Welfordsson Paul, Danielsson Anna-Karin, Björck Caroline, Grzymala-Lubanski Bartosz, Hambraeus Kristina, Löfman Ida Haugen, Braunschweig Frieder, Lidin Matthias, Finn Sara Wallhed
Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
Department of Women's and Children's Health, Akademiska sjukhuset, Uppsala University, Uppsala, Sweden.
PLoS One. 2025 Aug 4;20(8):e0328990. doi: 10.1371/journal.pone.0328990. eCollection 2025.
Alcohol use is an important cardiovascular risk factor and a major contributor to morbidity and mortality. Successful implementation of alcohol interventions in cardiology depends on patient acceptability.
To understand patient perspectives on the feasibility of implementing alcohol interventions in cardiology services.
Multi-site qualitative study. We conducted semi-structured interviews with a heterogenous-purposive sample of 15 adult cardiology patients with hazardous alcohol use. Participants were recruited from three geographically diverse regions in Sweden (Dalarna, Gävleborg, Stockholm) and were varied in terms of sociodemographic characteristics, cardiovascular diagnosis, risk factor profile, and level of alcohol use. We applied the Capability, Opportunity, Motivation and Behaviour (COM-B) system during coding and conducted a reflexive thematic analysis.
We identified 56 feasibility factors: 15 related to capability, 10 to opportunity, and 31 to motivation. Four themes emerged: 1. Alcohol use as relevant to cardiology, where participants recognized cardiovascular risk factors, expressed motivation for change, and identified a need to address alcohol use sensitively; 2. Aligning interventions with expectations and goals, where participants linked acceptability of alcohol interventions to personal goals and social norms; 3. Morbidity and shifting priorities, where participants prioritized quality of life and respect for autonomy; 4. Addressing barriers to alcohol dependence treatments, where participants saw a need to improve access to care.
Findings suggest that alcohol interventions are acceptable to cardiology patients with hazardous alcohol use. Implementation strategies that prioritize quality of life, respect autonomy, and align with individual expectations and goals may be among the most acceptable. We also identified an opportunity to improve access to treatments for alcohol dependence within multidisciplinary heart teams or hospital-based addiction care services.
饮酒是一个重要的心血管危险因素，也是发病和死亡的主要原因。在心脏病学中成功实施酒精干预措施取决于患者的接受程度。
了解患者对在心脏病学服务中实施酒精干预措施可行性的看法。
多地点定性研究。我们对15名有危险饮酒行为的成年心脏病患者进行了异质性目的抽样的半结构化访谈。参与者来自瑞典三个地理区域不同的地区（达拉纳、耶夫勒堡、斯德哥尔摩），在社会人口统计学特征、心血管诊断、危险因素概况和饮酒水平方面各不相同。我们在编码过程中应用了能力、机会、动机和行为（COM-B）系统，并进行了反思性主题分析。
我们确定了56个可行性因素：15个与能力相关，10个与机会相关，31个与动机相关。出现了四个主题：1. 饮酒与心脏病学相关，参与者认识到心血管危险因素，表达了改变的动机，并确定需要敏感地处理饮酒问题；2. 使干预措施与期望和目标相一致，参与者将酒精干预措施的可接受性与个人目标和社会规范联系起来；3. 发病率和优先事项的转变，参与者将生活质量和对自主权的尊重列为优先事项；4. 解决酒精依赖治疗的障碍，参与者认为有必要改善获得护理的机会。
研究结果表明，酒精干预措施对于有危险饮酒行为的心脏病患者是可接受的。将生活质量、尊重自主权以及与个人期望和目标相一致作为优先事项的实施策略可能是最可接受的。我们还发现了一个机会，即在多学科心脏团队或医院成瘾护理服务中改善酒精依赖治疗的可及性。
