Wilson Celeste R, Harris Sion Kim, Sherritt Lon, Lawrence Nohelani, Glotzer Deborah, Shaw Judith S, Knight John R
Department of Medicine, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
Pediatrics. 2008 Nov;122(5):e1022-9. doi: 10.1542/peds.2008-1183.
Pediatricians are in an ideal position to screen parents of their patients for alcohol use. The objective of this study was to assess parents' preferences regarding screening and intervention for parental alcohol use during pediatric office visits for their children.
A descriptive multicenter study that used 3 pediatric primary care clinic sites (rural, urban, suburban) was conducted between June 2004 and December 2006. Participants were a convenience sample of consecutively recruited parents who brought children for medical care. Parents completed an anonymous questionnaire that contained demographics; 2 alcohol-screening tests (TWEAK and Alcohol Use Disorders Identification Test); and items that assessed preferences for who should perform alcohol-screening, acceptance of screening, and preferred interventions if the screening result was positive.
A total of 929 of 1028 eligible parents agreed to participate, and 879 of 929 completed surveys that yielded sufficient data for analysis. Most participants were mothers. A total of 101 of 879 parents screened positive on either the TWEAK or the Alcohol Use Disorders Identification Test. Parents with a negative alcohol screen (alcohol-negative) were more likely than parents with a positive alcohol screen (alcohol-positive) to report that they would agree to being asked about their alcohol use. There were no significant differences in preferences within alcohol-positive and alcohol-negative groups for screening by the pediatrician or computer-based questionnaire. Most preferred interventions for the alcohol-positive group were for the pediatrician to initiate additional discussion about drinking and its effect on their child, give educational materials about alcoholism, and refer for evaluation and treatment. Alcohol-positive men were more accepting than alcohol-positive women of having no intervention.
A majority of parents would agree to being screened for alcohol problems in the pediatric office. Regardless of their alcohol screen status, parents are accepting of being screened by the pediatrician, a computer-based questionnaire, or a paper-and-pencil survey. Parents who screen positive prefer that the pediatrician discuss the problem further with them and present options for referral.
儿科医生处于筛查患者父母饮酒情况的理想位置。本研究的目的是评估父母对于在孩子的儿科门诊就诊期间筛查和干预父母饮酒行为的偏好。
在2004年6月至2006年12月期间开展了一项描述性多中心研究，该研究使用了3个儿科初级保健诊所地点（农村、城市、郊区）。参与者是连续招募的带孩子就医的父母的便利样本。父母们填写了一份匿名问卷，其中包含人口统计学信息；2项酒精筛查测试（TWEAK和酒精使用障碍识别测试）；以及评估谁应进行酒精筛查、接受筛查的偏好，以及如果筛查结果为阳性时首选干预措施的项目。
1028名符合条件的父母中共有929名同意参与，929名中879名完成了调查，得到了足够用于分析的数据。大多数参与者为母亲。879名父母中共有101名在TWEAK或酒精使用障碍识别测试中筛查呈阳性。酒精筛查呈阴性的父母（酒精阴性）比酒精筛查呈阳性的父母（酒精阳性）更有可能报告他们会同意被询问饮酒情况。在酒精阳性和酒精阴性组内，对于由儿科医生或基于计算机的问卷进行筛查的偏好没有显著差异。酒精阳性组最首选的干预措施是让儿科医生就饮酒及其对孩子的影响展开进一步讨论、提供有关酗酒的教育材料，并转介进行评估和治疗。酒精阳性的男性比酒精阳性的女性更能接受不进行干预。
大多数父母会同意在儿科门诊接受酒精问题筛查。无论其酒精筛查状况如何，父母都接受由儿科医生、基于计算机的问卷或纸笔调查进行筛查。筛查呈阳性的父母更希望儿科医生与他们进一步讨论该问题并提供转介选项。
