Magister Artium (Psychology) - MA(Psych) / Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential factors are associated with substance use among women of childbearing-age. The study explored factors associated with substance use among pregnant women using a qualitative research design and the bio-ecological theoretical framework to explore and guide the researcher throughout the study. Participants were selected using purposive sampling. Only participants accessed from the Department of Social Development meeting the inclusion criteria of the study were interviewed using semi-structured interviews. Immediate referral for psychological intervention during the interview was available for participants who needed it. Braun and Clarke’s (2006) six phases of thematic analysis were utilised to analyse the data. The study adheres to ethical guidelines for the participants’ protection. Participants were informed about the study before the initiation of the interviews and the details of their voluntary participation were explained. The key findings from this study illustrate that socio-cultural factors, personal factors, emotional response and intimate relationships are the major contributing factors to substance use among pregnant women in this sample. The results outline the preventative measures that pregnant women implement. Lastly, the study reveals the positive and negative perceptions of substance use programmes that participants share. Some of the study findings are similar to the existing literature and some of the findings differed. Recommendations emanating from the study include that the stakeholders, rehabilitation centres, Department of Health and future researchers should act proactively against substance use during pregnancy.

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Submitted by Maike Costa (maiksebas@gmail.com) on 2016-02-17T11:37:02Z No. of bitstreams: 1 arquivototal.pdf: 2816883 bytes, checksum: c3d241f122f35e156a62ad448b1a994c (MD5) / Made available in DSpace on 2016-02-17T11:37:02Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2816883 bytes, checksum: c3d241f122f35e156a62ad448b1a994c (MD5) Previous issue date: 2015-06-30 / In the course of time, psychoactive substances is used in the treatment of some diseases, so asstimulants and in the devotion to the sacred; today, the reasons for the use of drugs have been quite diversified and drug addiction is becoming a matter of concern for Brazilian society. The religious phenomenon and spirituality have contributed significantly in prevention and recovery from drug addiction, as well as public theology has collaborated in the process of prevention and social care, along with treatment centers and faith based therapeutics communities. This thesis presents the results of a survey, which main objective was to identify the sacred images to young people between 18 and 35 who are in the recovery process in domestic in the Manasseh Project, who for more than 20 years is working with treatment programs in 21 states of Brazil. As theoretical framework, we base on Durand's Theory of the Imaginary, which identifies imaginary structures and mystical data, thus configuring the image of the sacred, what contributes to enhance the recovery process of the drug addicted. The mystic data, were analyzed by the Nine Elements Test, (AT-9 by Yves Durand). The analysis identified the images that reflect heroism, protection, and hope in the divine intervention in the process de drug addiction recovery, that once internalized , lead towards a practical faith in the supernatural, acting in the will and in the character of the man who is found dehumanized by the addiction. In the discourse about spirituality, we conclude that the image elements showed the faith, the church and the Word of God as predominant factors to face overall process of treatment in recovering from addiction. / No decorrer dos tempos, as substâncias psicoativas foram usadas no tratamento de algumas doenças, assim também como estimulantes e na devoção ao sagrado; nos dias atuais, os motivos para o uso das drogas têm sido bastante diversificados e a dependência química vem se tornando uma questão preocupante para a sociedade brasileira. O fenômeno religioso e a espiritualidade têm contribuído de forma relevante na prevenção e na recuperação da dependência química, assim como a teologia pública tem colaborado no processo de prevenção e cuidado social, juntamente com os centros de apoio e instituições ligadas à confissão religiosa. Esta dissertação apresenta os resultados de uma pesquisa, cujo objetivo maior foi o de identificar as imagens do sagrado para os jovens entre 18 e 35 anos de idade que estão no processo de recuperação em regime interno na Instituição Manassés, que há mais de 20 anos trabalha com o tratamento de dependência química em 21 estados do Brasil, Como aporte teórico, fizemos uso da Teoria Geral do Imaginário (TGI) elaborada por Gilbert Durand, dando suporte à análise das imagens, assim como o Teste de Nove Elementos, AT-9 elaborado por Yves Durand, com o objetivo de comprovar empiricamente a TGI, e levantar/conhecer imagens individuais e grupais, mapeando o tipo de estrutura do imaginário. A metodologia utilizada foi a pesquisa descritiva, de campo, com abordagem qualitativa. Os dados míticos coletados e analisados através do AT-9 permitiram identificar as imagens registradas; imagens que contribuem para elucidar o processo de recuperação dos dependentes químicos, e uma vez internalizadas, impulsionam uma fé no sobrenatural, atuando na vontade e no caráter do homem que se encontra excluído e desumanizado pelo vício. Nos discursos acerca da espiritualidade os elementos das imagens evidenciaram a fé, a igreja e a Palavra de Deus como fatores predominantes para o enfrentamento e todo o processo do tratamento na recuperação da dependência química.

