eHealth Unit, Primary Care and Population Health Research Department, University College London, Upper Third Floor, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, UK.
Centre for Implementation Science, Health Service and Population Research Department, King's College London, 16 De Crespigny Park, Camberwell, London, UK.
J Public Health (Oxf). 2019 Jun 1;41(2):e185-e191. doi: 10.1093/pubmed/fdy067.
The public health message around alcohol is complex, with benefits versus harms, the confusing concept of risk and drinking guidance changing over time. This provides a difficult context for alcohol screening in primary care, with established barriers from the practitioner perspective, but less is known about the patients' perspective. This study explores patients' views on drinking.
Eligible participants were recorded as drinking above low risk levels in primary care. Six practices in North London participated. Interviews were in-depth, semi-structured, transcribed verbatim and underwent detailed thematic analysis.
Interviews were conducted with 8 women and 12 men, aged 26-83 years, mostly educated to undergraduate level and of 'White' ethnicity. UK drinking guidance was viewed as irrelevant for reasons related to life stage, lifestyle and absence of harm. Dependence, loss of functionality and control were perceived as key features of problematic drinking. Healthy lifestyles, in terms of diet, exercise and not smoking, were thought to mitigate potential problems associated with alcohol intake.
The findings suggest that public health messages and brief advice should focus on harm experienced at different life stages, among people with different lifestyles, to challenge the ubiquitous view that 'I'm not a real boozer'.
围绕酒精的公共卫生信息较为复杂，涉及到利弊权衡、风险概念的混淆以及饮酒指导意见随时间变化等问题。这为基层医疗中的酒精筛查提供了一个困难的背景，从从业者的角度来看存在既定的障碍，但对患者的观点了解较少。本研究探讨了患者对饮酒的看法。
在北伦敦的 6 家诊所中，符合条件的参与者被记录为在基层医疗中饮酒超过低风险水平。访谈是深入的、半结构化的，逐字转录，并进行了详细的主题分析。
共对 8 名女性和 12 名男性进行了访谈，年龄在 26-83 岁之间，大多数受教育程度达到本科水平，为“白人”种族。英国的饮酒指导意见被认为不切实际，原因与生活阶段、生活方式和没有危害有关。依赖、丧失功能和失去控制被认为是饮酒问题的关键特征。健康的生活方式，如饮食、锻炼和不吸烟，被认为可以减轻与酒精摄入相关的潜在问题。
研究结果表明，公共卫生信息和简短建议应侧重于不同生活阶段、不同生活方式人群的所经历的危害，以挑战普遍存在的观点，即“我不是一个真正的酒徒”。
