Search

Supplemental Material, Appendix_2_Interview_guide_care_workers for Elderly Well-Being and Alcohol: A Tricky Cocktail by Søren Harnow Klausen, Søren Engelsen, Regina Christiansen and Jakob Emiliussen in International Journal of Qualitative Methods

Introduction: Alcohol ranks as a major risk factor for health-related harm and mortality. Older males who encounter alcohol problems late in life are an under-studied part of the affected population. This article seeks to broaden our understanding of this group by combining empirical data with humanistic cultural analysis. Specifically, it seeks to show how the desire to cope alone can be linked to generationally specific constructions of hegemonic masculinity. Method: Clinical empirical methods are fused here with those of literary analysis. The subjects which the clinical researcher chooses for scrutiny are different from those most natural to literary study, yet the interpretive approaches of qualitative phenomenological investigation and literary close reading are in fact quite similar, and we argue that new knowledge can be generated by evaluating cultural texts alongside the testimony of phenomenological research subjects. Findings and discussion: Our findings illustrate a thematic connection between subject testimony and literary texts from the relevant historical period. In the sources we compared – a qualitative study conducted in Denmark and a British novel, Kingsley Amis’s 1954 Lucky Jim – we found a strong link between the values of masculinity and the values of independence. Older men’s resistance of institutional treatment for alcohol problems has motivations which go beyond the desire not to rely on outside aid, a desire which may apply to any illness. As Lucky Jim helps us show, alcohol use functions for men of a certain generation as a symbol of rebellion against institutions, and having institutions play a dominant role in their alcohol cessation may create resistance in these men.

BACKGROUND: Interpretative phenomenological analysis (IPA) is an approach to qualitative analysis that has increasingly been used in health and psychology over the past 10-15 years.AIM: To address the practical impressions of applying IPA, from the perspective of novice researchers.DISCUSSION: The authors have observed two areas to which they would like to draw novice researchers' attention: interpretations of the six steps of IPA and what 'interpretation' means in IPA. They provide tentative suggestions in these areas for supporting researchers new to IPA.CONCLUSION: More transparency in analysis when publishing work, alongside the introduction of interpretation as the 'seventh' step of IPA, may increase the quality of IPA research and help new researchers to understand the approach better.

This systematic review seeks to expand the description and understanding of late-onset AUD andasks “Which risk factors have been reported for late-onset heavy drinking and AUD?” Method: UsingPRISMA guidelines, a literature review and search was performed on May 19, 2015 using the followingdatabases: MEDLINE, EMBASE, PubMed, and PsychInfo. Nine studies were included in the final review.Results: The search revealed that only very few studies have been conducted. Hence, the evidence islimited but suggests that stress, role/identity loss, and friends’approval of drinking are associated withan increased risk for late-onsetAUDor heavy drinking,whereas retirement, death of a spouse or a closerelative does not increase the risk. Discussion: Inherent differences in measurements and methodologiesprecluded a meta-analysis. Therefore, the results presented here are descriptive in nature. Moststudies base their conclusions on a certain preconception of older adults with alcohol problems, whichleads to a rowof circular arguments. The factors that have been measured seem to have changed overtime. Conclusion: There has been a lack of focus on the field of late-onset AUD since the 1970s, whichpossibly has led to misrepresentations and preconceptions on the complex nature of late-onset AUD.There is limited evidence for any specific risk factor for late-onset AUD or heavy drinking. We suggestthe adoption of a qualitative approach to uncover what is intrinsic to late-onset AUD followed byquantitative studies with more agreement on methods and definitions.

Adopting a phenomenological hermeneutical approach, this qualitative study focuses on an understudied group of older adults experiencing very-late-onset alcohol use disorder. This group constitutes 11% to 16% of all older adults with alcohol problems. To illuminate the experiences of the older adults the authors interviewed 12 older adults age 60 to 76 years (7 men). The participants were interviewed for 45 to 60 minutes using a semistructured format. The analysis was done in accordance with the principles of interpretative phenomenological analysis which allows for description and interpretation. Generally, findings are in accordance with existing literature. The authors found that older adults tend to define their alcohol problems in a unique way, which has implications for treatment and prevention efforts. The authors identified a tendency for the participants to define alcohol problems in relation to work or inability to take care of family. Further the findings suggest that older adults might try to avoid stigmatization. Hence, older adults with onset of alcohol use disorder after age 60 years may evaluate their alcohol use with respect to a “private” self-regulation standard thereby resisting labelling themselves as “alcoholics.” This might keep them from initiating treatment or may delay treatment seeking.

Aim: This qualitative study is concerned with the motivations that lead older adults to enter treatment for alcohol problems. There is a need to expand our understanding of the unique characteristics and problems of this population to be able to devise specialised and effective treatments and preventive measures. Method: We conducted an analysis of secondary findings from interview data collected in a qualitative interpretative phenomenological analysis (IPA) study. Our participants were 12 elderly people aged 60 years or more who had experienced late-onset alcohol use disorder. Transcription, categorisation, collapsing and analysis were conducted rigorously in accordance with the IPA standards. Findings: Family can function as a pressure structure in terms of fostering motivation for treatment. Participants were to a certain extent ambivalent about treatment, which led them to devaluing treatment and its effects. Our results are on par with comparable results from other studies. Conclusion: Older adults who experience very-late-onset of alcohol use disorder experience familial pressure and health concerns which lead them to enter treatment. Our participants seemed ambivalent about treatment and its necessity, which seems to lead to a devaluation of therapy.

Nogle mennesker udvikler et alkoholproblem, efter de er fyldt 60 år. Et kvalitativt studie har kortlagt nogle forklaringer på hvorfor, og at der er mulighed for at sætte forebyggende ind fremfor behandlende.