Metodeutvikling ved etterundersøkelse av kvinner med alkoholproblemer

Abstract

Artikkelen beskriver de vansker som er forbundet med langtidsstudier av en så stigmatisert pasientgruppe som kvinnelige alkoholmisbrukere er. Hovedvekten er lagt på beskrivelse av kontaktetablering, metodeutvikling og aweining mellom forskningsmessige og etiske hensyn. Forfatteren er spesialist i psykiatri. Hun var i tidsrommet 1976–81 overlege ved Blå Kors Sosialbygg, Bergen, som mottar klienter med alkoholproblemer til avrusning og videreformidling i behandlingsapparatet. De siste to årene hat forfatteren vært NAVF- stipendiat rned henblikk på å gjøre en personlig etterundersøkelse av kvinnelige alkoholmisbrukere. The article presents some of the ethical, practical and methodological problems of a personal, long-term follow-up study of 53 women treated for alcohol dependence. The author describes the problems of establishing contact with this client group. Passive avoidance is the most frequent response to a written request about a research interview. This is an understandable reaction to any kind of research involving sensitive personal matters. But, especially in this group, it also means activation of feelings of shame as well as fantasies about being exploited or controlled. To overcome this difficulty, the researcher has to go and see the informant in her home. In a face-to-face situation, the researcher and the client have an opportunity to discuss more directly the clients feelings and the ethics involved. Following this procedure, 80% of the identified women were willing to participate in the follow-up interview. The actual patient group is socially unstable and difficult to trace by the public census. The necessity of gaining access to informal information on their actual living place, is stressed. Most of the interviews took place in the clients' home. This interview situation facilitated an atmosphere of openness and self-reflection on the part of the clients. On the other hand, it also created a tendency which favored small talk on everyday problems. Thus the interview situation put demands upon the researcher to keep a delicate balance between the necessary control of the interview versus a spontaneous conversation, the needs of the client to talk for her own sake versus the researcher's scientific curiosity, and professional distance versus personal closeness. If the researcher is an experienced clinician, a follow-up interview in many cases will have positive therapeutical implications for the actual client group. Planning for the possibility of follow-up studies as part of the administrative organization of the treatment, patient consent can be obtained for using a stable contact person in her social network as a helper in the process of longer term follow-up and, thus, will facilitate the present studies.