Ungefär 185 miljoner människor har en drogrelaterad beroendeproblematik i världen. Att vårda patienter med beroendeproblematik komplext för sjuksköterskor i vården. Negativa attityder och stigmatisering leder till brister i behandling och negativa konsekvenser för patienterna. Sjuksköterskor påtalar brister i kunskap och önskar mer utbildning. Syftet är att beskriva sjuksköterskors attityder till patienter med beroendeproblematik och hur detta påverkar den vården de ger. Litteraturöversikten bygger på 10 vårdvetenskapliga artiklar med både kvalitativ och kvantitativ design. Databaser som artiklarna hämtades ifrån var Cinahl och PubMed. Genom en strukturerad granskning av samtliga artiklar byggdes två huvudteman upp utifrån subteman efter att identifierat likheter i artiklarnas resultat. Första huvudtemat är ”Stereotypa föreställningar” med följande subtema ”Den omoraliska patienten”, ”Den våldsbenägna patienten”, ”Okunskap om beroendeproblematik och droger” samt ”Erfarenheter”. Det andra huvudtemat är ”Risk för vårdlidande” med subteman ”Felaktiga bedömningar” samt ”Underbehandling”. Resultatet påvisar att negativa attityder och förutfattade meningar är ett övergripande problem hos sjuksköterskorna som möter patienter med beroendeproblematik. Flera studier i resultatet visar på att bristande kunskap och stöd från verksamheten förstärker det negativa attityderna och påverkar bedömning samt behandling i vården. / Approximately 185 million people in the world have a drug-related addiction problem. Caring for patients with addiction problems is complex for nurses in care. Negative attitudes and stigmatization lead to shortcomings in treatment and negative consequences for patients. Nurses point out shortcomings in knowledge and want more training. The purpose is to describe nurses' attitudes towards patients with addiction problems and how this affects the care they provide. The literature review is based on 10 care science articles with both qualitative and quantitative design. Databases from which the articles were retrieved were Cinahl and PubMed. Through a structured review of all articles, two main themes were built up based on sub-themes after identifying similarities in the articles' results. The first main theme is "Stereotypical perceptions" with the following sub-themes "The immoral patient", "The violent patient", "Ignorance of addiction problems and drugs" and "Experiences". The second main theme is "Risk for care sufferers" with sub-themes "Incorrect assessments" and "Undertreatment". The results show that negative attitudes and preconceived notions are an overall problem among the nurses who face patients with addiction problems. Several studies in the results show that lack of knowledge and support from the business reinforces the negative attitudes and affects assessment and treatment in care.

Bakgrund: Narkotika och alkoholberoende definieras som kontinuerlig användning av substansen trots skadlig effekt. Under årtiondet har det rapporterats ca 124 000 narkotikabrott i Sverige och detta har ökat med 39%. Alkohol och narkotikaberoende påverkar hjärnan och individens beteende som orsaka oförmåga att kontrollera substans intaget. Personer med substansberoende är oftast stigmatiserade och karaktäriseras som aggressiva och våldsamma individer. Sjuksköterskor har ett stort ansvar i omvårdnaden och att vårda patienter med narkotika eller alkoholberoende kan vara tidskrävande. Metod: En litteraturöversikt med åtta kvantitativ och kvalitativ vetenskapliga artiklar. Syfte: Att beskriva sjuksköterskors erfarenhet av att vårda patienter med substansberoende i form av narkotika och alkohol. Resultat: Resultaten presenterades i fyra huvudkategorier som består av 1. Brist på kunskap och utbildning. 2. Känsla av rädsla och hotfulla situationer. 3. Frustration och tillitsproblem. 4. Stigmatisering. Konklusion: Att vårda patienter med alkohol och narkotikaberoende beskrevs att vara utmanande och komplex. Brist på kunskap samt utbildning har visat sig vara den största orsaken till att sjuksköterskor känner sig osäkra att vårda dessa patienter. / Background: Alcohol and drug addiction is defined as continuous use of the substance despite the harm it causes. In the last decade, approximately 124 000 drug crimes were reported in Sweden and it has increased 39%. Drug and alcohol addiction affects the brain and the person's behavior which causes the inability to control the drug use. Individuals with substance addiction are often stigmatized and characterized as dangerous and violent people. Nurses have a huge number of responsibilities caring for patients in general and nursing patients with drugs and alcohol addiction can take a lot of effort. Method: A literature review study with eight scientific articles with quantity and quality research. Aim: The aim of the study is to describe the experience of nurses caring for patients with alcohol and drug addiction. Findings: The results are presented in four main themes: 1. Lack of knowledge and education. 2. Feeling of fear and threatening situations. 3. Frustration and mistrust. 4. Stigma. Conclusion:Caring patients with drugs and alcohol addiction was described as challenging and complex. Lack of knowledge and education was the main reason that nurses felt insecure caring for patients with drug and alcohol addiction.

