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手术前后减少酒精摄入:两种治疗方法的定性研究

Reducing Alcohol Use Before and After Surgery: Qualitative Study of Two Treatment Approaches.

作者信息

Chapman Lyndsay, Ren Tom, Solka Jake, Bazzi Angela R, Borsari Brian, Mello Michael J, Fernandez Anne C

机构信息

Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, United States.

College of Medicine, Central Michigan University, Mount Pleasant, MI, United States.

出版信息

JMIR Perioper Med. 2023 Jul 26;6:e42532. doi: 10.2196/42532.

DOI:10.2196/42532
PMID:37494103
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10413235/
Abstract

BACKGROUND

High-risk alcohol use is a common preventable risk factor for postoperative complications, admission to intensive care, and longer hospital stays. Short-term abstinence from alcohol use (2 to 4 weeks) prior to surgery is linked to a lower likelihood of postoperative complications.

OBJECTIVE

The study aimed to explore the acceptability and feasibility of 2 brief counseling approaches to reduce alcohol use in elective surgical patients with high-risk alcohol use in the perioperative period.

METHODS

A semistructured interview study was conducted with a group of "high responders" (who reduced alcohol use ≥50% postbaseline) and "low responders" (who reduced alcohol use by ≤25% postbaseline) after their completion of a pilot trial to explore the acceptability and perceived impacts on drinking behaviors of the 2 counseling interventions delivered remotely by phone or video call. Interview transcripts were analyzed using thematic analysis.

RESULTS

In total, 19 participants (10 high responders and 9 low responders) from the parent trial took part in interviews. Three main themes were identified: (1) the intervention content was novel and impactful, (2) the choice of intervention modality enhanced participant engagement in the intervention, and (3) factors external to the interventions also influenced alcohol use.

CONCLUSIONS

The findings support the acceptability of both high- and low-intensity brief counseling approaches. Elective surgical patients are interested in receiving alcohol-focused education, and further research is needed to test the effectiveness of these interventions in reducing drinking before and after surgery.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03929562; https://clinicaltrials.gov/ct2/show/NCT03929562.

摘要

背景

高危饮酒是术后并发症、入住重症监护病房以及住院时间延长的常见可预防风险因素。术前短期戒酒(2至4周)与术后并发症发生可能性降低相关。

目的

本研究旨在探讨两种简短咨询方法在围手术期减少高危饮酒择期手术患者饮酒量方面的可接受性和可行性。

方法

在一组“高反应者”(基线后饮酒量减少≥50%)和“低反应者”(基线后饮酒量减少≤25%)完成一项试点试验后,进行了一项半结构化访谈研究,以探讨通过电话或视频通话远程提供的两种咨询干预措施对饮酒行为的可接受性和感知影响。使用主题分析法对访谈记录进行分析。

结果

共有19名来自原试验的参与者(10名高反应者和9名低反应者)参加了访谈。确定了三个主要主题:(1)干预内容新颖且有影响力,(2)干预方式的选择增强了参与者对干预的参与度,(3)干预措施之外的因素也会影响饮酒。

结论

研究结果支持高强度和低强度简短咨询方法的可接受性。择期手术患者对接受以酒精为重点的教育感兴趣,需要进一步研究来测试这些干预措施在减少手术前后饮酒方面的有效性。

试验注册

ClinicalTrials.gov NCT03929562;https://clinicaltrials.gov/ct2/show/NCT03929562 。

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本文引用的文献

1
Preoperative alcohol interventions for elective surgical patients: Results from a randomized pilot trial.择期手术患者术前酒精干预:一项随机试点试验的结果。
Surgery. 2022 Dec;172(6):1673-1681. doi: 10.1016/j.surg.2022.09.012. Epub 2022 Oct 22.
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The use and impact of self-monitoring on substance use outcomes: A descriptive systematic review.自我监测在物质使用结果中的使用和影响:描述性系统评价。
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Gaps in Alcohol Screening and Intervention Practices in Surgical Healthcare: A Qualitative Study.手术医疗保健中酒精筛查和干预措施的差距:一项定性研究。
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Opioid Prescribing After Surgery in the United States, Canada, and Sweden.美国、加拿大和瑞典的术后阿片类药物处方。
JAMA Netw Open. 2019 Sep 4;2(9):e1910734. doi: 10.1001/jamanetworkopen.2019.10734.
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Perioperative alcohol cessation intervention for postoperative complications.围手术期戒酒干预对术后并发症的影响
Cochrane Database Syst Rev. 2018 Nov 8;11(11):CD008343. doi: 10.1002/14651858.CD008343.pub3.
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Preoperative Behavioural Intervention versus standard care to Reduce Drinking before elective orthopaedic Surgery (PRE-OP BIRDS): protocol for a multicentre pilot randomised controlled trial.术前行为干预与标准护理以减少择期骨科手术前饮酒(PRE-OP BIRDS):一项多中心试点随机对照试验方案
Pilot Feasibility Stud. 2018 Aug 16;4:140. doi: 10.1186/s40814-018-0330-4. eCollection 2018.
7
Alcohol and Opioid Use, Co-Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review.酒精和阿片类物质使用、共同使用与阿片类药物流行背景下的慢性疼痛:批判性综述。
Alcohol Clin Exp Res. 2018 Mar;42(3):478-488. doi: 10.1111/acer.13594. Epub 2018 Feb 6.
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STOP smoking and alcohol drinking before OPeration for bladder cancer (the STOP-OP study), perioperative smoking and alcohol cessation intervention in relation to radical cystectomy: study protocol for a randomised controlled trial.膀胱癌手术前戒烟戒酒(STOP-OP研究),根治性膀胱切除术围手术期吸烟与戒酒干预:一项随机对照试验的研究方案
Trials. 2017 Jul 17;18(1):329. doi: 10.1186/s13063-017-2065-6.
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Opioids Prescribed After Low-Risk Surgical Procedures in the United States, 2004-2012.2004-2012 年美国低风险手术术后开阿片类药物处方的情况。
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Psychol Bull. 2016 Feb;142(2):198-229. doi: 10.1037/bul0000025. Epub 2015 Oct 19.