Haighton Catherine, Wilson Graeme, Ling Jonathan, McCabe Karen, Crosland Ann, Kaner Eileen
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
Department of Pharmacy, Health and Well-being, Sunderland University, Sunderland, United Kingdom.
PLoS One. 2016 Feb 5;11(2):e0148601. doi: 10.1371/journal.pone.0148601. eCollection 2016.
Epidemiological surveys over the last 20 years show a steady increase in the amount of alcohol consumed by older age groups. Physiological changes and an increased likelihood of health problems and medication use make older people more likely than younger age groups to suffer negative consequences of alcohol consumption, often at lower levels. However, health services targeting excessive drinking tend to be aimed at younger age groups. The aim of this study was to gain an in-depth understanding of experiences of, and attitudes towards, support for alcohol related health issues in people aged 50 and over.
Qualitative interviews (n = 24, 12 male/12 female, ages 51-90 years) and focus groups (n = 27, 6 male/21 female, ages 50-95 years) were carried out with a purposive sample of participants who consumed alcohol or had been dependent.
Participants' alcohol misuse was often covert, isolated and carefully regulated. Participants tended to look first to their General Practitioner for help with alcohol. Detoxification courses had been found effective for dependent participants but only in the short term; rehabilitation facilities were appreciated but seen as difficult to access. Activities, informal groups and drop-in centres were endorsed. It was seen as difficult to secure treatment for alcohol and mental health problems together. Barriers to seeking help included functioning at a high level, concern about losing positive aspects of drinking, perceived stigma, service orientation to younger people, and fatalistic attitudes to help-seeking. Facilitators included concern about risk of fatal illness or pressure from significant people.
Primary care professionals need training on improving the detection and treatment of alcohol problems among older people. There is also a compelling need to ensure that aftercare is in place to prevent relapse. Strong preferences were expressed for support to be provided by those who had experienced alcohol problems themselves.
过去20年的流行病学调查显示，老年人群的酒精消费量稳步上升。生理变化以及健康问题和药物使用可能性的增加，使老年人比年轻人群更易遭受酒精消费带来的负面影响，且往往在较低饮酒量时就会出现。然而，针对过度饮酒的健康服务往往面向年轻人群。本研究的目的是深入了解50岁及以上人群在酒精相关健康问题方面的经历和对支持的态度。
对有饮酒或酒精依赖经历的目标参与者样本进行了定性访谈（n = 24，12名男性/12名女性，年龄51 - 90岁）和焦点小组讨论（n = 27，6名男性/21名女性，年龄50 - 95岁）。
参与者的酒精滥用往往是隐蔽、孤立且受到严格控制的。参与者在酒精问题上往往首先向他们的全科医生寻求帮助。脱毒课程对有依赖的参与者被发现是有效的，但只是短期有效；康复设施受到赞赏，但被认为难以获得。活动、非正式团体和临时救助中心得到认可。人们认为同时治疗酒精和心理健康问题很困难。寻求帮助的障碍包括高水平的功能状态、担心失去饮酒的积极方面、感知到的耻辱感、服务面向年轻人以及对寻求帮助的宿命论态度。促进因素包括对致命疾病风险的担忧或来自重要他人的压力。
初级保健专业人员需要接受培训，以提高对老年人酒精问题的检测和治疗能力。此外，迫切需要确保提供后续护理以防止复发。人们强烈倾向于由自身有过酒精问题经历的人提供支持。
