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综合医院住院患者的简短酒精干预:一项随机对照试验。

Brief alcohol intervention for general hospital inpatients: a randomized controlled trial.

作者信息

Freyer-Adam Jennis, Coder Beate, Baumeister Sebastian E, Bischof Gallus, Riedel Jeannette, Paatsch Karin, Wedler Barbara, Rumpf Hans-Jürgen, John Ulrich, Hapke Ulfert

机构信息

Ernst-Moritz-Arndt-University of Greifswald, Institute of Epidemiology and Social Medicine, Walther-Rathenau-Str. 48, 17487 Greifswald, Germany.

出版信息

Drug Alcohol Depend. 2008 Mar 1;93(3):233-43. doi: 10.1016/j.drugalcdep.2007.09.016. Epub 2007 Dec 3.

Abstract

AIM

To test the effectiveness of a brief alcohol intervention among non-dependent general hospital inpatients with alcohol problems, delivered by either a specialized liaison service or hospital physicians.

METHOD

All inpatients of 29 wards from four general hospitals of one region in Germany were screened for alcohol problems (n=14,332). Of those screening positive, 595 patients were included in a randomized controlled group design using a time-frame. Patients with alcohol dependence were not considered in this study. Patients received Motivational Interviewing based counselling either by a specialized liaison service, by hospital physicians trained under routine conditions or received hospital treatment as usual without additional counselling. One year later, alcohol consumption, motivation and well-being were assessed. Sample survey analyses and generalized estimating equations were conducted.

RESULTS

At baseline, the three groups differed regarding motivation, with higher motivation among the controls. At follow-up, the groups did not differ regarding alcohol consumption, alcohol-related problems and well-being. All groups decreased their alcohol consumption significantly. Regarding motivation, longitudinal analyses revealed significant interaction effects of time and intervention (p<0.05), indicating a stronger increase of readiness to change drinking and a less profound drop of readiness to seek help among those who received intervention compared to the controls.

CONCLUSION

The intervention was not effective in reducing alcohol consumption or in increasing well-being 12 months after hospitalization. It had a positive effect on readiness to change drinking and on readiness to seek formal help for alcohol problems. The intervention groups compensated their lag of motivation.

摘要

目的

测试由专门的联络服务机构或医院医生对非依赖型且有酒精问题的综合医院住院患者进行简短酒精干预的效果。

方法

对德国一个地区四家综合医院29个病房的所有住院患者进行酒精问题筛查(n = 14332)。在筛查呈阳性的患者中,595名患者被纳入一项采用时间框架的随机对照分组设计。本研究未纳入酒精依赖患者。患者接受了基于动机性访谈的咨询,咨询方式要么是通过专门的联络服务机构,要么是由在常规条件下接受培训的医院医生进行,或者是像往常一样接受医院治疗但不接受额外咨询。一年后,对酒精消费、动机和幸福感进行评估。进行了抽样调查分析和广义估计方程分析。

结果

在基线时,三组在动机方面存在差异,对照组的动机更高。在随访时,三组在酒精消费、与酒精相关的问题和幸福感方面没有差异。所有组的酒精消费量均显著下降。关于动机,纵向分析显示时间和干预存在显著的交互作用(p < 0.05),这表明与对照组相比,接受干预的患者中,改变饮酒意愿的增加更为明显,而寻求帮助意愿的下降则不那么显著。

结论

该干预措施在住院12个月后对减少酒精消费或提高幸福感无效。它对改变饮酒意愿和寻求酒精问题正式帮助的意愿有积极影响。干预组弥补了他们在动机方面的滞后。

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