Bakgrund: Substansberoende i form av narkotika och alkohol är ett växande samhällsproblem. Det förekommer en stigmatisering av personer med substansberoende i samhället och det kan finnas en risk att dessa individer upplever ett sämre bemötande inom hälso- och sjukvården. I sjuksköterskans roll finns ett ansvar att ge vård på lika villkor på ett respektfullt sätt. Syfte: Syftet var att beskriva sjuksköterskors upplevelser av att vårda patienter med substansberoende. Metod: Utifrån Fribergs metod utfördes en litteraturöversikt bestående av nio kvalitativa artiklar samt en kvantitativ artikel. Databaserna som användes var CINAHL Complete och PubMed. Resultat: I resultatet identifierades fyra teman; Att vara rädd, osäker och misstro patienten, att vara otillräcklig och frustrerad, att ha bristande kunskap och att skapa en vårdrelation. Resultatet visade att sjuksköterskor upplevde att det var känslomässigt utmanande att vårda patienter med substansberoende. Mer kunskap och utbildning om substansberoende efterfrågades av sjuksköterskor och ett öppet förhållningssätt bidrog till att meningsfulla vårdrelationer kunde skapas. Slutsats: Det är viktigt att som sjuksköterska vara medveten om sina attityder och hur det kan påverka vårdandet, för att vården ska kunna ges på lika villkor. Mer kunskap, vägledning och tydliga rutiner behövs för att öka möjligheterna att skapa en lyckad vårdrelation. / Background: Substance addiction, in particular alcohol and narcotics, is a societal problem that keeps on growing. At the same time, stigma surrounds people with substance abuse and there is a risk that it has a negative impact on the care given by the healthcare. In their professional role, however, nurses have a responsibility to treat patients equally and with due respect. Aim: The aim was to describe nurses experience of treating patients with a substance abuse Method: Nine qualitative articles and one quantitative article were reviewed. CINAHL Complete and PubMed were used to identify the articles. Results: Four themes were identified: To feel afraid, insecure and not trusting the patient; to feel inadequate and frustrated; to lack knowledge and the importance of creating a caring relationship. The findings showed nurses felt it was emotionally demanding to treat patients with substance disorder. More information and education on the topic of substance abuse was asked for by the nurses. In addition, an open mindset contributed to establishing a meaningful relationship between the nurse and the patient. Conclusion: It is important in the role as a professional nurse to be aware and reflect on one’s prejudices and the potential impact it has on the care given. In particular in order to provide care on equal terms. More information and guidance are needed to improve the chances of a successful meeting with the patients.

Religiousness has been shown to have an inverse relationship with at least some types of addiction. The present study examined whether intrinsic religiousness predicts substance addiction and video game addiction in a sample of participants that included mostly undergraduate students from the Appalachian region, as well as some participants surveyed with the use of social media advertisements. Intrinsic religiousness has been defined as internalizing the tenets of one’s faith. Participants self-reported their religiousness using the Religious Surrender and Attendance Scale – 3 (RSAS-3), which has been shown to measure intrinsic religiousness. Religiousness as measured by the RSAS-3 predicted lower levels of substance use addiction. Statistical significance was not found for the relationship between religiousness and video game addiction. The present study extends findings regarding religiousness and addiction but future research should also take into account different theological and denominational beliefs and commitments related to health outcomes.

