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      Giving room to subjectivity in understanding and assessing problem gambling: A patient-centered approach focused on quality of life

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          Abstract

          Background and aims

          Problem gambling is characterized by high stigma and self-stigma, making relevant measurement of the burden of the disorder complex. The aim of our qualitative study was to describe health-related quality of life (HRQOL) impacted by problem gambling from the patients’ perspective.

          Methods

          We conducted 6 focus groups with 25 current or lifetime at-risk problem gamblers to identify key domains of quality of life impacted by problem gambling. A content analysis from the focus groups data was conducted using Alceste © software, using descendant hierarchical classification analysis, to obtain stable classes and the significant presences of reduced forms. The class of interest, detailing the core of impacted quality of life, was described using a cluster analysis.

          Results

          Thematic content analysis identified three stable classes. Class 1 contained the interviewers’ speech. Class 3 was composed of the vocabulary related to gambling practice, games and gambling venues (casino, horse betting, etc.). Class 2 described the core of impact of gambling on quality of life and corresponded to 43% of the analyzed elementary context units. This analysis revealed seven key domains of impact of problem gambling: loneliness, financial pressure, relationships deterioration, feeling of incomprehension, preoccupation with gambling, negative emotions, and avoidance of helping relationships.

          Conclusions

          We identified, beyond objective damage, the subjective distress felt by problem gamblers over the course of the disorder and in the helping process, marked in particular by stigma and self-stigma. Four impacted HRQOL areas were new and gambling-specific: loneliness, feeling of incomprehension, avoidance of helping relationships, and preoccupation with gambling. These results support the relevance of developing, in a next step, a specific HRQOL scale in the context of gambling.

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          Most cited references42

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          A Tong, P SAINSBURY, J. Craig (2007)
          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Graphic representation of pain.

            J. Scott, E Huskisson (1976)
            Article 0 comments Cited 342 times – based on 0 reviews     Review now
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              Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms

              Erika Langham, Hannah Thorne, Matthew Browne … (2016)
              Background Harm from gambling is known to impact individuals, families, and communities; and these harms are not restricted to people with a gambling disorder. Currently, there is no robust and inclusive internationally agreed upon definition of gambling harm. In addition, the current landscape of gambling policy and research uses inadequate proxy measures of harm, such as problem gambling symptomology, that contribute to a limited understanding of gambling harms. These issues impede efforts to address gambling from a public health perspective. Methods Data regarding harms from gambling was gathered using four separate methodologies, a literature review, focus groups and interviews with professionals involved in the support and treatment of gambling problems, interviews with people who gamble and their affected others, and an analysis of public forum posts for people experiencing problems with gambling and their affected others. The experience of harm related to gambling was examined to generate a conceptual framework. The catalogue of harms experienced were organised as a taxonomy. Results The current paper proposes a definition and conceptual framework of gambling related harm that captures the full breadth of harms that gambling can contribute to; as well as a taxonomy of harms to facilitate the development of more appropriate measures of harm. Conclusions Our aim is to create a dialogue that will lead to a more coherent interpretation of gambling harm across treatment providers, policy makers and researchers.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Behav Addict
                Journal ID (iso-abbrev): J Behav Addict
                Journal ID (pmc): jba
                Journal ID (publisher-id): JBA
                Title: Journal of Behavioral Addictions
                Publisher: Akadémiai Kiadó (Budapest )
                ISSN (Print): 2062-5871
                ISSN (Electronic): 2063-5303
                Publication date (Electronic, pub): 20 January 2019
                Publication date (Print, pub): March 2019
                Volume: 8
                Issue: 1
                Pages: 103-113
                Affiliations
                [1 ]CESP, UVSQ, INSERM, University Paris-Sud, Université Paris-Saclay , Villejuif, France
                [2 ]Inserm U894, Centre Psychiatrie et Neurosciences , Paris, France
                [3 ]AP-HP, Department of Psychiatry and Addictology, Hôpitaux Universitaires Paris Ouest , Paris, France
                [4 ]Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes , Paris, France
                [5 ]Addictology and Psychiatry Department, CHU Nantes , Nantes, France
                [6 ]Université de Tours, Inserm U1246, Université de Nantes , Nantes, France
                [7 ]APHP, Hôpitaux Universitaires Paris-Sud , Villejuif, France
                [8 ]Faculté de Médecine Paris Sud, Université Paris XI , Paris, France
                Author notes
                [* ]Corresponding author: Nicolas A. Bonfils; Inserm U894, Centre Psychiatrie et Neurosciences, Issy-Les-Moulineaux, Paris 92130, France; Phone: +33 6 37 29 40 15; Fax: +33 1 71 19 63 72; E-mail: nicolas_bonfils@ 123456yahoo.com
                Article
                DOI: 10.1556/2006.7.2018.137
                PMC ID: 7044609
                PubMed ID: 30663328
                SO-VID: 4b68b324-37c5-49d7-93aa-ec6c7a321aa2
                Copyright © © 2018 The Author(s)
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                Date received : 06 April 2018
                Date revision received : 17 July 2018
                Date revision received : 30 October 2018
                Date revision received : 23 November 2018
                Date accepted : 28 November 2018
                Page count
                Figures: 2, Tables: 2, Equations: 0, References: 52, Pages: 11
                Funding
                Funding sources: None.
                Categories
                Subject: Full-Length Report

                Keywords: quality of life,problem gambling,patient-reported outcome,focus groups,health-related quality of life,qualitative research
                Data availability:
                Keywords: quality of life, problem gambling, patient-reported outcome, focus groups, health-related quality of life, qualitative research

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