Hungerford Daniel W, Williams Janet M, Furbee Paul M, Manley William G, Helmkamp James C, Horn Kimberly, Pollock Daniel A
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Am J Emerg Med. 2003 Jan;21(1):14-22. doi: 10.1053/ajem.2003.50004.
This study evaluates the feasibility of screening and brief intervention (SBI) for alcohol problems among young adults (18-39 years) in a rural, university ED. Research staff screened a convenience sample of patients waiting for medical treatment with the Alcohol Use Disorders Identification Test (AUDIT), used motivational interviewing techniques to counsel screen-positive patients (AUDIT >/= 6) during the ED visit, and referred patients to off-site alcohol treatment as appropriate. Patients were interviewed again at 3 months. Eighty-seven percent of age-eligible drinkers (2,067 of 2,371) consented to participate. Forty-three percent (894 of 2,067) screened positive, of which 94% were counseled. Forty percent of those counseled set a goal to decrease or stop drinking and 4% were referred for further treatment. Median times for obtaining consent, screening, and intervention were 4, 4, and 14 minutes, respectively. Project staff reported that 3% of patients screened or counseled were uncooperative. Seventy percent of 519 patients who participated in follow-up interviews agreed the ED is a good place to help patients with alcohol problems. High rates of informed consent and acceptance of counseling confirmed this protocol's acceptability to patients and indicated patients were comfortable divulging alcohol-related risk behavior. The modest times required for the process enhanced acceptability to patients as well as ED staff. The high prevalence of alcohol problems and the broad acceptance of SBI in this sample provide evidence of the ED's promise as a venue for this clinical preventive service.
本研究评估了在一所农村大学急诊科对18至39岁的年轻人进行酒精问题筛查和简短干预（SBI）的可行性。研究人员使用酒精使用障碍识别测试（AUDIT）对等待治疗的便利样本患者进行筛查，在急诊就诊期间采用动机性访谈技术为筛查呈阳性的患者（AUDIT≥6）提供咨询，并酌情将患者转介至院外酒精治疗。在3个月时对患者再次进行访谈。87%符合年龄条件的饮酒者（2371人中的2067人）同意参与。43%（2067人中的894人）筛查呈阳性，其中94%接受了咨询。接受咨询的患者中有40%设定了减少或戒酒的目标，4%被转介接受进一步治疗。获得同意、进行筛查和干预的中位时间分别为4分钟、4分钟和14分钟。项目工作人员报告称，接受筛查或咨询的患者中有3%不合作。参与随访访谈的519名患者中有70%认为急诊科是帮助有酒精问题患者的好地方。高知情同意率和对咨询的接受度证实了该方案对患者的可接受性，并表明患者愿意透露与酒精相关的风险行为。该过程所需时间适中，提高了患者以及急诊科工作人员的接受度。该样本中酒精问题的高患病率和对SBI的广泛接受证明了急诊科作为这种临床预防服务场所的前景。
