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      Understanding the client characteristics of Aboriginal residential alcohol and other drug rehabilitation services in New South Wales, Australia

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          Abstract

          Background

          Aboriginal alcohol and other drug residential rehabilitation (residential rehabilitation) services have been providing treatment in Australia of over 50 years. However, there are no studies in Australia or internationally that document characteristics of clients attending Indigenous residential rehabilitation services worldwide. This is the first multi-site paper to describe key client characteristics of six Indigenous (hereafter Aboriginal Australians as the term recommended by the Aboriginal Health and Medical Research Council of New South Wales) residential rehabilitation services in Australia.

          Methods

          All recorded client admissions between 1 January 2011 to 31 December 2016 were considered from six operating services in the Australian state of New South Wales. Data collected were classified into categories based on demographics, treatment utilisation, substance use, mental health and quality of life characteristics. Means, median and percentages were calculated (where appropriate).

          Results

          There were 2645 admissions across the six services in the study period, with an average of 440 admissions per year across all services. Participants were aged between 26 to 35 years, with fewest participants aged 46 +. Program length ranged from 12 to 52 weeks (mean of 12 weeks). The completion rates and length of stay for each service ranged from less than two to more than 12 weeks. The principal drug of choice was alcohol and amphetamines in half of the services. Not all services used them, but a range of tools were used to measure treatment, substance use and mental health or quality of life outcomes.

          Conclusion

          This study is the first internationally to describe the key features of multiple Aboriginal residential rehabilitation services. The variation in tools used to collect client data made it difficult to compare client characteristics across services. Future research could explore predictors of treatment completion, identify opportunities for standardisation in client assessments and validate cultural approaches of care. These efforts would need to be guided by Aboriginal leadership in each service.

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          Interpreting scores on the Kessler Psychological Distress Scale (K10).

          G. Andrews, T. Slade (2001)
          To provide normative data on the Kessler Psychological Distress Scale (K10), a scale that is being increasingly used for clinical and epidemiological purposes. The National Survey of Mental Health And Well-Being was used to provide normative comparative data on symptoms, disability, service utilisation and diagnosis for the range of possible K10 scores. The K10 is related in predictable ways to these other measures. The K10 is suitable to assess morbidity in the population, and may be appropriate for use in clinical practice.
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            The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users.

            M Gossop, P Griffiths, B Powis … (1995)
            The Severity of Dependence Scale (SDS) was devised to provide a short, easily administered scale which can be used to measure the degree of dependence experienced by users of different types of drugs. The SDS contains five items, all of which are explicitly concerned with psychological components of dependence. These items are specifically concerned with impaired control over drug taking and with preoccupation and anxieties about drug use. The SDS was given to five samples of drug users in London and Sydney. The samples comprised users of heroin and users of cocaine in London, and users of amphetamines and methadone maintenance patients in Sydney. The SDS satisfies a number of criteria which indicate its suitability as a measure of dependence. All SDS items load significantly with a single factor, and the total SDS score was extremely highly correlated with the single factor score. The SDS score is related to behavioural patterns of drug taking that are, in themselves, indicators of dependence, such as dose, frequency of use, duration of use, daily use and degree of contact with other drug users; it also shows criterion validity in that drug users who have sought treatment at specialist and non-specialist agencies for drug problems have higher SDS scores than non-treatment samples. The psychometric properties of the scale were good in all five samples, despite being applied to primary users of different classes of drug, using different recruitment procedures in different cities in different countries.
            Article 0 comments Cited 113 times – based on 0 reviews     Review now
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              The EUROHIS-QOL 8-item index: comparative psychometric properties to its parent WHOQOL-BREF.

