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Compliance in the treatment of alcoholism
Thesis (PhD) -- University of Stellenbosch, 1993.
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| Format: | Thesis |
| Language: | English |
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Stellenbosch : Stellenbosch University
2012
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| _version_ | 1867614056192409600 |
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| access_status_str | Open Access |
| author | Gerber, Maritz Fourie |
| author2 | Moller, A. T. |
| author_browse | Gerber, Maritz Fourie Moller, A. T. |
| author_facet | Moller, A. T. Gerber, Maritz Fourie |
| author_sort | Gerber, Maritz Fourie |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD) -- University of Stellenbosch, 1993. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/57887 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:45:58.010Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2012 |
| publishDateRange | 2012 |
| publishDateSort | 2012 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/57887 Compliance in the treatment of alcoholism Gerber, Maritz Fourie Moller, A. T. Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology. Alcoholics -- Rehabilitation Alcoholism -- Treatment Patient compliance Dissertations -- Psychology Thesis (PhD) -- University of Stellenbosch, 1993. The research literature shows that alcoholism are particularly prone to dropping out of rehabilitation programs and attrition rates for the first month of hospitalization of between 18% and 80% have been reported. This phenomenon is referred to as patient noncompliance or treatment non‑adherence. Successful curative intervention in alcoholism as a chronic condition is dependent upon the alcoholic remaining in treatment for a substantial time. However, health care professionals have not yet devised an effective method for the containment of patients in alcohol rehabilitation programs. The present study is a combined retro‑ and prospective investigation with a twofold objective. The first objective was to explore the uni‑ and multivariate differences between treatment compliant and noncompliant alcoholics with regard to the standard range of biographic and clinical variables routinely assessed in rehabilitation units. The second objective was to determine the feasibility of integrating statistically selected variables into a predictive index of treatment noncompliance. For this purpose a learning set comprising two groups of respectively 150 treatment compliant and 149 noncompliant subjects were selected from patients undergoing residential alcohol rehabilitation. The uni‑ and multivariate intergroup differences were retrospectively explored with regard to 157 individual variables, representative of the following variable subsets: biographic characteristics, family relationships, personal history, mental state, physical health, liver functions, hematological values, alcohol drinking and substance ingestion. The results of these analyses show that the two groups in the learning set differed significantly (p < .05) in that more noncompliant subjects: -with higher school education were inclined toward terminating their alcohol rehabilitation at a relatively early stage; -developed employment instability shortly before their admission to the alcohol rehabilitation program; -experienced strained paternal and sibling relationships; -displayed poor relationships with equals and subordinates, were inclined toward a domineering interpersonal style, and showed an active disposition; -displayed preoccupation of thought, pressure of thought, objectively depressed mood, and lack of insight at admission; -displayed symptoms of disturbed sensibility, touch, localization, pain threshold, paraesthesia, and muscular vibration; -abused alcohol over weekends, experienced drowsiness, diminished sexual drive, and a pessimistic outlook on life following ingestion of alcohol, had mothers who were teetotallers, were between 30 and 40 years old and have been abusing alcohol for not longer than five years. Significantly (p < .05) more compliant subjects abused alcohol daily, experienced religious problems as a result of their drinking, and were motivated for treatment. The second objective, to determine the feasibility of integrating selected variables into a predictive index of treatment noncompliance, was executed in two phases. The first phase required the calculation of a logistic regression equation based upon the intergroup differences in each of the individual variables. The logistic function produced a predicted binary variable (Y) that was directly proportional to the expectation of a treatment compliant response. The logistic regression equation was therefore referred to as the predictive index of noncompliance (PINC). The second phase consisted of the prospective validation of the PINC on 94 subjects undergoing residential alcohol rehabilitation. During the first phase the individual variables were categorized in subsets and subjected to logistic discriminant computation. The individual variables that best predicted a noncompliant treatment response were then subjected to logistic discrimination in different combinations until those variables that contributed most to the statistical prediction of treatment noncompliance were identified. This process resulted in the following logistic regression equation, which correctly predicted the treatment response of 72.0% of the compliant and 68.5% of the noncompliant subjects, and 70.2% of the total learning set: −2,0987 + 1,3281 (Pareesthesia) + 0,6898 (Beer ingestion: No/Yes) 0,8809 (Relationship with Father) − 0,2316 (Neuroticism Risk Index) 0,7042 (Preoccupation of Thought) + 1,6173 (Motivation for Treatment) 0,3952 (Tobacco Smoking) + 1,3317 (Relationship with Equals). The validation study showed that the PINC was capable of correctly predicting the treatment response of 75.0% of the compliant and 30.8% of the noncompliant validation subjects, and 62.8% of the total validation group. The two most important reasons for not obtaining the learning set's 70.2% correct classification rate in the validation group are (a) the low improvement above chance (20.2) of the final classification function for the learning set, and (b) the fact that the validation group differed from the learning set regarding the duration of its rehabilitation program. Doctoral 2012-08-27T11:38:42Z 2012-08-27T11:38:42Z 1993 Thesis http://hdl.handle.net/10019.1/57887 en Stellenbosch University 458 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Alcoholics -- Rehabilitation Alcoholism -- Treatment Patient compliance Dissertations -- Psychology Gerber, Maritz Fourie Compliance in the treatment of alcoholism |
| title | Compliance in the treatment of alcoholism |
| title_full | Compliance in the treatment of alcoholism |
| title_fullStr | Compliance in the treatment of alcoholism |
| title_full_unstemmed | Compliance in the treatment of alcoholism |
| title_short | Compliance in the treatment of alcoholism |
| title_sort | compliance in the treatment of alcoholism |
| topic | Alcoholics -- Rehabilitation Alcoholism -- Treatment Patient compliance Dissertations -- Psychology |
| url | http://hdl.handle.net/10019.1/57887 |
| work_keys_str_mv | AT gerbermaritzfourie complianceinthetreatmentofalcoholism |