Abraham Traci H, Wright Patricia, White Penny, Booth Brenda M, Cucciare Michael A
a Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System , North Little Rock , Arkansas , USA.
b Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System , North Little Rock , Arkansas , USA.
J Addict Dis. 2017 Oct-Dec;36(4):252-263. doi: 10.1080/10550887.2017.1373318. Epub 2017 Sep 1.
Although rates of unhealthy drinking are high among women Veterans with mental health comorbidities, most women Veterans with mental comorbidities who present to primary care with unhealthy drinking do not receive alcohol-related care. Barriers to alcohol-related treatment could be reduced through patient-centered approaches to care, such as shared decision-making.
We assessed the feasibility and acceptability of a telephone-delivered shared decision-making intervention for promoting alcohol behavior change in women Veterans with unhealthy drinking and co-morbid depression and/or probable post-traumatic stress disorder.
We used 3, 2-hour focus group discussions with 19 women Veterans to identify barriers and solicit recommendations for using the intervention with women Veterans who present to primary care with unhealthy drinking and mental health comorbidities. Transcripts from the focus groups were qualitatively analyzed using template analysis.
Although participants perceived that the intervention was feasible and acceptable for the targeted patient population, they identified the treatment delivery modality, length of telephone sessions, and some of the option grid content as potential barriers. Facilitators included strategies for enhancing the telephone-delivered shared decision-making sessions and diversifying the treatment options contained in the option grids. Focus group feedback resulted in preliminary adaptations to the intervention that are mindful of women Veterans' individual preferences for care and realistic in the everyday context of their busy lives.
尽管患有心理健康合并症的女性退伍军人中不健康饮酒率很高，但大多数因不健康饮酒而到初级保健机构就诊的患有心理健康合并症的女性退伍军人并未接受与酒精相关的护理。通过以患者为中心的护理方法，如共同决策，可以减少与酒精相关治疗的障碍。
我们评估了一种通过电话进行的共同决策干预措施在促进患有不健康饮酒以及合并抑郁症和/或可能患有创伤后应激障碍的女性退伍军人改变饮酒行为方面的可行性和可接受性。
我们与19名女性退伍军人进行了3次为时2小时的焦点小组讨论，以确定障碍，并征求关于对因不健康饮酒和心理健康合并症而到初级保健机构就诊的女性退伍军人使用该干预措施的建议。使用模板分析法对焦点小组的记录进行定性分析。
尽管参与者认为该干预措施对目标患者群体是可行且可接受的，但他们将治疗提供方式、电话会议时长以及选项网格的一些内容确定为潜在障碍。促进因素包括增强通过电话进行的共同决策会议的策略以及使选项网格中包含的治疗选项多样化。焦点小组的反馈导致对干预措施进行了初步调整，这些调整考虑到了女性退伍军人对护理的个人偏好，并且在她们忙碌生活的日常背景下是现实可行的。
