帮助有酗酒问题的人：心理健康急救指南 - 德尔菲专家共识研究。
Helping someone with problem drinking: mental health first aid guidelines - a Delphi expert consensus study.
机构信息
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, 35 Poplar Rd (Locked Bag 10), Parkville, Victoria 3052, Australia.
出版信息
BMC Psychiatry. 2009 Dec 7;9:79. doi: 10.1186/1471-244X-9-79.
BACKGROUND
Alcohol is a leading risk factor for avoidable disease burden. Research suggests that a drinker's social network can play an integral role in addressing hazardous (i.e., high-risk) or problem drinking. Often however, social networks do not have adequate mental health literacy (i.e., knowledge about mental health problems, like problem drinking, or how to treat them). This is a concern as the response that a drinker receives from their social network can have a substantial impact on their willingness to seek help. This paper describes the development of mental health first aid guidelines that inform community members on how to help someone who may have, or may be developing, a drinking problem (i.e., alcohol abuse or dependence).
METHODS
A systematic review of the research and lay literature was conducted to develop a 285-item survey containing strategies on how to help someone who may have, or may be developing, a drinking problem. Two panels of experts (consumers/carers and clinicians) individually rated survey items, using a Delphi process. Surveys were completed online or via postal mail. Participants were 99 consumers, carers and clinicians with experience or expertise in problem drinking from Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States. Items that reached consensus on importance were retained and written into guidelines.
RESULTS
The overall response rate across all three rounds was 68.7% (67.6% consumers/carers, 69.2% clinicians), with 184 first aid strategies rated as essential or important by > or =80% of panel members. The endorsed guidelines provide guidance on how to: recognize problem drinking; approach someone if there is concern about their drinking; support the person to change their drinking; respond if they are unwilling to change their drinking; facilitate professional help seeking and respond if professional help is refused; and manage an alcohol-related medical emergency.
CONCLUSION
The guidelines provide a consensus-based resource for community members seeking to help someone with a drinking problem. Improving community awareness and understanding of how to identify and support someone with a drinking problem may lead to earlier recognition of problem drinking and greater facilitation of professional help seeking.
背景
酒精是可避免疾病负担的主要风险因素。研究表明，饮酒者的社交网络可以在解决危险（即高风险）或问题饮酒方面发挥重要作用。然而，社交网络通常没有足够的心理健康素养（即关于心理健康问题的知识，例如问题饮酒或如何治疗这些问题）。这是一个令人担忧的问题，因为饮酒者从社交网络中获得的反应会对他们寻求帮助的意愿产生重大影响。本文介绍了心理健康急救指南的制定情况，该指南向社区成员介绍了如何帮助可能存在或可能正在出现饮酒问题（即酗酒或依赖）的人。
方法
对研究和非专业文献进行系统回顾，以制定包含如何帮助可能存在或可能正在出现饮酒问题的人（即酗酒或依赖）的策略的 285 项调查。两个专家小组（消费者/照顾者和临床医生）使用德尔菲法分别对调查项目进行了评分。调查是通过在线或邮寄方式完成的。参与者是来自澳大利亚、加拿大、爱尔兰、新西兰、英国和美国的 99 名有酗酒问题经验或专业知识的消费者、照顾者和临床医生。获得 80%以上专家组成员认可的重要性的项目被保留并写入指南中。
结果
三轮调查的总体回复率为 68.7%（67.6%的消费者/照顾者，69.2%的临床医生），有 184 项急救策略得到了 80%以上专家组成员的认可。这些被认可的指南提供了以下方面的指导：识别酗酒问题；如果对某人的饮酒问题表示担忧，如何与他们接触；支持该人改变饮酒习惯；如果他们不愿意改变饮酒习惯，如何应对；促进专业帮助的寻求并应对专业帮助被拒绝的情况；以及管理与酒精相关的医疗紧急情况。
结论
该指南为寻求帮助有饮酒问题的人的社区成员提供了基于共识的资源。提高社区对如何识别和支持有饮酒问题的人的意识和理解，可能会导致更早地发现酗酒问题，并更有效地促进专业帮助的寻求。
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