormalities during and after withdrawal in patients diagnosed with opioid use disorder. Noro Psikiyatr Ars 2023; 60(4): 304–309.
- The Development of the World Health Organization Quality of Life Assessment Instrument (the WHOQOL). Quality of Life Assessment: International Perspectives. Berlin: Springer, 1994: 41–57.
- Muller AE, Skurtveit S, Clausen T. Many correlates of poor quality of life among substance users entering treatment are not addiction-specific. Health Qual Life Outcomes 2016; 14: 39.
- Dişsiz M. Alkol bağımlılığı ve yaşam kalitesi. JAREN/Hemşirelik Akademik Araştırma Dergisi 2015; 1(2): 91-95.
- Bell J, Shanahan M, Mutch C, et al. A randomized trial of effectiveness and cost-effectiveness of observed versus unobserved administration of buprenorphine-naloxone for heroin dependence. Addiction 2007; 102(12): 1899–1907.
- Tracy EM, Laudet AB, Min MO, et al. Prospective patterns and correlates of quality of life among women in substance abuse treatment. Drug Alcohol Depend 2012; 124(3): 242–249.
- Brown S, Jun MK, Min MO, Tracy EM. Impact of dual disorders, trauma, and social support on quality of life among women in treatment for substance dependence. J Dual Diagn 2013; 9(1): 61–71.
- Kakko J, Svanborg KD, Kreek MJ, Heilig M. 1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomised, placebo-controlled trial. Lancet 2003; 361(9358): 662–668.
- Şamar B, Taş M, Kayın M, Ünübol B. Comprehensive analysis of social stigma of ındividuals with substance use disorder in Turkey in the context of Erving Goffman’s stigma theory. J Ethn Subst Abuse 2023; doi: 10.1080/15332640.2023.2176394.
- Raymond HF, McFarland W. Racial mixing and HIV risk among men who have sex with men. AIDS Behav 2009; 13(4): 630–637.
- McLaughlin D, Long A. An extended literature review of health professionals’ perceptions of illicit drugs and their clients who use them. J Psychiatr Ment Health Nurs 1996; 3(5): 283–288.
- Solomon SS, Celentano DD, Srikrishnan AK, et al. Mortality among injection drug users in Chennai, India (2005-2008). AIDS 2009; 23(8): 997–1004.