Browsing by Author "Irungu, Harrison M."

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    Determinants of alcohol relapse among middle-aged married men in rehabilitation centres in Kiambu county, Kenya
    (KCA University, 2025) Irungu, Harrison M.
    Alcohol relapse remains a critical public health concern, particularly among middle-aged married men in Kiambu County, Kenya, where relapse rates exceed 60% despite the presence of multiple rehabilitation centres. This study examined the psychological, social, and structural determinants contributing to alcohol relapse within this demographic. Specifically, the study aimed to: (1) identify psychological factors influencing alcohol relapse among middle-aged married men in Kiambu County; (2) assess social dynamics of alcohol relapse among middle-aged married men in Kiambu County; (3) evaluate the effectiveness of current rehabilitation interventions applied to middle-aged married men in Kiambu County; and (4) provide evidence-based recommendations for enhancing long-term recovery outcomes. The study was guided by two frameworks: (1) the Relapse Prevention Model and (2) the Biopsychosocial Model of Addiction. A descriptive cross-sectional research design was adopted, combining quantitative and qualitative methods to capture the multifaceted nature of relapse. The study focused on middle-aged (40-64) married men undergoing rehabilitation for alcohol use disorder in Kiambu County, alongside rehabilitation staff and spouses. A total of 108 individuals participated, comprising 72 recovering men (responded to questionnaire items), whereas 12 rehabilitation staffs, 12 representatives of recovering men, and 12 spouses were involved in focus group discussion. Quantitative data were collected through structured questionnaires and analysed using descriptive statistics and multiple regression, while qualitative data from focus group discussions were subjected to manual thematic analysis. Findings from both methods were integrated through triangulation for a comprehensive understanding of relapse dynamics. The results revealed that psychological factors—particularly stress, emotional distress, low self-efficacy, and craving—had the strongest positive correlation with relapse (r = 0.72), indicating that emotional instability significantly heightens relapse vulnerability. Social determinants such as marital conflict, peer pressure, and limited family support also showed a substantial correlation with relapse (r = 0.64), highlighting the influence of social contexts in recovery outcomes. Conversely, structural factors—especially access to aftercare services, counselling continuity, and rehabilitation follow-up—were negatively correlated with relapse (r = –0.68), demonstrating their protective role. Multiple regression analysis confirmed that psychological distress was the most significant predictor of relapse, followed by social stressors, while structural support acted as a mitigating factor. Qualitative findings enriched these patterns, revealing that most recovering men relapsed in response to financial strain, unresolved marital tensions, and pervasive alcohol availability. Participants emphasized inadequate post-rehabilitation follow-up and minimal family involvement as key contributors to repeated relapse episodes. The study concludes that relapse among middle-aged married men in Kiambu County is best understood as a systemic issue spanning psychological, social, and structural dimensions. Sustainable recovery therefore requires integrated interventions that enhance coping skills, strengthen family and community support, and institutionalize continuous aftercare frameworks. The findings bridge theoretical and practical gaps in addiction counselling by illustrating how intrapersonal, interpersonal, and institutional factors interact to determine long-term sobriety. The study recommends the incorporation of structured relapse prevention modules, family-inclusive counselling, and robust aftercare systems to enhance rehabilitation outcomes and inform culturally responsive addiction policies and practices.