Addressing alcohol use among primary care patients: differences between family medicine and internal medicine residents.
Addressing alcohol use among primary care patients: differences between family medicine and internal medicine residents.
复制标题
解决初级保健患者的饮酒问题：家庭医学和内科住院医师之间的差异。
DOI：
10.1007/bf02599649
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发表时间：
1994
影响因子：
5.7
通讯作者：
Everett,AS
中科院分区：
文献类型：
--
作者：
Schorling,JB;Klas,PT;Willems,JP;Everett,AS
目的：为了确定家庭医学和内科住院医师之间是否存在解决酒精使用率的差异，并确定态度、信心和看法是否影响这些关系。设置：两所大学门诊诊所，一所由家庭医学和其他初级保健和分类内科住院医师组成。设计：对连续患者进行的横断面研究，这些患者已接受第二年和第三年住院医师至少一年的随访。使用密歇根酒精中毒筛查测试（MAST）确定酒精滥用，评分为5分视为阳性。前一年的酒精使用率由患者报告和图表审查确定。结果：49名居民中有334人完成了MAST。患者组中的酒精中毒率为：家庭医学8.3%;初级保健29.1%;分类医学18.0%（p<0.001）。筛查行为因居住类型而异：47%的家庭医学，71%的初级保健和65%的分类居民患者报告在前一年被问及酒精使用情况（p<0.001）; 15%的家庭医学、38%的初级保健和24%的分类住院医师患者有病历记录（p<0.001）。酒精滥用的感知患病率、干预的信心和SAAS上的几个量表与居住类型和解决酒精使用有关，但控制这些变量并不影响居住类型与患者报告或筛查图表文件之间的关联。解决酒精使用率不同的内科和家庭医学的居民，但不是由于居民的看法和态度的差异。
Objectives: To determine whether rates of addressing alcohol use differed between family medicine and internal medicine residents, and to determine whether attitudes, confidence, and perceptions affected these relationships.Setting: Two university outpatient clinics, one staffed by family medicine and the other by primary care and categorical internal medicine residents.Design: Cross-sectional study of consecutive patients who had been followed by second- and third-year residents for at least one year.Measurements: Alcohol abuse was determined using the Michigan Alcoholism Screening Test (MAST), with a score a 5 considered positive. Rates of addressing alcohol use in the preceding year were determined by patient report and chart review. Attitudes were assessed using the Substance Abuse Attitude Survey (SAAS).Results: 334 patients of 49 residents completed the MAST. Rates of alcoholism among the patient groups were: family medicine, 8.3%; primary care, 29.1%; and categorical medicine, 18.0% (p<0.001). Screening behavior varied by type of residency: 47% of the family medicine, 71% of the primary care, and 65% of the categorical residents’ patients reported being asked about alcohol use in the preceding year (p<0.001); chart documentation was present for 15% of the family medicine, 38% of the primary care, and 24% of the categorical residents’ patients (p<0.001). Perceived prevalence of alcohol abuse, confidence in intervening, and several scales on the SAAS were related to residency type and to addressing alcohol use, but controlling for these variables did not affect the association between residency type and either patient report or chart documentation of screening.Conclusion: Rates of addressing alcohol use differed for internal medicine and family medicine residents, but were not due to differences in resident perceptions and attitudes.