              Neusa Sica da Rocha, Mick J Power, Donald Bushnell … (2012)
              To test the psychometric properties of the EUROHIS-QOL 8-item index, a shortened version of the World Health Organization Quality of Life Instrument-Abbreviated Version (WHOQOL-BREF). The sample consisted of 2359 subjects identified from primary care settings, with 1193 having a confirmed diagnosis of depression. Data came from six countries (Australia, Brazil, Israel, Russia, Spain, and the United States) involved in a large international study, the Longitudinal Investigation of Depression Outcomes. The structure of the EUROHIS-QOL 8-item index follows that of the WHOQOL-BREF assessment. Internal consistency was measured by using Cronbach's alpha. Convergent validity was assessed by using correlations with different measures for mental health (Symptom Checklist 90), physical health (self-evaluation), and quality of life (WHOQOL-BREF and short form 36 health survey). Discriminant group validity was assessed between diagnosed depressed and nondepressed patients. Differential item functioning and unidimensionality were analyzed by using Rasch analysis. Factor structure was assessed with structural equation modeling analyses. Internal consistency was acceptable (ranged between 0.72 and 0.81 across countries), and the index discriminated well between depression (t = 6.31-20.33; P < 0.001) across all countries. Correlations between the EUROHIS-QOL 8-item index and different measures--Symptom Checklist 90 (r = -0.42), physical health (r = -0.42), WHOQOL-BREF domains (r = 0.61-0.77), and short form 36 health survey (r = 0.58)--were all significant (P < 0.001). The index is unidimensional with desired item fit statistics. Two items ("daily living activities" and "enough money to meet your needs") had residuals exceeding 4. Differential item functioning was observed with general quality of life, general health, relationships, and home items for age. A common one-factor structure with acceptable fit was identified in three out of six countries (comparative fit index = 0.85, root mean square error of approximation = 0.11). The EUROHIS-QOL 8-item index showed acceptable cross-cultural performance and a satisfactory discriminant validity and would be a useful measure to include in studies to assess treatment effectiveness. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Douglas B. James:
                ORCID: http://orcid.org/0000-0001-6211-4730
                d.b.james@student.unsw.edu.au
                Journal
                Journal ID (nlm-ta): Addict Sci Clin Pract
                Journal ID (iso-abbrev): Addict Sci Clin Pract
                Title: Addiction Science & Clinical Practice
                Publisher: BioMed Central (London )
                ISSN (Print): 1940-0632
                ISSN (Electronic): 1940-0640
                Publication date (Electronic): 29 July 2020
                Publication date PMC-release: 29 July 2020
                Publication date (Print): 2020
                Volume: 15
                Electronic Location Identifier: 27
                Affiliations
                [1 ]GRID grid.1005.4, ISNI 0000 0004 4902 0432, National Drug and Alcohol Research Centre, , The University of New South Wales, ; Sydney, NSW 2052 Australia
                [2 ]GRID grid.1013.3, ISNI 0000 0004 1936 834X, Faculty of Medicine and Health, Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, , The University of Sydney, ; Camperdown, NSW Australia
                [3 ]GRID grid.1018.8, ISNI 0000 0001 2342 0938, Centre for Alcohol Policy Research, , La Trobe University, ; Bundoora, VIC Australia
                [4 ]GRID grid.1003.2, ISNI 0000 0000 9320 7537, School of Public Health, , University of Queensland, ; St Lucia, QLD Australia
                [5 ]GRID grid.482212.f, ISNI 0000 0004 0495 2383, Royal Prince Alfred Hospital, Drug Health Services, , Sydney Local Health District, ; Camperdown, NSW Australia
                Author information
                http://orcid.org/0000-0001-6211-4730
                Article
                Publisher ID: 193
                DOI: 10.1186/s13722-020-00193-8
                PMC ID: 7388208
                PubMed ID: 32727625
                SO-VID: 099a5b5b-2fed-4ad6-9bb4-55fc49b2c36f
                Copyright © © The Author(s) 2020
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 25 November 2019
                Date accepted : 13 June 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Award ID: 1117198
                Award ID: 1148497
                Award ID: 1117582
                Award Recipient :
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2020

                ScienceOpen disciplines: Health & Social care
                Keywords: indigenous,residential rehabilitation,alcohol,amphetamines,drug
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: indigenous, residential rehabilitation, alcohol, amphetamines, drug

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