基层医疗中治疗酒精使用障碍 - 一项新创新的定性评估：15 法。
Treating alcohol use disorders in primary care - a qualitative evaluation of a new innovation: the 15-method.
机构信息
Department of Global Public Health, Karolinska Institutet, Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm, Sweden.
Department of Clinical Neurosciences, Karolinska Institutet, Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm, Sweden.
出版信息
Scand J Prim Health Care. 2021 Mar;39(1):51-59. doi: 10.1080/02813432.2021.1882079. Epub 2021 Feb 15.
OBJECTIVE
This study aims to explore how the characteristics of an innovation, the 15-method, a stepped care model for treatment of alcohol use disorders in primary care was perceived.
METHODS/DESIGN/SETTING/SUBJECT: General practitioners and heads of primary care units ( = 10) that delivered the 15-method in a randomized controlled trial participated in individual interviews at two occasions in Stockholm, Sweden. Data were analyzed with theoretical thematic analysis, using Diffusion of Innovation Theory.
RESULTS
The participants described that offering the 15-method met a need among their patients. Participants were positive towards the training and the manual for the method. They mentioned a previous lack of routines to work with alcohol use disorders. The 15-method was described as easy to use. It would however be more feasible to implement in a team of different professions, rather than among general practitioners only. Priorities made by regional health care managers were described as important for the implementation, as well as financial incentives. A barrier to implementation was that alcohol screening was perceived as difficult. While the 15-method was perceived as effective in reducing the patients' alcohol use and cost effective, participants expressed uncertainty about the long-term effects.
CONCLUSIONS
The 15-method provides structure for treatment of alcohol use disorders and is described by general practitioners and heads as a promising approach. Being able to offer treatment for alcohol dependence may increase the uptake of alcohol interventions in primary care.KEY POINTSLittle attention has been given to develop treatment models for alcohol use disorders that are adapted to primary care settings.This study describes how an innovation, the 15-method, a stepped care model for treatment of alcohol use disorders in primary care was perceived.The 15-method provides structure for treatment of alcohol use disorders in primary care and is described by general practitioners and heads as a promising approach.Being able to offer treatment for alcohol dependence may increase the uptake of alcohol interventions in primary care.
目的
本研究旨在探讨创新特征——15 法，一种针对初级保健中酒精使用障碍的分级护理模式，是如何被感知的。
方法/设计/地点/研究对象：在瑞典斯德哥尔摩，10 名实施 15 法的全科医生和初级保健单位负责人参加了一项随机对照试验，他们在两个时间点接受了个人访谈。数据采用创新扩散理论的理论主题分析进行分析。
结果
参与者描述了提供 15 法满足了他们患者的需求。参与者对培训和该方法的手册持积极态度。他们提到之前缺乏处理酒精使用障碍的常规方法。15 法被描述为易于使用。然而，在不同专业的团队中实施会比仅在全科医生中实施更可行。区域医疗保健经理的优先事项被描述为实施的重要因素，以及财务激励。实施的一个障碍是，酒精筛查被认为是困难的。虽然 15 法被认为在减少患者的饮酒量和具有成本效益，但参与者对长期效果表示不确定。
结论
15 法为治疗酒精使用障碍提供了结构，被全科医生和负责人描述为一种有前途的方法。能够提供酒精依赖的治疗可能会增加初级保健中酒精干预措施的采用。
关键点
针对适应初级保健环境的酒精使用障碍治疗模式，关注较少。
本研究描述了一种创新——15 法，一种针对初级保健中酒精使用障碍的分级护理模式，是如何被感知的。
15 法为初级保健中酒精使用障碍的治疗提供了结构，被全科医生和负责人描述为一种有前途的方法。
能够提供酒精依赖的治疗可能会增加初级保健中酒精干预措施的采用。
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