College of Health and Biomedicine, Victoria University, Melbourne, Australia.
Turning Point, Eastern Health Clinical School, Monash University, Melbourne, Australia.
Int J Ment Health Nurs. 2018 Apr;27(2):693-701. doi: 10.1111/inm.12355. Epub 2017 Jun 8.
Stigmatization of families supporting an adult member with substance misuse is common and undermines their capacity to support the person and maintain their own well-being. The aims of the present study were to understand affected family members (AFMs)' experience of stigma within the context of substance misuse, and to explicate what steps, if any, they took to try to counteract stigma and social isolation. Semistructured, audio-recorded qualitative interviews were conducted with 31 AFMs from Victoria in Australia. Interpretative phenomenological analysis was used to guide data collection and analysis. Two main themes and related subthemes abstracted from the data illustrated how participants perceived and responded to stigma associated with a family member's substance misuse: 'engaging in secrecy, and minimizing contact with others' and 'lack of knowledge and empathy, and judgmental attitudes reinforcing isolation'. A third theme, 'adopting measures to moderate the effect of stigma', highlights how some attempted to respond to stigma by challenging informal supports' misconceptions about substance misuse, and being open selectively with others about their situation. Stigma against AFMs should be identified and challenged. Mental health nurses and other clinicians in the alcohol and other drugs field are in a strong position to support AFMs, with a particular focus on reducing courtesy stigma, challenging some clinicians' judgmental attitudes, and improving ways of communicating with families.
污名化支持滥用药物的成年家庭成员的现象很常见,这会削弱他们支持该成员并维护自身福祉的能力。本研究的目的是了解受影响的家庭成员(AFMs)在药物滥用背景下所经历的污名,并详细说明他们采取了哪些措施来对抗污名和社会孤立。在澳大利亚维多利亚州,对 31 名 AFMs 进行了半结构化、录音的定性访谈。采用解释性现象学分析来指导数据收集和分析。从数据中提取的两个主要主题和相关子主题说明了参与者如何感知和应对与家庭成员药物滥用相关的污名:“参与保密,尽量减少与他人的接触”和“缺乏知识和同理心,以及判断态度加剧孤立”。第三个主题“采取措施减轻污名的影响”突出了一些参与者试图通过挑战非正式支持对药物滥用的误解,以及选择性地向他人公开自己的情况来应对污名。应该识别和挑战针对 AFMs 的污名。酒精和其他药物领域的心理健康护士和其他临床医生处于支持 AFMs 的有利地位,特别是要减少礼貌性污名,挑战一些临床医生的判断态度,并改进与家庭沟通的方式。