Bakgrund: Personal inom hälso- och sjukvården ska “beakta ett barns behov av information, råd och stöd” när ett barns förälder eller annan vuxen i barnets närhet lider av eller drabbas av sjukdom, skada, beroende eller vid dödsfall. Barn i familjer där minst en förälder har ett missbruk eller beroende löper större risk att utsättas för fysiskt och psykiskt våld. Barn som växer upp under sådana förhållanden löper även en ökad risk att själva utveckla beroendeproblematik. Information och stöd kan vara avgörande för deras framtida hälsa. Syfte: Att undersöka vilken kunskap och vilka erfarenheter sjuksköterskor verksamma inom beroendepsykiatrin har av att uppmärksamma om det finns barn i patientens närhet som är i behov av information och stöd, samt vilka hindrande respektive främjande faktorer som finns för att kunna tillgodose detta behov. Metod: Sex sjuksköterskor deltog i individuella intervjuer. Intervjuerna analyserades med manifest innehållsanalys. Resultat: Samtliga respondenter uppgav att de alltid tillfrågar sina patienter om det finns barn i deras närhet. De främjande faktorer som har framkommit är att det hos sjuksköterskorna fanns en vilja till förbättring och utveckling i verksamheten samt att barnen uppmärksammas. De hindrande faktorerna beskrivs vara miljön inom beroendepsykiatrin, sjuksköterskornas utbildningsläge, olika rädslor samt viss tidsbrist. Slutsats: Om en strukturerad handlingsplan för att stödja och informera barnen fanns att tillgå skulle detta tillsammans med det engagemang som redan finns hos sjuksköterskorna kunna leda till ett förbättrat stöd till de barn som lever tillsammans med en vuxen med missbruksproblematik. / Background: Staff within the Swedish health care should “consider a child’s need of information, advice and support when the child’s parent or other adult in the child’s vicinity suffers from illness, injury, addiction or death”. Children in families where one parent suffers from substance addiction or abuse are at greater risk of being exposed to physical and psychological violence. Children who grow up under those circumstances are also at greater risk of developing addiction problems. Information and support may be vital for their future quality of life. Aim: To examine the knowledge and experiences nurses working in the field of addicition psychiatry have regarding inquiring about whether there are children close to their patient who are in need of information, support, and also what impeding and promoting factors they experience in regards to providing that information and support to the child. Methods: Six nurses participated in individual interviews. The interview results was analyzed using a manifest content analysis. Results: All of the nurses said that they always ask their patients if they have children among them. The promoting factors are their will to improve and development of the business and that they pay attention to the children. The impeding factors are described as the environment within the psychiatry, the nurses education, different fears and a lack of time. Conclusions: If a structured plan to support and inform the children were available, together with the commitment the nurses have expressed, could lead to an improved support for children living with an adult with substance abuse problems.

