الفهرس 
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Abstract
SUMMARY
amilies of patients with drug addiction live with constant
shame and guilt, and often live with the constant wish
that they could make things better for their loved one. When a
family member has a dependency, the whole family usually
develops ways of coping with the problems associated with the
dependency. Often, there is less communication: the family
avoids talking about the issue, avoids expressing emotions, and
may keep the addiction secret from the community. Some
family members may take on some of the responsibilities
abandoned by the addicted person.
Expressed emotions refer to an index of particular
emotions, attitudes and behaviors expressed by relatives about a
family member. Expressed emotions are not a measure of
emotional expressiveness; rather it is a measure of the extent to
which an individual family member talks about another family
member. The three attitudes pertaining to expressed emotions
are known as hostile, critical comment, and EOI. Critical
comments indicate unambiguous resentment, dislike or
disapproval. Hostility refers to rejecting statement regarding the
individual as a person rather than his behavior. Over
involvement is the exaggerated self-sacrificing intrusive control
and overprotective concern regarding the patient?
As noted, addiction is a disease in which the biological,
psychological, and social factors are playing major roles, but
social factors and determinants have more basic roles in the
F
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incidence, prevalence and persistence of addiction. One of the
social determinants is family factors especially the family’s
expressed emotions. Families can be sources of strength and
support, or they can passively enable the addiction to advance.
Aim of the work:
The present study aimed to assess expressed emotions
among families having patients with drug addiction.
Subjects and methods:
Research design:
Descriptive design was followed in carrying out this
study.
Setting:
The current study was conducted at the in-patient
addiction treatment unit in El-Abbassia Mental Health Hospital.
Size:
The study sample was composed of 100 of the addict
patients’ relatives of male and female patients from both sexes.
The actual field work took three months and started from
16\8\2015 to 20\10\2015.
Data were collected through an interviewing
questionnaire with the relatives during the visiting period that
was from 10:30 am to 1 pm at Sunday and Monday for male
patients, and Saturday for the female patients.
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Data collection tools:
They were modified by the investigator, and were based on:
Tool (1): A socio-demographic and clinical data-structured
interview schedule for addict patients and their relatives:
This tool was developed by the investigator, and it
covered the degree of kinship between the patient and his
relative, the type of cohabitation, the socio-demographic
characteristics of both the patient and his relative as age,
marital status, economic status, education, occupation, period
of addiction and the clinical data of addiction that included data
such as the duration of addiction, number of previous
hospitalizations and total duration of hospitalizations.
Tool (2): The expressed emotions scale (EES):
This scale was developed by Berksun (1992) and was
previously used with caregivers of schizophrenic patients.
Tool (3): The family Attitude Scale (FAS):
This scale was developed by Kavanagh et al. (1997).
The findings of the present study summarized as follows:
• More than two thirds (72%) of the emotions were high EE,
and slightly more than two thirds (70%) were high criticism
and hostility; also 96% were high involvement. from the
total percentage of EE of the family attitude, 96% were
moderate while 2% were high and 2% were low.
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117
• The results of the patient’s relatives over involvement
towards their patient were 78%.
• There was a significant relation between the patient’s sex and
the relative’s EE, where all the female patients had 13.9% of
their relatives to show high EE compared to 86.1% in male
patients. Moderate EE towards male patients was 100%. (P
value =.038).
• There was a significant relation between the patients’ and
relatives’ sociodemographic data and EE level.
• There was a significant relation between the patient’s first
smoking age and the relative’s EE, where a higher percentage
of high EE (90.3%) was directed towards the patients who
began smoking at age < 15 years old versus 9.7% that was
towards the patients who began smoking at age > 15 years
old. Also, there was a difference in the relative’s EE that was
85.7% towards the patients who began smoking at age > 15
years old versus 14.3%, which was toward the patients who
began smoking at age < 15 years. (P value < .005).
• There was no relation between the beginning age of the
patient’s substance abuse and the relative’s EE (P = .061).
• There was a relation between the dependent substance that
the patient used and the relative’s EE, where the highest
percentage of high EE (90.3%) was in relatives that their
patient used heroin versus in 4.2% for hash and 5.6% for
tramadol (P value < .005).
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• There was a relation between the relative’s EE and the
patient’s number of hospital admissions, where in patients with
the first time of hospital admission the EE was 77.8% (high)
and 3.6% (moderate). Also, it is noticed that in patients with
previous three times of hospital admissions, high EE was
11.1% and 0% for moderate EE (P value < .005).
Based on the present study, the following recommendations
were suggested:
According to research results, expressed emotions were
high with the female addict patients than males, so further
studies are required to assess the expressed emotions’ levels among
the female patients’ families in comparison to the expressed
emotions of the male patients’ families.
Suggestions for future research:
1. Further nursing research is required to assess the family’s
expressed emotions and its perception by the patients with
psychiatric conditions.
2. Future research should focus on the effect of family’s
expressed emotions on the disease outcome, and its relation
to the addict patient’s relapse.
3. Future research should focus on the different needs of the
addict patient’s family of high and low expressed emotions.
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In nursing education:
The topic of expressed emotions in general, and
specifically with addiction should be included as a basic
component of the psychiatric and mental health nursing.
In nursing practice:
1. All the staff nurses, especially psychiatric and addiction
nurses should have the knowledge about family’s expressed
emotions, meaning, level and effect on the disease outcome,
and the patient’s relapse or re- hospitalization.
2. Encouraging nurses to pursue their education can help the
family psych education