Strecher V J, Kobrin S C, Kreuter M W, Roodhouse K, Farrell D
Health Communications Research Laboratory, School of Public Health, University of North Carolina at Chapel Hill 27599-7400.
J Fam Pract. 1994 Jul;39(1):26-32.
The physician can be an important part of a comprehensive strategy to assist persons with alcohol problems. This study was designed to contribute to the development of physician-initiated brief interventions for patients with alcohol problems by incorporating into an existing screening instrument questions that solicit information relevant to behavior change strategies.
Adult patients from 12 family practices in North Carolina (N = 2716) completed a self-administered questionnaire assessing alcohol consumption and other health-related behaviors. Alcohol problems were assessed using the four-item CAGE (Have you ever felt you should cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt bad or guilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves, or to get rid of a hangover?). For this study, CAGE was adapted to address only the past 12 months. Patient interest in reducing the amount of alcohol consumed was measured using the Transtheoretical Model developed by Prochaska and colleagues. Patients were also asked about their motives for and barriers to reducing consumption.
Five percent of all patients and 9% of patients who reported drinking alcohol gave positive responses on at least two CAGE items. Patients with three or four positive CAGE responses were 74% more likely to report an interest in reducing alcohol consumption than were those with one or two. Intrinsic reasons were the most important motives for reducing consumption. No pattern was found in barriers.
We found that in the management of patients with alcohol-related problems, there are many clinical opportunities for patient counseling and referral in the family practice setting. Individually tailored brief interventions that take into consideration the patient's interest in, motives for, and barriers to reducing alcohol consumption are likely to be successful for the family practice physician.
医生可以成为协助解决酒精问题者的综合策略的重要组成部分。本研究旨在通过将与行为改变策略相关的信息纳入现有的筛查工具问题，为医生发起的针对酒精问题患者的简短干预措施的开发做出贡献。
来自北卡罗来纳州12个家庭诊所的成年患者（N = 2716）完成了一份自我管理的问卷，评估饮酒情况和其他与健康相关的行为。使用四项CAGE问卷评估酒精问题（你是否曾觉得应该减少饮酒量？别人批评你的饮酒行为是否让你烦恼？你是否曾因饮酒而感到难过或内疚？你是否曾在早晨第一件事就是喝酒来镇定神经或消除宿醉？）。在本研究中，CAGE仅针对过去12个月进行了调整。使用Prochaska及其同事开发的跨理论模型测量患者减少饮酒量的兴趣。还询问了患者减少饮酒的动机和障碍。
所有患者中有5%，报告饮酒的患者中有9%对至少两项CAGE项目给出了肯定回答。CAGE有三项或四项肯定回答的患者报告有减少饮酒兴趣的可能性比有一项或两项肯定回答的患者高74%。内在原因是减少饮酒的最重要动机。在障碍方面未发现模式。
我们发现，在管理与酒精相关问题的患者时，家庭诊所环境中有许多临床机会进行患者咨询和转诊。考虑到患者减少饮酒的兴趣、动机和障碍而进行的个性化简短干预措施，对家庭医生来说可能会取得成功。
