Kvamme Brita Odland, Asplund Kenneth, Bjerke Trond Nergaard
Division of Addiction and Specialized Psychiatry, University Hospital of North Norway, Tromsø, Norway.
Department of Nursing Science, Mid-Sweden University, Sundsvall, Sweden.
Scand J Caring Sci. 2015 Dec;29(4):716-23. doi: 10.1111/scs.12202. Epub 2015 Apr 8.
The majority of patients being treated for alcohol abuse disorders experience one or more relapses after treatment. The fact that people use this inebriant in a way leading to so much harm and suffering might seem a conundrum. Therapists, family and others might find the person's relapse to be dramatic and upsetting, and one might question whether the person has the sufficient will or motivation to change. However, few previous studies have explored relapse from the patient's perspective. The aim of this study was to illuminate the patient's lived experience of relapse and to develop a deeper understanding of this phenomenon. The study consisted of qualitative interviews using a phenomenological hermeneutical approach. Three main themes emerged from the analyses: 'craving', 'self-image' and 'time'. The findings were discussed in the context of phenomenological literature. Cravings could occur unpredictably; nevertheless, craving was a common experience for the patients and signified a risk of relapse. Bodily experiences of craving were frequently mentioned, and alcohol addiction could be understood as to be a disease or a learned habit. Self-image was, at times, adversely affected by relapse episodes. Therefore, feelings of shame, self-respect and recognition were significant concepts. This study found that the perception of time as past, present and future greatly influenced the participants' experiences of relapse and rehabilitation. Thus, relapse was an upsetting and dramatic experience that could cause great discomfort and sometimes life-threatening situations. However, relapse could also be viewed as a planned event. This study highlights important truth and reality about alcoholism and relapse grounded in people's lived experience.
大多数接受酒精滥用障碍治疗的患者在治疗后会经历一次或多次复发。人们以一种会导致如此多伤害和痛苦的方式使用这种致醉物,这一事实似乎是一个难题。治疗师、家人和其他人可能会觉得患者的复发令人震惊和不安,人们可能会质疑这个人是否有足够的意愿或动力去改变。然而,以前很少有研究从患者的角度探讨复发问题。本研究的目的是阐明患者复发的生活经历,并对这一现象有更深入的理解。该研究采用现象学诠释学方法进行定性访谈。分析得出了三个主要主题:“渴望”、“自我形象”和“时间”。研究结果在现象学文献的背景下进行了讨论。渴望可能会不可预测地出现;尽管如此,渴望是患者的一种常见经历,意味着有复发的风险。身体上对渴望的体验经常被提及,酒精成瘾可以被理解为一种疾病或一种习得的习惯。自我形象有时会受到复发事件的不利影响。因此,羞耻感、自尊和认可感是重要的概念。本研究发现,对过去、现在和未来时间的认知极大地影响了参与者对复发和康复的体验。因此,复发是一种令人不安和震惊的经历,可能会导致极大的不适,有时甚至会危及生命。然而,复发也可以被视为一个有计划的事件。本研究突出了基于人们生活经历的关于酗酒和复发的重要真相和现实。