Cowlishaw Sean, Gale Lone, Gregory Alison, McCambridge Jim, Kessler David
Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK; visiting fellow, Centre for Gambling Research, ANU Centre for Social Research and Methods, Research School of Social Sciences, Australian National University (ANU), Canberra, Australia.
Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Br J Gen Pract. 2017 Apr;67(657):e274-e279. doi: 10.3399/bjgp17X689905. Epub 2017 Mar 13.
Primary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems.
To indicate the extent of gambling problems among patients attending general practices, and explore settings or patient groups that experience heightened vulnerability.
Cross-sectional study of patients attending 11 general practices in Bristol, South West England.
Adult patients ( = 1058) were recruited from waiting rooms of practices that were sampled on the basis of population characteristics. Patients completed anonymous questionnaires comprising measures of mental health problems (for example, depression) and addictive behaviours (for example, risky alcohol use). The Problem Gambling Severity Index (PGSI) measured gambling problems, along with a single-item measure of gambling problems among family members. Estimates of extent and variability according to practice and patient characteristics were produced.
There were 0.9% of all patients exhibiting problem gambling (PGSI ≥5), and 4.3% reporting problems that were low to moderate in severity (PGSI 1-4). Around 7% of patients reported gambling problems among family members. Further analyses indicated that rates of any gambling problems (PGSI ≥1) were higher among males and young adults, and more tentatively, within a student healthcare setting. They were also elevated among patients exhibiting drug use, risky alcohol use, and depression.
There is need for improved understanding of the burden of, and responses to, patients with gambling problems in general practices, and new strategies to increase identification to facilitate improved care and early intervention.
初级保健是解决与健康相关行为的重要环境，可能为识别赌博问题提供一个场所。
指出在全科诊所就诊的患者中赌博问题的程度，并探索易受伤害性较高的环境或患者群体。
对英格兰西南部布里斯托尔11家全科诊所的患者进行横断面研究。
从根据人口特征抽样的诊所候诊室招募成年患者（n = 1058）。患者完成匿名问卷，其中包括心理健康问题（如抑郁症）和成瘾行为（如危险饮酒）的测量。问题赌博严重程度指数（PGSI）测量赌博问题，以及家庭成员中赌博问题的单项测量。根据诊所和患者特征得出程度和变异性的估计值。
所有患者中有0.9%表现出问题赌博（PGSI≥5），4.3%报告问题严重程度为低到中度（PGSI 1 - 4）。约7%的患者报告家庭成员中有赌博问题。进一步分析表明，任何赌博问题（PGSI≥1）的发生率在男性和年轻人中较高，在学生医疗保健环境中更具试探性。在有药物使用、危险饮酒和抑郁症的患者中也有所升高。
需要更好地了解全科诊所中赌博问题患者的负担及应对措施，以及增加识别率以促进改善护理和早期干预的新策略。
