Barriers to alcohol addiction treatment in women and men experiencing alcohol addiction in a Thai context : Exploring lived experiences and healthcare providers’ perspectives

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 stud

Barriers to successful treatment of alcohol addiction as perceived by healthcare professionals in Thailand – a Delphi study about obstacles and improvement suggestions

Background: Many Thai people experiencing alcohol addiction do not seek help, and those who do often have inadequate access to treatment. There are few research studies focusing on alcohol addiction treatment in Thailand. Objective: The purpose of the current study was to identify barriers to the treatment of alcohol addiction and to collect experts’ suggestions for improving treatment in Thailand. The Delphi technique was used to achieve consensual agreement among an expert panel within the field of alcohol addiction and treatment. Design: Three rounds of a Delphi survey were completed by a panel of experts in alcohol addiction, including physicians, nurses, social workers, psychologists, healthcare officers, and an Alcoholics Anonymous member. The open-ended answers provided by 34 experts in the first round resulted in 60 statements, which were later grouped into three themes. After three rounds of questionnaires, 51 statements were accepted as consensus. Results: Thirty-two experts participated in all three Delphi rounds. Over 80% of participants were particularly concerned about five obstacles to alcohol addiction treatment. The majority of suggestions from the expert panel were related to patients’ right to treatment and the national policy for reducing the negative effects of alcohol. According to the results of the present study, the experts suggested that the treatment of alcohol addiction should be continuous from primary care to tertiary care, and convenient pathways should be established in healthcare services. The experts would also like to increase the number of healthcare providers and improve their knowledge and skills in working with people experiencing alcohol addiction. Conclusions: Equal rights to health and treatment for people experiencing alcohol addiction in Thailand require policy improvements, as well as acceptance and awareness of alcohol addiction from both the public and policymakers

Lived Experience of Thai Women with Alcohol Addiction

Purpose: This study explores the lived experiences of Thai women in relation to alcohol addiction in treatment. Methods: Twelve women aged 20 to 65 years, were participated. The participants were recruited from two special hospitals and one outpatient clinic in a general hospital. Descriptive phenomenology was applied to analyze the transcripts of the individual interviews. Result: The explored phenomenon of Thai women experiencing alcohol addiction included four essential aspects, (1) feeling inferior and worthless (2) feeling physically and emotionally hurt, (3) fearing physical deterioration and premature death, and (4) feeling superior and powerful. Through these different aspects of Thai women's lived experiences, the following essence was synthesized. The essence of the lived experience of alcohol addiction among the studied Thai women was ambivalence between feeling inferior and worthless and feeling superior and powerful when acting as a man. Drinking alcohol lessened life's difficulties and fears; for example, of violence, bodily demolition, premature death and marginalization from family and society. Conclusion: Thai women who experience alcohol addiction are treated with gender-related double standards when trying to undo gender traditional roles. Their marginalization from family and society deepens making them even more vulnerable to the positive side effects of alcohol drinking