Syftet med uppsatsen är att undersöka vuxna barns personliga erfarenheter av att ha vuxit upp med missbrukande föräldrar och deras syn på stöd och hjälp. Kvalitativa intervjuer genomfördes med vuxna barn i åldrarna 25-35 år som vuxit upp med minst en förälder som missbrukat alkohol. Resultatet visar att missbrukets omfattning och karaktär beskrevs och uppfattades på lite olika sätt. Gemensamt var dock upplevelsen av att missbruket påverkade relationerna och samspelet negativt i familjerna. Familjelivet beskrevs som kaotiskt och oförutsägbart av flera intervjupersoner, bråk och konflikter förekom ofta. Alla hanterade sin situation genom att på olika sätt försöka anpassa sig efter föräldrarnas beteende och behov. Ett exempel på detta var att majoriteten av intervjupersonerna tog ett stort ansvar för hemmet och småsyskonen då föräldrarna var onyktra. Missbruket var heller ingenting som det pratades om, varken inom eller utanför familjen. Resultatet visar också att intervjupersonernas erfarenheter av stöd och hjälp såg förhållandevis olika ut. I några familjer hade socialtjänsten varit inkopplad, men det hjälpte inte för att lösa föräldrarnas problem. Ett par intervjupersoner har gått i stödgrupp för barn till missbrukande föräldrar, medan andra inte har fått något stöd alls, varken från den närmaste omgivningen eller från samhället. För några intervjupersoner utgjorde däremot det sociala nätverket ett viktigt stöd. Gemensamt för alla var att de uttryckte att de fått för lite stöd och hjälp under uppväxten. Lojaliteten gentemot föräldrarna var något som försvårade möjligheten att få hjälp, både från den närmaste omgivningen och från samhällets sida. Att barn som idag växer upp med missbrukande föräldrar behöver få mer stöd och hjälp från samhället var något som alla var överens om. Skolpersonal som dagligen träffar barnen lyftes fram som viktiga vuxna som kan göra skillnad för dessa barn. / The purpose of this bachelor thesis is to study the experiences of persons growing up with substance abusing parents. Qualitative interviews with adult children of alcoholic parents were conducted. Some informants in this study grew up with one alcohol abusing parent, while some grew up with two alcohol abusing parents. The results shows that the extent of addiction was different among parents, but common were that relationships and interactions in families were negatively infected by the substance abusing behaviour. Family life was characterized by chaos and unpredictability by many informants. A high level of conflicts was also common in the families. As children most of the informants took a lot of responsibility, especially for the care of younger siblings. The parental alcohol abuse was hidden from the community, and was almost never talked about, neither inside or outside of the family. All the informants expressed an absence of social support and help, from their networks as well as from society. Some of the families had contact with the social services, but none of the informants felt like they got enough help. Some of the informants got help from a support group for children with substance abusing parents, while others did not get any help at all. All informants felt loyalty to their family and parents and therefore avoided to reveal their parents alcohol abuse, which made it even more difficult for the community to help. The informants expressed that children growing up today with substance abusing parents need a lot more help from society. One way to reach out to these children is to educate teachers and other professionals in school in how to pay better attention to children of alcoholic parents.

Background: Adverse childhood experiences (ACEs) lead to high risk behaviors in adults. Annually, around 10,000 people die from alcohol-related motor vehicle injuries, and >1.1 million arrested for driving under the influence of alcohol or narcotics. An estimated 700,000 children reported abuse each year; 8.4% reported experiencing sexual abuse. Studies have reported the role of ACEs in alcohol consumption during adulthood. Additionally, evidence exists about the influence of parental substance abuse behaviors on addiction to alcohol and other substances of abuse. However, the association of adult drunk driving with childhood sexual abuse, and /or exposure to parental substance abuse behaviors has not been investigated. Objective: This study aimed to estimate the association of sexual abuse and/or parental substance abuse behaviors during childhood 2017 Appalachian Student Research Forum Page 57with drunk driving in US adults. Methods: Data were obtained from 4,374,390 adults who participated in the 2012 Behavioral Risk Factor Surveillance System (BRFSS). Participants' self-reported responses were used to define study outcome- drunk driving (no/yes) and study exposure- childhood sexual abuse (no/yes) and parental substance abuse behavior (no/yes). Covariates included age, sex, race, income, education, and marital status. Simple and multivariable logistic regression models were used to assess the relative odds of drunk driving among US adults who reported sexual abuse and/or exposure to parental substance behaviors during childhood. Interaction models were conducted to test for joint effects of study exposures on the outcome. Results: Approximately 3.6% of adults reported DD, 10.55% reported exposure to parental substance abuse behavior, and 11.1% adults reported childhood sexual abuse. Compared to adults who didn't experience sexual abuse during childhood, those who experienced were significantly associated with increased odds of drunk driving behavior (adjusted Odds Ratio (aOR): 1.67, 95% confidence interval (CI):1.27-2.20). Adults who reported exposure to parental substance abuse behavior were found to be associated with increased odds of drunk driving behavior (aOR:1.30, 95%CI:1.00-1.68) compared to unexposed adults. Conclusion: Adults who were sexually abused during childhood and had exposures to parental substance abuse behaviors were associated with increased relative odds of drunk driving. The study findings help public health professionals identify targeted high risk groups for interventions. Appropriate public health interventions and/or policies should be developed to prevent sexual abuse and exposure to parental substance abuse during childhood. Health education and promotional campaigns are vital to minimize drunk driving cases by targeting communities and individuals with high risk behaviors.

