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Table 2 Studies examining QoL in partners to persons with substance use problems

From: The quality of life when a partner has substance use problems: a scoping review

Reference, year, and country

Aim and methods

Sample size and population

Type of substance use in the person with SUP

Test method for associations between having a partner with SUP and own QoL

Controlled for own SUP in PP-SUP in estimations of associations with QoL

QoL perspectives from results section

1. Brown et al. [36]

1995

Canada

To explore gender differences in married substance abusers admitted to treatment, particularly with a view to clarifying the relationship between client functioning and that of the spouse.

Cross-sectional study

QLQ (Quality of life Questionnaire)

N = 85

Gender of partners: 67 female and 18 male

Mean age of partners: 37 years

Substance abuse (alcohol and other drug use)

Not performed

Not controlled for

Gender differences in partners’ QoL, with men scoring significantly lower on:

• physical well-being

• parent-child relations (less involvement with children and poorer parenting)

• altruistic behavior (inability to provide support to others)

2. Barber et al. [35]

1997

Australia

To identify whether some coping responses are more likely than others to be associated with psychological adjustment in the partners of drinkers

A multiple regression study

Wolcott & Glazer’s 12-item Well-being scale

N = 60

Gender of partners: 57 women, 3 men

Mean age of partners: 45 years

Heavy drinking

Standard multiple regression

Not controlled for

• No association between the use of negative behaviors towards the drinker and psychological well-being, irrespective of being used when the partner is drunk or sober

• Negative behaviors towards the drinker when sober were marginally negatively related to psychological well-being

• Positive behaviors towards the drinker had a marginally significant correlation with well-being

3. Dawson et al. [8]

2007

USA

To examine the association between partner alcohol problems and select physical and mental health outcomes among married or cohabiting women, before and after adjusting for potential confounders, and to compare these associations with those reflecting the impact of the women’s own alcohol-use disorders

A cross-sectional, retrospective survey of a nationally representative sample of U.S. adults 18 years of age and older.

Short Form-12 Health Survey Questionnaire, Version 2 (SF-12v2)-based physical quality of life. SF-12v2-based mental/ psychological quality of life

11,683 married or cohabiting women (PP-SUPs)

Mean age of partners: 42 years

Alcohol problems

- Unadjusted (bivariate) regression models constructed to estimate the magnitude and significance of the associations between partner alcohol problems and the health outcomes.

- Linear regression models for associations between numbers of stressors and QoL-scores.

Controlled for

• Significantly lower psychological QoL scores in women whose partners had alcohol problems

• No significant difference in physical QoL between women with and without partner alcohol problems

• Lower psychological QoL was significantly associated with higher level of own alcohol use of the participants

• Partner alcohol problems were significantly associated with higher probability of being in fair or poor health and a lower mean psychological QoL scores

4. Casswell et al. [37]

2011

New Zealand

A first step in investigating relationships between exposure to heavy drinkers in respondents’ lives with measures of health status and well-being

A cross-sectional general population survey

European Quality of Life-5 Dimensions (EQ-5D)

Personal Well-being Index (PWI)

N = 3068 (total sample)

29% had a heavy drinker in their lives

Partners to heavy drinkers: 15%

Mean age of partners: Not reported

Gender of partners: Not reported (but for total sample 1232 males, 1836 females).

Heavy drinking

Proportional odds model used to predict relationship

Controlled for, but not reported on PP-SUPs exclusively

• Three-quarters of respondents who had a heavy drinking partner were in the highest exposure group (i.e., they were exposed to three or more heavy drinkers)

• QoL in PP-SUP not reported

• Women reported higher QoL than men

• Poor QoL in respondents associated significantly with level of exposure to heavy drinker

• The QoL domains activity, pain, and discomfort were significantly associated with high level of exposure to heavy drinkers

• Older age, low income, low education level, higher levels of own drinking were significantly associated with lower QoL

5. Hussaarts et al. [30]

2012

Netherlands

Examine problem areas that patients with substance use disorders and their family members experience in terms of quality of relations, psychological problems, physical distress, and quality of life.

