Issue 22. May 2022 | Cardiometry | 429 ORIGINAL RESEARCH Submitted: 5.02.2022; Accepted: 23.02.2022; Published online: 25.05.2022 Counselling to promote self-esteem -pilot analysis R. Ajitha Nancy Rani1*, V. Hemavathy2 1Research Scholar, Department of Psychiatric Nursing, Sree Ba- laji College of Nursing, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India. 2Supervisor, Principal, Department of Psychiatric Nursing, Sree Balaji College of Nursing, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India. *Corresponding author: [email protected] Abstract Alcohol is not able to control the drinking habit due to both physical and emotional dependence on alcohol. Counseling aims to address the underlying causes of alcoholism. Alcohol is classified as a ‘brain disease’. Counseling services are therefore an important factor in recovering from addiction and promot- ing self-esteem. Self-esteemis a reflection of human under- standing and a sense of human worth. Counseling is a meth- od that helps to use a problem-solving process to promote self-esteem. This study aims to determine the effectiveness of counseling, promote self-esteem, and link self-esteem with de- mographic variability. Post-counseling study methodology after counseling, in the Study group, 8.33% of alcohol dependents had a low score, 50% alcohol dependence had a moderate lev- el of the score and 41.67% was a high score. Among the control group, 41.67% of alcohol dependents had a low score, 58.33% received a moderate level and none of them achieved a high score. Therefore, counseling provides professional support, ad- vice, and recommended addiction services. Keywords Counseling, Alcohol, Alcoholism, self-esteem, Effectiveness, Counseling services Imprint R. Ajitha Nancy Rani, V. Hemavathy. Counselling to promote self-esteem -pilot analysis. Cardiometry; Issue 22; May 2022; p. 429-434; DOI: 10.18137/cardiometry.2022.22.429434; Avail- able from: http://www.cardiometry.net/issues/no22-may-2022/ counselling_promote_self-esteem 1 Introduction Prolonged alcohol exposure reduces self-esteem.  According to the latest information published by the World Health Organization (WHO), the average person drinking alcohol by people over the age of 15 is 6.2 litres of pure alcohol per year, equivalent to 13.5 g of pure alcohol per day.  Alcohol, also known as alcoholism or dependence, refers to repeated use and dependence on alcohol.  It is an ongoing disease, in which patients are unable to control their compulsive drinking. They will be busy with alcohol and will con- tinue to drink even if it starts to cause problems. Al- cohol is thought to be caused by mental and physical dependence. It can lead to serious tissue damage and disease throughout the body. Common side effects of alcohol abuse include mental health and social prob- lems, liver disease, and risk/crime risk.  “Alcohol and self-esteem are intertwined. Alcohol use may tem- porarily increase or decrease self-esteem, but a healthy measure of self-esteem is a powerful tool in the fight against alcoholism. Alcohol and self-esteem are ex- tremely damaging.”  As an antidepressant, Alcohol can adversely affect a person’s mental state, especially if they are suffering from external disorders.  Alco- hol, or dependence, is a serious illness that can have serious consequences. But in many cases, it can lead to legal problems and criminal charges, such as drunk driving in addition, can lead to serious physical and mental health problems . Counselling helps clients feel confident and motivated to stay positive and com- mitted to their goals. 2 Review of Literature Uceedguzeh (2018) Alcoholism is a Multi-Sys- temic Cellular Insult to Organs, according to the au- thor. Chronic alcohol abuse is known to be associat- ed with pathophysiological changes that often lead to life-threatening clinical outcomes, e.g., breast and co- lon cancer, pancreatic disease, cirrhosis of the liver, di- abetes, osteoporosis, arthritis, kidney disease, immune system dysfunction, hypertension, coronary artery disease, cardiomyopathy, and can be as far-reaching as to cause central nervous system disorders. Eileen Fs Kaner (2018) assess the effectiveness of screening and brief alcohol intervention to re- duce excessive alcohol consumption in hazardous or harmful drinkers in general practice or emergency 430 | Cardiometry | Issue 22. May 2022 care settings. It included randomized controlled tri- als (RCTs) of brief interventions to reduce hazardous or harmful alcohol consumption and found moder- ate‐quality evidence that brief alcohol interventions have little impact on the frequency of binges per week (MD ‐0.08, 95% CI ‐0.14 to ‐0.02; 15 studies, 6946 