[Awareness of pre-alcoholics and changes process in their awareness--analysis of narratives by patients and their families].

This study aimed to compare the process of changes in the recognition of pre-alcoholism between alcoholic patients and their family members, and examine the timing and methods of intervention for patients and their families. We conducted semi-structured interviews with 15 patient-family pairs, consisting of inpatients on the alcoholism ward and their family members in the same household. Our analysis of interview data showed that the process of changes in the patients' drinking behavior, i.e., from healthy drinking to alcohol dependence, had the following 4 stages: "look to benefits of alcohol consumption", "escape reality that they found hard to bear", "manifest health-related impairment", and "have increasing difficulties in restraining themselves from drinking". Drinking problems became more serious when the patients went through several stages at one time, or when they moved back and forth between the stages. There was a time gap between patients and their families in recognizing drinking problems, which leads to the worsening of the problems. Behind this lied communication and emotional problems between patients and their family members. The findings suggest the need to take account of the pre-alcoholic stages, and adequately respond to and care for both patients and families from an early stage onward.