Abstract
M.Cur.
The abuse of alcohol has a huge impact on health-related problems worldwide. The
incidence rate of alcohol abuse in South Africa is on the increase according to Van
Niekerk (2001:325). Alcohol dependency causes dysfunction in families resulting in
problems such as physical abuse, sexual abuse, impaired relationships and poor
parenting (Prest & Protinsky 1993:352).
The family system becomes dysfunctional by organising itself in a way which enables
and protects the alcohol dependant’s drinking habits. This phenomenon is called “
co-dependency”. The family is ignorant of the problem and becomes isolated.
The concept “co-dependency” has been used since the late 1970’s to describe the
problems affecting the spouse of the alcoholic and later to include the children.
Co-dependency is characterised by features such as low self-esteem, poor identity
formation, overuse of denial and the urge to control others. The co-dependant’s
involvement with others in order to care and control leads to mental health problems
such as depression, anxiety and substance abuse. It becomes a vicious cycle difficult
to escape from.
Health care professionals may be unaware of the underlying family problems when
the co-dependant seeks help for physical and mental illness, resulting in the
complexity of the problem not being addressed. Psychiatric nurses need guidelines to
facilitate the mental health of the co-dependant spouse.
The first goal of this study was to explore and describe the lived experience of the
co-dependant spouse. The second goal was to develop guidelines for the psychiatric
nurse to facilitate the mental health of the co-dependant spouse.
The theoretical framework of the Theory for Health Promotion in Nursing by the
Department of Nursing of the Rand Afrikaans University (2002:2-7) was used as
point of departure in conducting this research. The researcher followed a functional
approach according to the Botes model for nursing research (RAU, 2002:8-13).
An explorative, descriptive, contextual and qualitative research design was used for
this study (Babbie & Mouton, 2001:79-81). In-depth semi-structured
phenomenological interviews were conducted with participants meeting the criteria
for inclusion. Purposive sampling was used (Burns & Grove 1997:307). A pilot study
was conducted.
To ensure trustworthiness, the researcher made use of Guba’s model (Lincoln & Guba
1985: 290-300). The researcher used Tesch’s approach (Poggenpoel in De Vos,
1998:343) to transcribe the recorded interviews and to analyse the data gathered from
the interviews. A literature control was conducted to re-contextualise the results
within the literature.
The researcher came to the conclusion that the total being of the co-dependant is
dismantled by the effect of the addictive process. It was found that the ripple effect of
co-dependency is far reaching, causing dysfunction of the family structure and mental
health problems of the individual family members. In order to break the vicious cycle
of addiction, simultaneous intervention at different levels of the addiction process was
required. Therefore co-dependency should be dealt with as part of a bigger process by
the psychiatric nurse when intervening.
Guidelines were developed for the psychiatric nurse in order to facilitate the mental
health of the co-dependant in a holistic manner. Conclusions were drawn, limitations
of the research were highlighted and recommendations were made for the nursing
practice, nursing education and nursing research.