Cross-sectional study

European Quality of Life-5 Dimensions (EQ-5D)

n = 32

Dyads (persons with substance use disorders s and a family member)) were recruited from a substance abuse treatment program

22 partners

Gender of partners: 23% males

Mean age of partners: 45 years

Substance use disorder

Not performed

Not controlled for

• No QoL differences between subgroups (patients, partners, or parents)

• Poor QoL in family members and in line with heroin addicts

6. Stenton et al. [34]

2014

Australia

Examine challenges to the health and well-being of families of people with alcohol problems

A cross-sectional survey incorporating open-ended questions for qualitative analysis and closed-ended questions for quantitative analysis

Quantitative part:

Quality of life: single question, “How would you rate your quality of life?”

Qualitative part:

Open-ended questions about the seriousness of impact of their close relative’s drinking or substance misuse on their health and well-being

39 Al-Anon members

12 partners

Gender of partners: Not reported

Mean age of partners: Not reported

Problem drinking

Pearson’s product moment for correlation

Not controlled for

Quantitative part:

• Higher levels of psychological distress in participants was associated with significantly poorer overall QoL

• The participants’ satisfaction with a support group was associated with better overall QoL

• QoL in PP-SUP not reported

Qualitative part:

• Poor relationships and lack of trust

• Fear of aggression

• Anxiety, sadness, and grief

• Financial difficulties/poverty

• Poor communication

7. Cicek et al. [29]

2015

Croatia

Comparing the quality of life (QoL) and family burden in relatives of patients with heroin dependence to healthy controls.

A prospective case-control study

World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF)

A total of 50 heroin-dependent patients and 50 of their relatives, and 50 healthy subjects and 50 of their relatives were included in the study

Partners: 16%

Gender of partners: Not reported, but 50% of total sample relatives were women

Mean age of partners: Not reported (but 41 years for total sample of relatives)

Opioid dependence

Pearson product- moment correlation and Spearman’s rank correlation

Not controlled for

• No specific partner reports on QoL

• QoL significant lower in family members of patients with heroin dependence than controls

• All QoL subscale scores negatively correlated with the duration of illness

8. Jiang et al. [33]

2015

Australia

To identify which factors correlate with whether the respondent takes on this caring role for the person in their life whose drinking has most adversely affected them in the current year and to examine how caring for that person impacts the respondent’s quality of life and well-being, and use of services

Cross-sectional survey

European Quality of Life-5 Dimensions (EQ-5D)

Personal Well-being Index (PWI)

778 respondents (total survey sample 2649) reported they were harmed because of the drinking of someone they knew (most harmful drinker; MHD).

67 partners

Gender of partners: Not reported, but 67% of respondents harmed by MHD were women

Mean age of partners: Not reported

Harmful drinking

Not performed

Not controlled for

• No QoL differences (EQ-5D) between subgroups (partners and others)

• No significant differences in QoL (EQ-5D) in respondents who care for their ‘most harmful drinker’ (MHD) and those who did not

• No significant differences in QoL between specific categories of MHD relationships

• Personal well-being (PWI) significantly worse for people harmed by MHD than people who had no MHD in life

• Poorer personal well-being (PWI) for caregivers of MHD in the household than non-caregivers

9. Nogueira et al. [38]

2015

Spain

To provide new empirical evidence about the effects of alcohol dependence on the health-related QoL of the dependent person and those around them using the general population as the control group

Cross-sectional study

Short-Form Health Survey-36 (SF-6D)

150 patients with alcohol dependence, 64 family members of patients with alcohol dependence, and 600 persons from the general population

67.7% partners

Gender of partners: Not reported

Mean age of partners: Not reported

Alcohol dependence

Logistic regressions

Not controlled for

QoL not reported for partners

• Significantly lower QoL in family members than in general population (no specific partner reports on QoL)

• Reduction in mean utility scores in SF-6D dimensions in family members, particularly in mental health and vitality, with a positive impact from physical function compared to the general population

• Age and gender (being a woman) negatively correlated with QoL