School of Health Sciences, University of Nottingham, Nottingham, United Kingdom.
NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom.
PLoS One. 2023 Sep 27;18(9):e0291573. doi: 10.1371/journal.pone.0291573. eCollection 2023.
The aim of the study was to ascertain the views and experiences of those working in urgent and emergency care (UEC) settings towards screening, brief intervention, and referral to treatment (SBIRT) for alcohol, to inform future practice.
To explore i) views towards health promotion, ii) views towards and practice of SBIRT, iii) facilitators and barriers to delivering SBIRT, iv) training needs to support future SBIRT practice, and v) comparisons in views and attitudes between demographic characteristics, geographical regions, setting and occupational groups.
This was an open cross-sectional international survey, using an online self-administered questionnaire with closed and open-ended responses. Participants were ≥18 years of age, from any occupational group, working in urgent and emergency care (UEC) settings in any country or region.
There were 362 respondents (aged 21-65 years, 87.8% shift workers) from 7 occupational groups including physicians (48.6%), nurses (22.4%) and advanced clinical practitioners (18.5%). Most believed that health promotion is part of their role, and that SBIRT for alcohol prevention is needed and appropriate in UEC settings. SBIRT was seen to be acceptable to patients. 66% currently provide brief alcohol advice, but fewer screen for alcohol problems or make alcohol-related referrals. The most common barriers were high workload and lack of funding for prevention, lack of knowledge and training on SBIRT, lack of access to high-quality resources, lack of timely referral pathways, and concerns about patient resistance to advice. Some views and attitudes varied according to demographic characteristics, occupation, setting or region.
UEC workers are willing to engage in SBIRT for alcohol prevention but there are challenges to implementation in UEC environments and concerns about workload impacts on already-burdened staff, particularly in the context of global workforce shortages. UEC workers advocate for clear guidelines and policies, increased staff capacity and/or dedicated health promotion teams onsite, SBIRT education/training/resources, appropriate physical spaces for SBIRT conversations and improved alcohol referral pathways to better funded services. Implementation of SBIRT could contribute to improving population health and reducing service demand, but it requires significant and sustained commitment of time and resources for prevention across healthcare organisations.
本研究旨在了解从事急诊和急救护理工作的人员对酒精筛查、简短干预和转介治疗（SBIRT）的看法和经验，以为未来的实践提供信息。
探讨 i）对健康促进的看法，ii）对 SBIRT 的看法和实践，iii）提供 SBIRT 的促进因素和障碍，iv）支持未来 SBIRT 实践的培训需求，以及 v）在人口统计学特征、地理区域、工作场所和职业群体之间的看法和态度的比较。
这是一项开放性的国际横断面调查，使用在线自我管理问卷，包括封闭式和开放式回答。参与者年龄在 18 岁及以上，来自任何职业群体，在任何国家或地区的急诊和急救护理（UEC）环境中工作。
共有 362 名参与者（年龄 21-65 岁，87.8%为轮班工人）来自 7 个职业群体，包括医生（48.6%）、护士（22.4%）和高级临床医生（18.5%）。大多数人认为健康促进是他们工作的一部分，并且认为在 UEC 环境中需要并适合进行酒精预防的 SBIRT。SBIRT 被认为是可以接受的患者。66%的人目前提供简短的酒精建议，但较少的人筛查酒精问题或进行与酒精有关的转介。最常见的障碍是工作量大，缺乏预防资金，缺乏 SBIRT 的知识和培训，缺乏高质量资源的获取，缺乏及时的转介途径，以及对患者对建议的抵触的担忧。一些看法和态度根据人口统计学特征、职业、工作场所或地区而有所不同。
UEC 工作人员愿意参与酒精预防的 SBIRT，但在 UEC 环境中实施 SBIRT 存在挑战，并且担心工作量对已经负担过重的工作人员的影响，特别是在全球劳动力短缺的情况下。UEC 工作人员主张制定明确的指导方针和政策，增加员工能力和/或现场专门的健康促进团队，SBIRT 教育/培训/资源，进行 SBIRT 对话的适当物理空间，以及改善酒精转介途径以获得更好资金支持的服务。实施 SBIRT 可以有助于改善人口健康和减少服务需求，但需要医疗保健组织对预防工作进行重大和持续的时间和资源投入。