participants  Abhijit Nadkarni (2019) conducted a study on alcohol use and alcohol-use disorders among older adults in India and concluded Alcohol use and mis- use are a problem among Indian older adults. So- cio-demographic changes will further increase lon- gevity . Suvitha(2017) assessed the level of self-esteem and alcohol consumption among male adolescents. A descriptive design with a quantitative method was adopted. The study was restricted to the sample size of about 60 male adolescents aged between 18-20 years through the purposive sampling technique . The investigator used a standardized tool of AUDIT-Al- cohol use disorder identification test and Rosenberg self-esteem scale. Data analysis was done using SPSS v 16.0 software. Results revealed that the majority of the adolescents had positive self-esteem (80 %) and only (20%) presented low self-esteem. With AUDIT score, 75 % did not consume alcohol hazardously and no samples were fall under the category of high-risk level and alcohol dependence.  3 Materials and Methods A quantitative evaluative research approach was adopted to analyze the effectiveness of counseling regarding Coping strategies to promote self-esteem among alcohol-dependent . An experimental re- search design was used for the study . The sam- ple was alcohol dependence of 18 to above 60 years who fulfill inclusion criteria. Probability simple ran- dom sampling technique was applied with the tool of 3 parts, demographic variables, Rosenberg self-esteem scale, and counseling interventions . 4 Results and Discussion Table 1 shows the Data compares pre-test level  of self-esteem amongTest and control groups of alcohol dependence. Prior to counseling, in the Study group, 75% of alcoholism was low, 25% of alcohol- ism was moderate and no one received a high score. In the control group, 58.33% of alcoholics had a low score, 41.67% of alcoholism had an average score and none of them had a high score. The level of self-esteem effect on Test Vs Control group has been correlated using chi-square . Figure 1 shows the Self-Esteem among Test and Control Group of Alcohol Depen- dence. Table 2 shows the Data Compare Post-Test  Level of Self-Esteem among a Control Group  of Alcohol Dependence. After psychological counsel- ling, in the Experiment group, 8.33% of people who drank alcohol had low scores, 50% of them had a moderate level and 41.67% of them had high scores. In the control group, 41.67% of alcohol addicts re- ceived low scores, 58.33% of them forced middle scores and none of them registered for high scores. Statistically, there is a difference between the test and the control group. The level of confidence among the test and control groups was assessed by chi-square. Figure 2 represents Self-Esteem within Experiment and Control Group. Considering the initial test, the Alcohol-Based Ex- amination Test Team scored 14.33 points and in the control group, which scored 14.00 points, hence the difference obtained 0.27, this difference is small and significant statistically. The Table 3 shows the Assess- ment of Mean  Self Esteem Score between Ex- periment and Control Group. In terms of post-test testing, the alcohol-based Test team scored 21.08 points and after testing, scored 14.50 points, so the difference is 6.58, which gives sta- tistical importance. The difference between pre-test and post-test is derived using the student’s indepen- dent t-test . Figure 3 shows the Assessment of Mean Self-Esteem Score between Experiment and Control Group. Effectiveness of Counselling and Generalization of Self Esteem The test group scored 22.50% confidence points while the control group gained only 1.67%. Differenc- es in normal performance on pre-Vs post-test scores were calculated using a difference between 95% CI . Table 4 shows the Effectiveness of Counselling on the Level of Self-Esteem Table 5 shows the correlation of the post-test lev- el of self-esteem result with demographic variables of alcohol dependence. For 40-60 years, men / other people who depend on alcohol have higher self-es- teem than others . Mathematical significance is assessed using the Chi-square/ Yates test to adjust the chi-square . Issue 22. May 2022 | Cardiometry | 431 Table 1 Pre-Test  Level of Self-Esteem Score Self-esteem level Test Group Test Group Control Group Chi-square test n % n % Low 9 75.00% 7 58.33% 2=0.75P=0.39(NS) Moderate 3 25.00% 5 41.67% High 0 0.00% 0 0.00% Total 12 100.00% 12 100.00% Figure 1. Reflect Pre-Test Level  of Self-Esteem among Test and Control Group of Alcohol Dependence Table 2 Post-Test  Level Self-Esteem. Level of self-esteem Test Group  Control Group Chi-square test n % n % Low level 1 8.33% 5 41.67% 2=7.74P=0.05*(S) Moderate