Rush B R, Powell L Y, Crowe T G, Ellis K
Social Evaluation and Research Department, University of Western Ontario, London.
CMAJ. 1995 Mar 15;152(6):863-9.
To elucidate family physicians' motivations concerning early intervention for alcohol use and their perceived barriers to such intervention.
Qualitative study with the use of focus groups and semistructured interviews.
Community-based, fee-for-service family-medicine practices in London, Ont.
Twelve focus-group participants recruited through telephone contact by two family physicians on the project team. Participants were required to be physicians in family practice in London. Twelve interview participants recruited through a grand-rounds presentation at two local hospitals. Participants were required to be physicians in a community-based family practice in which primary care was not delivered by residents and to have agreed to participate in all phases (e.g., needs assessment, training and evaluation) of a training program on interventions to help patients reduce alcohol consumption or quit smoking.
Motivations concerning early intervention for alcohol use and perceived barriers to such intervention, as identified by physicians.
Physicians in the focus groups and those interviewed endorsed their role in helping patients to reduce alcohol consumption and cited several reasons for the importance of that role. There was strong support for viewing alcohol use as a lifestyle issue to be dealt with in the context of a holistic approach to patient care. Participants cited many barriers to fulfilling their role and were particularly concerned about the appropriateness of asking all adolescent and adult patients about alcohol use, even at visits intended to discuss other issues and concerns. Physicians gave several motivations for improving their work in reduction of alcohol consumption, including their current frustration with the lack of a systematic strategy or tangible materials to help them identify and manage patients.
Interventions with patients who use alcohol should be framed in the context of a holistic approach to family medicine. Qualitative knowledge of the motivations and barriers affecting physicians can inform future research and educational strategies in this area.
阐明家庭医生对酒精使用早期干预的动机以及他们认为的此类干预的障碍。
采用焦点小组和半结构式访谈的定性研究。
安大略省伦敦市以社区为基础、按服务收费的家庭医疗诊所。
通过项目团队的两名家庭医生电话联系招募了12名焦点小组参与者。参与者须为伦敦市从事家庭医疗的医生。通过在两家当地医院的学术讲座招募了12名访谈参与者。参与者须为在社区家庭医疗诊所工作的医生，且该诊所的初级保健不由住院医生提供，并已同意参与一项关于帮助患者减少酒精消费或戒烟干预措施的培训项目的所有阶段（如需求评估、培训和评估）。
医生确定的对酒精使用早期干预的动机以及对此类干预的感知障碍。
焦点小组中的医生和接受访谈的医生认可他们在帮助患者减少酒精消费方面的作用，并列举了该作用重要性的几个原因。强烈支持将酒精使用视为一个生活方式问题，应在对患者进行全面护理的背景下加以处理。参与者列举了履行其职责的许多障碍，尤其担心询问所有青少年和成年患者的酒精使用情况是否合适，即使是在旨在讨论其他问题和关切的就诊时。医生给出了改善其减少酒精消费工作的几个动机，包括他们目前因缺乏系统策略或切实可用的材料来帮助他们识别和管理患者而感到沮丧。
对饮酒患者的干预应以家庭医学的整体方法为背景。了解影响医生的动机和障碍的定性知识可为该领域未来的研究和教育策略提供参考。
