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对涉及酒精问题的面部骨折患者进行简短酒精干预——患者对筛查和干预态度的调查

Brief alcohol intervention in alcohol involved facial fracture patients-a survey of patient attitudes to screening and intervention.

作者信息

Lee Kai H, Dastaran Mehrnoosh, Chandu Arun

机构信息

Oral & Maxillofacial Surgery Unit, Department of Surgery, Western Health, St. Albans, Australia.

Oral & Maxillofacial Surgery Unit, Western Health, Footscray, Australia.

出版信息

Oral Maxillofac Surg. 2017 Jun;21(2):219-226. doi: 10.1007/s10006-017-0621-6. Epub 2017 Mar 28.

Abstract

PURPOSE

Alcohol intoxication is an important contributor to traumatic facial injuries. The period following injuries afford clinicians a useful window of opportunity to provide alcohol screening and brief intervention (SBI) which may affect changes in patients' future drinking behaviour. Although SBI has been reported to decrease at risk drinking and potentially trauma recurrence, it is not routinely utilised in most clinical settings in the world. This study aims to assess utilisation of, as well as patients' knowledge and attitude towards SBI in the management of patients presenting with alcohol-related facial fractures.

METHODS

Twenty consecutive patients who presented to Western Health with facial fractures who met selection criteria were offered an alcohol screening and survey questionnaire.

RESULTS

Ninety percent of patients were male and 50% were aged between 19 and 34. ASSIST score showed 65% were in the moderate risk category; 75% reported this was their first admission with alcohol related trauma. Although 75% acknowledged alcohol as a main cause of injury, only 40% agreed they drink too much. Forty-four percent felt that talking to a healthcare worker might help and 33% would consider accepting help. Forty-seven percent felt reading materials would be helpful in changing future drinking habits. Whilst 63% would like to know safe drinking limit, only 45% would like to have a discussion about alcohol-related harms.

CONCLUSIONS

Most patients presented in this survey were in moderate risk category who are amenable to behavioural change with provision of SBI. However, there is resistance to implementation of this intervention due to lack of knowledge, self-awareness and willingness to change. Nonetheless, patients are prepared to accept advice from clinicians and some formats of intervention. It is important to formulate a simple screening questionnaire and intervention strategy that are easy to administer to affect positive changes in patients with harmful drinking behaviours.

摘要

目的

酒精中毒是外伤性面部损伤的一个重要促成因素。受伤后的这段时期为临床医生提供了一个有用的机会窗口,可进行酒精筛查和简短干预(SBI),这可能会影响患者未来饮酒行为的改变。尽管据报道SBI可降低危险饮酒率并可能减少创伤复发,但在世界上大多数临床环境中,它并未得到常规应用。本研究旨在评估在处理与酒精相关的面部骨折患者时SBI的使用情况,以及患者对SBI的了解和态度。

方法

连续20例符合入选标准、因面部骨折就诊于西部健康中心的患者接受了酒精筛查和调查问卷。

结果

90%的患者为男性,50%的患者年龄在19至34岁之间。ASSIST评分显示,65%的患者属于中度风险类别;75%的患者报告这是他们首次因酒精相关创伤入院。尽管75%的患者承认酒精是受伤的主要原因,但只有40%的患者同意自己饮酒过量。44%的患者认为与医护人员交谈可能会有帮助,33%的患者会考虑接受帮助。47%的患者认为阅读材料有助于改变未来的饮酒习惯。虽然63%的患者想知道安全饮酒限量,但只有45%的患者愿意讨论与酒精相关的危害。

结论

本次调查中的大多数患者属于中度风险类别,通过提供SBI,他们的行为是可以改变的。然而,由于缺乏知识、自我意识和改变的意愿,这种干预措施的实施存在阻力。尽管如此,患者愿意接受临床医生的建议和一些形式的干预。制定一个简单易行的筛查问卷和干预策略,以影响有害饮酒行为患者的积极改变,这一点很重要。

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