Aalto Mauri, Pekuri Petteri, Seppä Kaija
Tampere University Hospital, Department of Psychiatry, Finland.
Drug Alcohol Rev. 2003 Jun;22(2):169-73. doi: 10.1080/09595230100100606.
The objective of this study was to identify possible obstacles to carrying out competent early identification and brief intervention (EIBI) of heavy drinkers in primary health care. Qualitative focus group discussion method study applying the deductive framework approach. Six focus groups involving 18 general practitioners and 19 nurses were recruited from primary health care of the City of Tampere, Finland. Possible obstacles are: (1) confusion regarding the content of early-phase heavy drinking, (2) lack of self-efficacy among primary health care professionals, (3) sense of lacking time needed for carrying out brief intervention, (4) not having simple guidelines for brief intervention, (5) sense of difficulty in identifying of early-phase heavy drinkers, and (6) uncertainty about the justification for initiating discussion on alcohol issues with patients. The main actions to be taken to promote brief intervention are to educate professionals about the content of early-phase heavy drinking and to produce directing, but not excessively demanding guidelines for carrying out EIBI. Probably successful personal experiences carrying out EIBI can improve professionals' self-efficacy and give to them final justification for discussion alcohol issues with their patients.
本研究的目的是确定在初级卫生保健中对重度饮酒者进行有效早期识别和简短干预(EIBI)可能存在的障碍。采用演绎框架法的定性焦点小组讨论方法研究。从芬兰坦佩雷市的初级卫生保健机构招募了6个焦点小组,其中包括18名全科医生和19名护士。可能存在的障碍有:(1)对早期重度饮酒内容的困惑;(2)初级卫生保健专业人员缺乏自我效能感;(3)感觉缺乏进行简短干预所需的时间;(4)没有简短干预的简单指南;(5)难以识别早期重度饮酒者;(6)不确定与患者展开酒精问题讨论的正当性。促进简短干预需采取的主要行动是对专业人员进行早期重度饮酒内容的教育,并制定指导EIBI实施的、但不过分苛刻的指南。成功实施EIBI的个人经历可能会提高专业人员的自我效能感,并为他们与患者讨论酒精问题提供最终依据。