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饮酒记录的有效性:临床病史与电话调查的比较

[Validity of alcohol consumption records: comparison of clinical history and telephone survey].

作者信息

Baena Díez J M, Conesa García A, Flores Cebrià R M, Riera Cervera D

机构信息

Area Básica de Salud (ABS) Sant Josep, L'Hospitalet de Llobregat, Barcelona.

出版信息

Aten Primaria. 1998 Oct 15;22(6):362-7.

PMID:9833351
Abstract

OBJECTIVES

To compare primary care clinical records (PCCRs) and a telephone survey of the population group seeking health care, for the prevalence of alcohol consumption. To determine factors linked to screening and observation of alcohol consumption, and to analyse the perception and recording of medical counselling on alcohol and tobacco consumption.

DESIGN

Descriptive, crossover study.

SETTING

Urban Health Centre.

PARTICIPANTS

Random sample of 320 patients with PCCRs, aged between 15 and 75.

MEASUREMENTS AND MAIN RESULTS

The PCCR was reviewed for age, sex, educational level, profession, frequency of attendance, chronic illnesses, alcohol and tobacco consumption, pathologies linked to alcohol consumption, screening and observance of this consumption as recommended by the preventive activities and health promotion programme (PAHPP), and the recording of counselling to smokers and at-risk drinkers. Later a standard questionnaire on the patients' alcohol and tobacco consumption and their perception of medical counselling was filled in by phone, 36.1% of patients consumed alcohol, according to the PCCR, which rose to 51.1% in the questionnaire (95% CI variation, 6.2-23.8). Initial screening of alcohol consumption was recorded in 67.4% of the PCCRs, with a significant association to age of 20 or over (OR = 20.5; CI, 2.9-142.6), and to education beyond primary level (OR = 8; CI, 1.7-38.5). The observation recommended by the PAHPP was correctly followed for 24.8% of patients, and was associated with being a smoker (OR = 2; CI, 1.2-3.4) and male (OR = 1.9; CI, 1.1-3.3). No significant differences were found when the under-recording in the PCCRs of alcohol counselling to at-risk drinkers (27.8% PCCRs and 35.7% questionnaire) was studied: but there were significant differences for tobacco dependency (20.7% PCCRs and 55.7% questionnaire; CI of variance: 23.6-46.4).

CONCLUSIONS

We found considerable under-recording of alcohol consumption in the clinical records, along with little medical counselling. Preventive activities should be given priority, especially among young people, since consumption starts in adolescence, and young people, along with women and patients of low educational level, are more susceptible to medical counselling.

摘要

目的

比较初级保健临床记录(PCCRs)与针对寻求医疗保健人群的电话调查中酒精消费的患病率。确定与酒精消费筛查和观察相关的因素,并分析关于酒精和烟草消费的医学咨询的认知与记录情况。

设计

描述性交叉研究。

地点

城市健康中心。

参与者

从320份PCCRs中随机抽取年龄在15至75岁之间的患者样本。

测量与主要结果

查阅PCCR以获取年龄、性别、教育程度、职业、就诊频率、慢性病、酒精和烟草消费、与酒精消费相关的病症、根据预防活动和健康促进计划(PAHPP)建议进行的该消费筛查及观察情况,以及对吸烟者和高危饮酒者咨询的记录。随后通过电话填写一份关于患者酒精和烟草消费及其对医学咨询认知的标准问卷。根据PCCR,36.1%的患者饮酒,在问卷中这一比例升至51.1%(95%CI变化范围为6.2 - 23.8)。67.4%的PCCR记录了酒精消费的初步筛查,与20岁及以上年龄(OR = 20.5;CI,2.9 - 142.6)以及小学以上教育程度(OR = 8;CI,1.7 - 38.5)存在显著关联。PAHPP建议的观察在24.8%的患者中得到正确执行,且与吸烟者(OR = 2;CI,1.2 - 3.4)和男性(OR = 1.9;CI,1.1 - 3.3)相关。在研究对高危饮酒者酒精咨询在PCCRs中的记录不足情况时(27.8%的PCCR和35.7%的问卷)未发现显著差异:但在烟草依赖方面存在显著差异(20.7%的PCCR和55.7%的问卷;方差CI:23.6 - 46.4)。

结论

我们发现临床记录中酒精消费记录存在大量不足,且医学咨询较少。应优先开展预防活动,尤其是在年轻人中,因为饮酒始于青春期,而且年轻人以及女性和低教育水平患者更容易接受医学咨询。

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