The aim of this study was to examine how adult children of parents with substance abuse describe their agency during childhood. The study was conducted by examining podcasts on substance abuse using qualitative content analysis. Eight different podcast episodes were included in which adult children describe their experiences of growing up in a family environment with alcohol and/or drugs. The focus of the analysis was how the adult children position themselves in their story in terms of agency and constraint. The main findings of the study was that the adult children described a range of experiences but with a focus on their vulnerability. The adult children described how they were subjected to uncertainty, neglect and sometimes violence throughout their childhood. At the same time they also positioned themselves as competent agents in their recounts. In their narratives they described how they used different strategies to control their situation and  complex process of disclosure. The strategies were also described as meaningful and used for a specific purpose even though they were sometimes understood as problematic later on. However  the adult children also positioned themselves as powerless in their narratives as they often experienced that their agency was constrained by their subordinated position as a child. An important recurrent experience was that despite their attempts to tell of their situation, it rarely led to a change. The adult children described several barriers to disclosure and how they often felt that nobody listened to them.

Growing up with parental substance abuse is a common social problem in the present society. The extent of this social problem is hard to determine and a childhood marked by parental substance abuse leads to an increased risk of serious consequences to the child, both during childhood and as an adult. The aim of this study is to examine, analyze and make these consequences visible in order to increase the knowledge and further improve the opportunities to be able to help these children in time. The scoping review methodology has been used in this study and the empirics consist of 15 scientific studies. The result shows that children tend to be negatively affected by growing up with parental substance abuse. During childhood, these children tend to feel bad and have feelings of sorrow, anxiety and fear. Children growing up in these types of families also tend to take an unnatural proportion of responsibility. Another recurring pattern is lack of trust, as well in their parents as in people outside their own family. Growing up in these conditions also increases the risk of not being able to finish school, to develop mental illness and to get into social problems later in life. The most important conclusion is that the parent’s substance abuse generally implies negative consequences to their children, but also that a lot of factors are involved and that all children are therefore affected in different ways and variations. / I dagens samhälle är det många barn som växer upp med föräldrar som har ett missbruk. Omfattningen av detta sociala problem är väldigt svår att fastställa och en uppväxt med föräldrar som har ett missbruk riskerar att ge allvarliga konsekvenser för barnet, såväl under barndomen som i vuxen ålder. Syftet med detta examensarbete är att undersöka, analysera och synliggöra dessa konsekvenser för att öka kunskapen och i större mån kunna hjälpa dessa barn i tid. Metoden litteraturöversikt har tillämpats och empirin i denna studie utgörs av 15 vetenskapliga artiklar. Resultatet visar på att barn i regel påverkas negativt av en uppväxt med föräldrar som har ett missbruk. Under uppväxten tenderar barn till föräldrar med missbruk att må dåligt och känna känslor som ledsamhet, oro och rädsla. I många fall behöver barn till föräldrar med missbruk ta onaturligt mycket ansvar för familjen. Ett återkommande mönster har också varit brist på tillit, både gentemot sina föräldrar men också till människor utanför familjen. Barn som växt upp under dessa förhållanden har också en avsevärt högre risk att till exempel inte klara av skolan, att utveckla psykisk ohälsa eller att senare i livet själva hamna i sociala problem. Den viktigaste slutsatsen är att föräldrarnas missbruk i regel innebär negativa konsekvenser för barnen, men också att många faktorer påverkar och att alla barn påverkas olika mycket och på olika sätt.

There is a lack of research on the academic resilience of minority, first-generation, online doctoral students (MFOD) who experienced poverty and parental substance abuse (PSA). The purpose of this study was to explore how MFOD who overcame poverty and PSA developed academic resilience. Resilience theory and Kember's model of attrition in online programs provided a conceptual framework for this study. The research questions guiding this qualitative study concerned how MFOD perceive and interpret their academic resilience and protective factors. A purposeful sample of 6 students participated in semistructured interviews. An interpretative phenomenological analysis was conducted, which included a case by case analysis, and a cross-case analysis. Results indicate that academic resilience is perceived as (a) determination, (b) evolving realization of the value of education, (c) paving the way for others, and (d) leveraging strengths to succeed in an online doctoral program. Protective factors are perceived as (a) resilience in adversity, (b) mindset about school, (c) identity resilience, and (d) transformational experiences. The results of this study reveal that the participants learned to see themselves beyond the context of their immediate environments. Positive social change implications include improving existing social policy to aggressively target high-poverty school districts and communities with PSA. More specifically, at-risk minority students would benefit from targeted interventions focused on family engagement in education and school retention.