Department of Veterans Affairs, Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Rd. (152-MPD), Menlo Park, CA, 94025, USA.
Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA, 94305, USA.
J Clin Psychol Med Settings. 2024 Mar;31(1):224-235. doi: 10.1007/s10880-023-09954-4. Epub 2023 Mar 23.
Addressing hazardous drinking during medical-surgical care improves patients' health. This formative evaluation examined patients' consideration of options to change drinking and engage in treatment. It explored whether interventions such as "DO-MoST" overcome treatment barriers. We interviewed 20 medical-surgical patients with hazardous drinking in a trial of DO-MoST, and 16 providers. Analyses used a directed content approach. Patients were receptive to and comfortable discussing drinking during medical-surgical care. Interventions like DO-MoST (patient-centered, motivational approach to shared decision making) addressed some treatment barriers. Patients and providers viewed such interventions as helpful by building a relationship with a psychologist who facilitated self-awareness of drinking behaviors, and discussing connections between alcohol- and physical health-related problems and potential strategies to address drinking. However, both groups expressed concerns about individual and system-level barriers to long-term change. Interventions like DO-MoST bridge the gap between the patient's medical treatment episode and transition to other health care settings. TRIAL REGISTRATION: The study is registered on ClinicalTrials.gov (ID: NCT03258632).
在医疗-外科护理中解决有害饮酒问题可以改善患者的健康状况。这项形成性评估研究了患者对改变饮酒习惯和接受治疗的各种选择的考虑。它探讨了“DO-MoST”等干预措施是否能够克服治疗障碍。我们对参与 DO-MoST 试验的 20 名有危险饮酒行为的医疗-外科患者和 16 名医护人员进行了访谈。分析采用了有针对性的内容分析方法。患者在医疗-外科护理期间愿意并愿意舒适地讨论饮酒问题。像 DO-MoST（以患者为中心、以动机为导向的共同决策制定方法）这样的干预措施解决了一些治疗障碍。患者和医护人员认为这些干预措施很有帮助，因为它们与心理学家建立了关系，这有助于提高对饮酒行为的自我意识，并讨论与酒精和身体健康相关问题之间的联系，以及解决饮酒问题的潜在策略。然而，两组人员都对长期改变的个人和系统障碍表示担忧。像 DO-MoST 这样的干预措施弥合了患者医疗治疗阶段与过渡到其他医疗保健环境之间的差距。试验注册：该研究已在 ClinicalTrials.gov 上注册（ID：NCT03258632）。