level 6 50.00% 7 58.33% High level 5 41.67% 0 0.00% Total 12 100.00% 12 100.00% Figure 2. Analyses Post-Test  level of Self-Esteem within Experiment and Control Group  432 | Cardiometry | Issue 22. May 2022 Table 3 Assessment of Mean  Self Esteem Score Between Experiment and Control Group Group N Mean  Mean Gain Score Student Independent t-test  Pre-Test Experiment 12 3.63 0.27 t=0.27 p=0.78 (NS) Control 12 2.26 Post –Test Experiment 12 2.94 6.58 t=6.80 p=0.001*** (S) Control 12 1.62 Figure 3. Assessment of Mean Self-Esteem Score between Experiment and Control Group  Table 4 Declares the Effectiveness of Counselling on the Level of Self-Esteem. Group Test Maximum score Mean score MeanDifference of self-esteem gain score with 95% Confidence interval Percentage Difference of self- esteem gain score with 95% Confidence interval Experiment group  Pre-test 30 14.33 6.75(3.52 – 9.98) 22.50% (11.73% –33.27%) Post-test 30 21.08 Control group Pre-test 30 14.00 0.50(-0.08 – 1.08) 1.67% (-0.27% –3.60%) Post-test 30 14.50 Table 5 Association among Post-Test Level  of Self Esteem Score with Demographic Variables (Test Group) Demographic variables  Post-test level Self-esteem score n Chi-square test/Yates corrected chi-square test  Low/Moderate High n % n % Age in Years 18 -40 years 6 100.00% 0 16.67% 6 2=5.49 p=0.02*(S) 41 -60 years 1 16.66% 5 83.34% 6 Religion Hindu 4 57.14% 3 42.86% 7 2=0.01 p=0.92 (NS) Muslim/Christian 3 60.00% 2 40.00% 5 Type of Family Nuclear family 6 66.67% 3 33.33% 9 2=1.03 p=0.31(NS) Joint family 1 33.33% 2 66.67% 3 Issue 22. May 2022 | Cardiometry | 433 5 Conclusion From current research, Addiction can make it dif- ficult to feel good about themselves and their abilities, especially focusing on past mistakes. Self-confidence with self-esteem can be an important part of the re- covery process, so finding ways to build self-confi- dence and self-esteemcan make it easier to appreciate strengths. Self-help strategies can be a great way to start developing self-confidence. Counselling is re- quired to address the root causes of alcoholism. Coun- selling supports emotional testing and provides excel- lent resources for combating alcoholism. Counselling helps in diagnosing the problem and the level of the problem the patient is addicted to, Counselling helps to find a solution, Counselling helps to learn and to prevent recurrence and helps maintain mental balance and quality of life, counselling provides additional support to deal with stress, and positive thinking im- proves health skills. Therefore, the purpose of Coun- selling practice was effective in promoting the confi- dence and self-esteemof alcohol-dependent patients and thus counselling is a specialized service designed, to help in promoting the well-being of the individuals. Statement on ethical issues Research involving people and/or animals is in full compliance with current national and international ethical standards. Demographic variables  Post-test level Self-esteem score n Chi-square test/Yates corrected chi-square test  Low/Moderate High n % n % Marital Status Married 6 66.67% 3 33.33% 9 2=1.03 p=0.31(NS) Unmarried 1 33.33% 2 66.67% 3 Occupation Cooley/Driver 6 100.00% 0 16.67% 6 2=5.49 p=0.02*(S) Businessmen/others 1 16.66% 5 83.34% 6 Monthly Income Rs 5000 – 15000 3 75.00% 1 25.00% 4 2=0.68 p=0.41(NS) Rs 15000 and above 4 50.00% 4 50.00% 8 Presence Of Family Members with the Habit of Substance Abuse Yes 6 66.67% 3 33.33% 9 2=1.02 p=0.31(NS) No 1 33.33% 2 66.67% 3 Duration of Taking Alcohol <4 years 3 75.00% 1 25.00% 4 2=0.68 p=0.40(NS) >4 years 4 50.00% 4 50.00% 8 Which of the Following is a Precipitating Factor to Consume Alcohol? Experimental/peer pressure 3 75.00% 1 25.00% 4 2=0.68 p=0.40(NS) Financial/Family 4 50.00% 4 50.00% 8 Which of These Periods Did you Attend the Last Counselling Session? 1 year back 2 40.00% 3 60.00% 5 2=1.18 p=0.27(NS) Never attended before. 5 71.42% 2 28.58% 7 Conflict of interest None declared. Author contributions The authors read the ICMJE criteria for authorship and approved the final manuscript. References 1. New advances in alcohol therapy. (2000). Nation- al Institute on Alcohol Abuse and Alcoholism. No.49. October 2000. 2. WHO Global status report on alcohol and health 1. Alcoholism - epidemiology. I. ISBN 978 92 4 156415 1 (NLM classification: WM 274 3. Lewis David (2017) Alcohol with You - 21 Ways to Control and Stop Drinking: How to Stop Your Addic- tion and Stop Alcohol. volume 1.271-272 4. Roy Eskapa, Claudia Christian, David Sinclair (2012) Alcohol Treatment: A Proven Therapeutic Ap- proach to Alcohol Abuse .302-303 5. Walitzer. K. S., & Sher. K. J. (1996). 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