Johansson K, Bendtsen P, Akerlind I
Department of Health and Society, Social Medicine and Public Health Science, Linköping University, S-581 83 Linköping, Sweden.
Public Health. 2005 Sep;119(9):781-8. doi: 10.1016/j.puhe.2004.12.006.
The aim of this study was to explore factors that influence general practitioners' (GPs') decisions regarding screening for high alcohol consumption.
GPs working at three primary healthcare centres in Sweden participated in focus group interviews. The interviews were recorded and transcribed verbatim, and a deductive framework approach was used for the analysis.
The majority of the participating GPs did not believe in asking all patients about their alcohol consumption. Reported factors that influenced how many and which patients were questioned about alcohol consumption were time, age of the patient, consultation setting, patient-physician relationship, what symptoms the patient presented with, and knowledge of measures if patients appear to have a high alcohol consumption. Thus, alcohol screening and intervention were not performed in all patient groups as was originally intended, but were performed in limited groups of patients such as those with alcohol-related symptoms.
Although the number of participants in this study was small and the conclusions cannot be generalized, the results provide some valuable insights into why GPs are hesitant to engage in screening for high alcohol consumption. Since prevention of alcohol-related health problems is an important public health issue, many different screening and intervention strategies have to be formulated and evaluated in order to reach patients with both hazardous and harmful alcohol consumption within the healthcare system. Screening all consecutive patients for a limited period or screening patient groups known to include a fairly high frequency of high alcohol consumers are two ways of limiting the time requirements and increasing role legitimacy. Still, there is a need for a broader public health strategy involving many players in the community in alcohol preventive measures, especially in more primary preventive approaches.
本研究旨在探讨影响全科医生（GP）对高酒精摄入量筛查决策的因素。
在瑞典三个初级医疗保健中心工作的全科医生参与了焦点小组访谈。访谈进行了录音并逐字转录，采用演绎框架法进行分析。
大多数参与的全科医生不认为有必要询问所有患者的酒精摄入量情况。报告显示，影响询问多少患者以及询问哪些患者酒精摄入量的因素包括时间、患者年龄、诊疗环境、医患关系、患者呈现的症状以及如果患者似乎有高酒精摄入量时的应对措施知识。因此，并非对所有患者群体都按原计划进行酒精筛查和干预，而是仅在有限的患者群体中进行，比如那些有酒精相关症状的患者。
尽管本研究的参与者数量较少，结论无法推广，但研究结果为全科医生为何不愿进行高酒精摄入量筛查提供了一些有价值的见解。由于预防与酒精相关的健康问题是一个重要的公共卫生问题，必须制定和评估许多不同的筛查和干预策略，以便在医疗保健系统中覆盖那些有危险和有害酒精消费行为的患者。在有限时间段内对所有连续就诊患者进行筛查，或者对已知高酒精消费者频率较高的患者群体进行筛查，是限制时间需求并提高角色合法性的两种方式。不过，仍需要一项更广泛的公共卫生策略，让社区中的许多参与者参与酒精预防措施，尤其是在更多的初级预防方法中。