Substance use disorders are a prominent issue within the United States that must be addressed given the high prevalence, economic cost, and negative health consequences of these medical conditions. Current treatments are inadequate due to the limited success of behavioral therapies and the lack of pharmacological interventions geared towards preventing the neuroplastic changes initiated by substances of abuse that lead to addiction. Sigma-1 receptors represent promising pharmacological targets for treatment of substance use disorders involving cocaine and methamphetamine use. A review of recent studies suggests that sigma-1 receptors contribute to the underlying mechanisms of action utilized by cocaine. Yet the use of sigma-1 receptor antagonists shows promising results of mitigating the physiological effects induced by cocaine. In contrast to cocaine, sigma-1 receptors have yet to be linked to the underlying mechanisms of action utilized by methamphetamine. However studies indicate that the use of sigma-1 receptors agonists creates a neuroprotective effect against the physiological effects induced by methamphetamine. Currently the pharmacological targeting of sigma-1 receptors is not utilized to treat substance use disorders. A review of literature was conducted in order to elucidate the mechanistic role that sigma-1 receptors play in mediating the physiological effects induced by cocaine and methamphetamine that lead to addiction. Using this information, the potential use of sigma-1 receptors as therapeutic targets was discussed in order to provide insight about the benefits and limitations of utilizing such an intervention as treatment for substance use disorders involving cocaine and methamphetamine use.

Syfte: Syftet med studien var att beskriva arbetsterapeuters erfarenhet av interventionsarbetet för personer med substansberoende i Sverige med fokus på narkotika och alkohol. Metod: En kvalitativ datainsamlingsmetod användes där elva yrkesverksamma arbetsterapeuter intervjuades. En semistrukturerad intervjuguide valdes för att undersöka arbetsterapeuternas erfarenheter. Urvalet av deltagare skedde genom ett ändamålsenligt urval samt snöbollsurval. Dataanalys genomfördes därefter med en kvalitativ innehållsanalys. Resultat: Resultatet presenteras i tre kategorier: Personcentrerat arbetssätt i interventionsarbetet, Interventioner kopplade till tidshantering och Interventioner kopplade till aktiviteter i dagliga livet. Resultatet visar att arbetsterapeuterna tillämpar olika typer av interventioner för patientgruppen, med grund i att ha den enskildes behov och önskan prioriterat. Vidare visar resultatet att interventioner kopplade till tidshantering och aktiviteter i dagliga livet är återkommande och övergripande delar som patientgruppen uppfattar svårigheter med. Slutsats: Slutsatsen är att arbetsterapeuter som arbetar med patienter som har/haft ett substansberoende kan arbeta både på individ- och gruppnivå med fokus på meningsfulla aktiviteter för att öka livskvalité och självständighet. / Purpose: The purpose of the study was to describe occupational therapists' experience of intervention work for people with substance addiction in Sweden with a focus on narcotic and alcohol. Method: A qualitative data collection method was used where eleven professional occupational therapists were interviewed. A semi-structured interview guide was chosen to investigate the occupational therapists' experiences. The selection of participants took place through an expedient selection and snowball selection. Data analysis was then carried out with a qualitative content analysis. Results: The results are presented in three categories: Person-centred approach to intervention work, Interventions linked to time management and Interventions linked to activities in daily life. The results show that the occupational therapists apply different types of interventions for the patient group, on the basis that the individual's needs and wishes are prioritized. Furthermore, the results show that interventions linked to time management and activities in daily life are recurring and overall parts that the patient group perceive difficulties with. Conclusion: The conclusion is that occupational therapists who work with patients who have/had a substance addiction can work both at the individual- and group level with a focus on meaningful activities to increase the quality of life and independence.

Vilka faktorer som främjar återhämtning från substansberoende kan vara komplex. Olika faktorer så som uppväxtvillkor och sociala färdigheter samspelar. I arbetet med substansberoende personer kan främjande faktorer och individuella förutsättningar förbises. Ökad kunskap skulle bidra till att förbättra vården av dessa personer. Syftet med den här studien var att belysa tidigare substansberoende personers upplevelser av främjande faktorer för återhämtning och bibehållen drogfrihet utan behandling med metadon eller buprenorfin. I studien intervjuades tre män och tre kvinnor med tidigare substansberoende. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. I resultatet beskrev intervjupersonerna sina upplevelser från tidig återhämtning fram till många års drogfrihet. De berättade om att de stärkts genom inre förändring, att de utvecklat sunda relationer och fått gemenskap, att de blivit en del av samhället och att de utvecklats som individer. Slutsatsen är att det är viktigt att lyfta fram dessa erfarenheter för att förbättra vården av personer med substansberoende.