Gaume Jacques, Bertholet Nicolas, Daeppen Jean-Bernard
Alcohol Treatment Center, Department of Community Health and Medicine, Lausanne University Hospital, Avenue de Beaumont 21 bis, Batiment P2, 1011 Lausanne, Switzerland
Alcohol Treatment Center, Department of Community Health and Medicine, Lausanne University Hospital, Avenue de Beaumont 21 bis, Batiment P2, 1011 Lausanne, Switzerland.
Alcohol Alcohol. 2017 Jan;52(1):65-71. doi: 10.1093/alcalc/agw047. Epub 2016 Jul 28.
To test whether measures of readiness to change (RTC) re-assessed every 3 months had predictive value for change in alcohol use over 12 months in a sample of adult outpatients with alcohol use disorder (AUD).
Of the case, 78 outpatients were followed monthly over one year and averaged 9.0 interviews each (total observations = 704). Alcohol abstinence days and heavy drinking days were assessed monthly using a 30-day timeline follow-back procedure. RTC was assessed using 3 'readiness rulers' (importance, readiness, and confidence to change, measured on a 0-10 visual analog scale). The effect of RTC on alcohol use over time was tested every 3 months using negative binomial generalized estimating equations (GEE), controlling for gender, age, baseline alcohol dependence severity and AUD treatment status (ongoing vs. ceased).
GEE models showed highly significant effects of readiness and confidence to change on respective alcohol outcomes. Effects of importance to change were weaker.
As hypothesized, higher RTC scores were associated with improved alcohol use outcomes in this longitudinal study. The strongest effects were for confidence to change. Finding significant predictive validity prospectively is consistent with a theoretical view of RTC as a dynamic construct. Further research might clarify how AUD treatment could actually elicit or increase RTC.
在患有酒精使用障碍(AUD)的成年门诊患者样本中,测试每3个月重新评估一次的改变准备度(RTC)指标是否对12个月内酒精使用的变化具有预测价值。
该病例中,78名门诊患者接受了为期一年的每月随访,平均每人接受9.0次访谈(总观察次数 = 704)。每月使用30天时间线追溯程序评估戒酒天数和重度饮酒天数。使用3个“准备度标尺”(重要性、准备度和改变信心,在0 - 10视觉模拟量表上测量)评估RTC。每3个月使用负二项广义估计方程(GEE)测试RTC对酒精使用随时间的影响,并控制性别、年龄、基线酒精依赖严重程度和AUD治疗状态(持续治疗与已停止治疗)。
GEE模型显示改变准备度和改变信心对各自的酒精使用结果有高度显著影响。改变重要性的影响较弱。
如假设的那样,在这项纵向研究中,较高的RTC分数与改善的酒精使用结果相关。最强的影响是改变信心。前瞻性地发现显著的预测效度与将RTC视为动态结构的理论观点一致。进一步的研究可能会阐明AUD治疗实际上如何引发或增加RTC。