| Abstract | Problem ovisnosti o alkoholu pogađa mnogobrojno stanovništvo u današnjem vremenu s
obzirom da više ne možemo reći da je ovisnost o alkoholu bolest individue već predstavlja
bolest cijele obitelji te je postao predmet interesa društvenih znanosti. Ukupna količina
konzumiranog alkohola u Europskoj regiji je 2010. godine iznosila 10.9 litara po osobi (WHO,
2014). Prema definiciji Svjetske zdravstvene organizacije, ovisnost o alkoholu je socijalno-
medicinska bolest koja nastaje zbog dugotrajnog konzumiranja alkoholnih pića (Hudolin i sur,
2005). Liječenje ovisnosti o alkoholu u Bosni i Hercegovini nakon bolničkog liječenja nastavlja
se kontinuirano u Klubovima liječenih alkoholičara (KLA). Tretman koji se provodi u KLA, a
ima za cilj liječenje ovisnosti o alkoholu prvenstveno se svodi na intervencije terapeuta i znanja
u vođenju Kluba liječenih alkoholičara. Istraživanje je provedeno s ciljem dobivanja uvida u
osobnu promjenu korisnika koji se nalaze na liječenju od ovisnosti o alkoholu, a koji su
uključeni u aktivnosti KLA, te utvrđivanja čimbenika koji doprinose poboljšanju životnog stila
apstinenata uz osvrt na obiteljsku podršku u procesu apstinencije.
Shodno prvom istraživačkom problemu o percipiranoj samoefikasnosti korisnika KLA,
dobiveni rezultati ukazuju da većina sudionika istraživanja iskazuje da im je u procesu liječenja
ovisnosti o alkoholu posebno značajan odnos koji ostvaruju sa terapeutom odnosno voditeljem
KLA. Na temelju analiziranih podataka i dobivenih rezultata možemo konstatirati da osobe koje
procjenjuju odnos s terapeutom boljim, više su uključene u rad grupe i procjenjuju grupnu klimu
boljom ujedno iskazuju i veću samoefikasnost u apstinenciji.
Rezultati istraživanja i analize drugog istraživačkog problema koji se odnosio na osobnu
dobrobit korisnika KLA, sugeriraju da bračni status sudionika, ukupan period apstinencije,
grupna klima, angažman i percipirana podrška obitelji imaju značajan doprinos u osobnoj
dobrobiti tijekom liječenja korisnika KLA te takav model objašnjava ukupno oko 44%
varijance.
Rezultati trećeg istraživačkog problema vezanih za objašnjenje procjene oporavka ukazuju
sljedeće: sociodemografska obilježja niti za jedan od dimenzija oporavka se nisu pokazala
značajnim prediktorom. Iznimka je muški spol koji doprinosi dimenziji Samopouzdanje i
pozitivna očekivanja. Obilježja liječenja također uglavnom nemaju značaj za objašnjenje
procjene oporavka, osim što se za dimenziju Samopouzdanje i pozitivna očekivanje pokazuje
značajnim izostajanje druge psihičke bolesti. Za sve dimenzije oporavka od značaja su obilježja
pomažućeg odnosa s terapeutom te razina uključenosti u grupni rad. Za sve dimenzije procjene
oporavka od značaja su aspekti obiteljskog funkcioniranja, socijalne podrške. Percepcija stigme
osoba na liječenju od ovisnosti o alkoholu se nije pokazala značajnim prediktorom za
objašnjenje dimenzija oporavka.
Provedeno istraživanje je teorijski obogatilo postojeća istraživanja u području liječenja
ovisnosti o alkoholu u KLA, ali i otvorilo nova pitanja za buduća istraživanja, dok implikacije
mogu biti korisne u praktičnom radu KLA. |
| Abstract (english) | Introduction and objective: Alcohol addiction is a disease that must be treated and clubs of
alcoholics in treatment (CAT) are among the most well-known forms of post-hospital treatment.
The goal of the research was to get an insight into the factors that contribute to the personal
change of people who are being treated for alcohol addiction, and who are involved in the
activities of CAT, and to determine the factors that contribute to improving the lifestyle of
abstainers with reference family support in the process of abstinence.
Methodology: The research included a total of N=163 people addicted to alcohol who were
registered as members of Clubs of alcoholics in treatment from Bosnia and Herzegovina.
Participants aged 20 to 65 took part in the research. The research population of this study
consisted of people who regularly come for treatment to the Clubs of alcoholics in treatment of
both sexes, who come to the meetings at the CAT based on a personal decision or based on the
decision of the Court, and who come to the CAT for at least three months.
The measuring instruments used in the research are:
Questionnaire of sociodemographic and treatment characteristics, constructed for the purposes
of this research; Scale of perceived self-efficacy in abstinence (shortened version) (Brief
Abstinence Self-Efficacy Measure, BASEM), (Patrick McKiernan et al., 2011); Personal
Wellbeing Index scale for adults, (eng. Personal Wellbeing Index–Adult), (Cummins, 2013);
The Recovery Assessment Scale, (Giffort et al., 1995); Helping Alliance Questionnaire (HAQ)
- Patient version, (Luborsky, 1987); The Group Climate Questionnaire (GCQ), (MacKenzie,
1983); Group engagement measure (GEM), (Macgowan, 2000); ICPS Family Functioning scale
(Noler, 1988); The Multidimensional Scale of Perceived Social Support, MSPSS, (Zimet et al.,
1988); Perceived Stigma of Addiction Scale, PSAS (Luom et al., 2010).
