Cochran Gerald, Field Craig, Caetano Raul
a Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine , Baltimore Maryland , USA.
Subst Abus. 2014;35(2):153-62. doi: 10.1080/08897077.2013.820679.
Screening and brief alcohol intervention has demonstrated efficacy in improving drinking and other risk behaviors for some patient populations. However, it is not clear that brief interventions are helpful to all injured patients who drink at risk levels. This paper identifies latent classes of intervention recipients based on injury-related consequences and risks of alcohol misuse and then determines which profiles experienced the greatest improvements in drinking.
A secondary analysis was conducted using data from injured patients (N = 737) who reported heavy drinking and received a brief alcohol intervention in a Level I trauma center. Latent class analysis was used to determine patient profiles, and 7 indicators commonly associated with alcohol-related injury from the Short Inventory of Problems+6 were used to determine the latent class measurement model. Covariates were regressed onto the model to assess factors related to class membership, and drinking outcomes were analyzed to examine improvements in drinking.
Five classes emerged from the data. The classes that reported the greatest improvements in drinking following discharge were those characterized by multiple alcohol-related risks and those characterized by a history of alcohol-related accidents and injuries. Attributing the current injury to drinking was a significant predictor of class membership among those classes that reported higher levels of improvement.
This study provides tentative evidence that subclasses exist among heavy drinking injured patients who received a brief intervention in a Level I trauma center, and some subclasses experience greater drinking improvements than others. Further research is required to substantiate the findings of this secondary analysis.
筛查和简短酒精干预已证明对某些患者群体在改善饮酒及其他风险行为方面有效。然而,尚不清楚简短干预对所有处于风险饮酒水平的受伤患者是否有帮助。本文基于与伤害相关的后果及酒精滥用风险确定干预接受者的潜在类别,然后确定哪些类别在饮酒方面有最大改善。
使用来自一级创伤中心报告大量饮酒并接受简短酒精干预的受伤患者(N = 737)的数据进行二次分析。潜在类别分析用于确定患者概况,使用来自问题简短清单+6中与酒精相关伤害通常相关的7个指标来确定潜在类别测量模型。将协变量回归到模型上以评估与类别归属相关的因素,并分析饮酒结果以检查饮酒方面的改善情况。
数据中出现了五类。出院后饮酒改善最大的类别是那些具有多种酒精相关风险的类别以及那些有酒精相关事故和伤害史的类别。将当前伤害归因于饮酒是那些报告改善水平较高的类别中类别归属的重要预测因素。
本研究提供了初步证据,即在一级创伤中心接受简短干预的大量饮酒受伤患者中存在亚类,并且一些亚类比其他亚类在饮酒方面有更大改善。需要进一步研究来证实这一二次分析的结果。