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向丙型肝炎非有害饮酒者传达饮酒问题:患者和提供者的观点。

Communicating about alcohol consumption to nonharmful drinkers with hepatitis C: patient and provider perspectives.

作者信息

Blixen Carol E, Webster Noah J, Hund Andrew J, Perzynski Adam T, Kanuch Stephanie W, Stoller Eleanor Palo, McCormick Richard A, Dawson Neal V

机构信息

Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, USA.

出版信息

J Gen Intern Med. 2008 Mar;23(3):242-7. doi: 10.1007/s11606-007-0483-y. Epub 2008 Jan 3.

Abstract

BACKGROUND

Abstaining from alcohol consumption is generally recommended for patients with Hepatitis C (HCV). However, mixed research findings coupled with a lack of consistent guidelines on alcohol consumption and HCV may influence what healthcare providers tell their HCV patients about drinking. This may be more problematic when advising nonharmful drinkers with HCV, a population for whom consumption would not be a problem in the absence of their HCV diagnosis.

OBJECTIVE

This study explores what healthcare providers advise their HCV patients who are drinking alcohol at nonharmful levels about alcohol use and what these patients actually hear.

DESIGN

We conducted separate focus groups and interviews about alcohol use and HCV with nonharmful drinkers with HCV (N = 50) and healthcare providers (N = 14) at a metropolitan teaching hospital. All focus groups and interviews were audio-taped, transcribed, and analyzed using NVivo, a qualitative data management and analysis program.

RESULTS

We found similar themes about HCV and alcohol consumption (stop completely, occasional drink is ok, cut down, and provision of mixed/ambiguous messages), reported by both providers and patients. Patient respondents who reported hearing "stop completely" were more likely to have had their last medical visit at the gastroenterology (GI) clinic as opposed to the internal medicine (IM) clinic. Furthermore, IM providers were more likely to give their recommendations in "medical language" than were GI providers.

CONCLUSIONS

To make the best health-related decisions about their disease, HCV patients need consistent information about alcohol consumption. Departments of Internal Medicine can increase provider knowledge about HCV and alcohol use by providing more education and training on HCV.

摘要

背景

对于丙型肝炎(HCV)患者,通常建议戒酒。然而,研究结果不一,且缺乏关于饮酒与HCV的一致指南,这可能会影响医疗服务提供者告知HCV患者关于饮酒的内容。对于建议HCV非有害饮酒者时,这可能会带来更多问题,因为在没有HCV诊断的情况下,这部分人群饮酒本不会有问题。

目的

本研究探讨医疗服务提供者就饮酒问题向HCV非有害饮酒患者提供了哪些建议,以及这些患者实际听到了什么。

设计

我们在一家大都市教学医院,对50名HCV非有害饮酒患者和14名医疗服务提供者分别进行了关于饮酒与HCV的焦点小组讨论和访谈。所有焦点小组讨论和访谈均进行了录音、转录,并使用定性数据管理和分析程序NVivo进行分析。

结果

我们发现,医疗服务提供者和患者都报告了关于HCV和饮酒的类似主题(完全戒酒、偶尔饮酒可以、减少饮酒量以及提供混合/模糊信息)。报告听到“完全戒酒”的患者受访者,相比在内科诊所,更有可能最近一次就诊于胃肠病学(GI)诊所。此外,与GI医疗服务提供者相比,IM医疗服务提供者更有可能用“医学语言”给出建议。

结论

为了就自身疾病做出与健康相关的最佳决策,HCV患者需要关于饮酒的一致信息。内科可以通过提供更多关于HCV的教育和培训,来增加医疗服务提供者关于HCV和饮酒的知识。

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