Results: The average length of attendance at CAT meetings was 33 months (M=32.82;
SD=34.58), with fairly high standard deviations. In total, the estimates of the helping
relationship with therapist are high on both factors, with the fact that there is a slightly higher
agreement with the fact that there is trust and understanding with the therapist (M=5.3,
SD=0.769) compared to the factor Shared orientation of the user with the therapist on the
treatment goals (M=5.00, SD= 0.892). Users highly value user engagement in group work
(M=4.49; SD= 0.909). The overall level of involvement in group work is high and amounts to
M=4.31 (SD=0.739). Family support was shown to be highly significant in the research during
the treatment of alcohol addiction, where the factors attachment and support of family members
were singled out, for which M is 4.39 while SD is 1.074 and family functionality (M=4.65, SD=
1.165). The factor inconsistency of family relationships, which refers to autonomy within the
family, shows M=3.46 and SD=1.161, while the factor rigidity among family members in KLA
shows M=3.77 and SD=1.183. The overall results of the analysis for perceived family support
are M=5.52 and SD=1.319, while for perceived support from friends, M=5.31 and SD=1.487.
According to the results of the research, stigma is somewhat present, so the participants agree
to the greatest extent that society is ready to accept a person undergoing treatment as a close
friend (M=2.86), and to the least extent ready to accept a person undergoing treatment for
alcoholism as a teacher of small children in a public school or to do jobs that include childcare
(M=2.50 and M=2.48).
Outcomes of alcoholism treatment were measured through three variables: perceived self-
efficacy, personal well-being and assessment of recovery. The results we obtained in the part
related to the Perceived self-efficacy of KLA users show that M is 4.00 while SD is .870. Within
this variable the factor safety of KLA users in non-consumption in case of craving for alcohol
stands out as particularly significant, where M is 4.28 and SD is 1.135 where the participants
showed a high degree of self-efficacy and confidence in their decision to maintain abstinence.
The results on the personal well-being of the research participants show that M = 7.653, while
SD = 1.852 indicating solid average assesments. The respondents tend to have more positive
values of the arithmetic mean on all four factors of recovery assessment, on the basis of which
it is immediately possible to infer that the clubs of treated alcoholics contribute positively to
the assessment of recovery from addiction about alcohol in the tested sample. They rate their
recovery the highest in the domain of positive expectations for the future and orientation
towards success (M=4,23, SD= 0,681), and the lowest in the domain of overcoming the
symptoms of addiction itself (M=4,06, SD=0,839), which indicates more directly recovery in
the form of healing. Other observed factors were Recovery management and reliance on other
people (M=4.21, SD= 0.67) and Orientation towards success and goals (M=4.27, SD=0.685).
According to the first research problem on the perceived self-efficacy of CAT users, the
obtained results indicate that the majority of research participants say that in the process of
treating alcohol addiction, the relationship they have with the therapist or leader of CAT is
particularly important to them. Based on the analyzed data and obtained results, we can state
that people who evaluate the relationship with the therapist as better, are more involved in the
work of the group and evaluate the group climate as better, also show greater self-efficacy in
abstinence. The results of the research and analysis of the second research problem, which was
related to the personal well-being of users of CAT, suggest that the marital status of the
participants, the total period of abstinence, group climate, engagement and perceived family
support have a significant contribution to the personal well-being during the treatment of users
of CAT, and such a model explains a total of about 44% of the variance. The results of the third
research problem related to the explanation of the assessment of recovery indicate the
following: sociodemographic characteristics for none of the dimensions of recovery proved to
be a significant predictor. The exception is the male gender, which contributes to the Self-
confidence and positive expectations dimension. The characteristics of the treatment are also
generally not significant for explaining the assessment of recovery, except for the Self-
confidence and positive expectation dimension, the absence of another mental illness is
significant. For all dimensions of recovery, the features of the helping relationship with the
therapist and the level of involvement in group work are important. Aspects of family
functioning and social support are important for all dimensions of recovery assessment. The
perception of stigma of persons undergoing alcohol addiction treatment did not prove to be a
significant predictor for explaining the dimensions of recovery.
Conclusion: Based on the analyzed, interpreted data and obtained results, we can state that
people who evaluate the relationship with the therapist as better are more involved in the work
of the group and evaluate the group climate as better, and that they also show greater self-
efficacy in abstinence. A previous diagnosis of mental illness as well as longer abstinence, i.e.
the absence of relapse, contribute to the explanation of the criterion variable. The results show
that people who rate their relationship with the therapist as better also report greater personal
well-being in the treatment process. People who report a higher level of family functioning and
greater social support report greater personal well-being from the alcohol addiction treatment
process. Research has shown that people who rate the relationship with the therapist as better
report higher assessments of recovery. A higher number of abstinent relapses during treatment
for alcohol dependence tends to influence the lower assessment of recovery in some aspects of
recovery, such as, for example. overcoming challenges. Based on the interpreted results of the
research, we can conclude that people who report a higher level of family functioning, i.e.
higher perceived social support, also show higher assessments of recovery. The scientific
contribution of this research is primarily reflected in the understanding of the phenomenon of
the process of treating the disease of alcoholism in our case through treatment in the Clubs of
alcoholics in treatment. The practical contribution is also reflected in the fact that the results of
the research will serve us for the purpose of improving the approach to group therapeutic work
with people undergoing treatment within the CAT with the use of the obtained results of this
research with a focus on application in the practice of the work of the CAT in Bosnia and
Herzegovina. |
