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

Abstract

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