Department of Global Public Health, Karolinska Institutet, 113 65 Solna, Sweden.
Department of Women's and Children's Health, Akademiska sjukhuset, Uppsala University, 752 37 Uppsala, Sweden.
Eur J Cardiovasc Nurs. 2024 Sep 5;23(6):668-674. doi: 10.1093/eurjcn/zvae033.
This study aimed to identify barriers and facilitators to implementing alcohol screening and brief interventions (SBI) in cardiology services.
This was a qualitative study. Individual, semi-structured interviews were conducted with 24 clinical cardiology staff (doctors, nurses, and assistant nurses) of varying experience levels and from various clinical settings (high-dependency unit, ward, and outpatient clinic), in three regions of Sweden. Reflexive thematic analysis was used, with deductive coding applying the Capability, Opportunity, Motivation (COM-B) theoretical framework. A total of 41 barriers and facilitators were identified, including 12 related to capability, 9 to opportunity, and 20 to motivation. Four themes were developed: (i) uncharted territory, where clinicians expressed a need to address alcohol use but lacked knowledge and a roadmap for implementing SBI; (ii) cardiology as a cardiovascular specialty, where tasks were prioritized according to established roles; (iii) alcohol stigma, where alcohol was reported to be a sensitive topic that staff avoid discussing with patients; and (iv) window of opportunity, where staff expressed potential for implementing SBI in routine cardiology care.
Findings suggest that opportunities exist for early identification and follow-up of hazardous alcohol use within routine cardiology care. Several barriers, including low knowledge, stigma, a lack of ownership, and a greater focus on other risk factors, must be addressed prior to the implementation of SBI in cardiology. To meet current clinical guidelines, there is a need to increase awareness and to improve pathways to addiction care. In addition, there may be a need for clinicians dedicated to alcohol interventions within cardiology services.
OSF (osf.io/hx3ts).
本研究旨在确定在心脏病学服务中实施酒精筛查和简短干预（SBI）的障碍和促进因素。
这是一项定性研究。在瑞典的三个地区，对不同经验水平的 24 名临床心脏病学工作人员（医生、护士和助理护士）进行了个人半结构化访谈，他们来自各种临床环境（高依赖病房、病房和门诊诊所）。采用反思性主题分析，应用能力、机会、动机（COM-B）理论框架进行演绎编码。共确定了 41 个障碍和促进因素，包括 12 个与能力相关、9 个与机会相关、20 个与动机相关。得出了四个主题：（i）未知领域，临床医生表示需要解决酒精使用问题，但缺乏实施 SBI 的知识和路线图；（ii）心脏病学作为心血管专业，根据既定角色对任务进行了优先级排序；（iii）酒精污名，据报道，酒精是一个敏感话题，工作人员避免与患者讨论；（iv）机会之窗，工作人员表示有潜力在常规心脏病学护理中实施 SBI。
研究结果表明，在常规心脏病学护理中存在早期识别和随访危险饮酒的机会。在心脏病学中实施 SBI 之前，必须解决一些障碍，包括知识水平低、污名、缺乏所有权以及更关注其他风险因素。为了满足当前的临床指南，需要提高认识，并改善成瘾护理途径。此外，心脏病学服务可能需要专门从事酒精干预的临床医生。
OSF（osf.io/hx3ts）。
