The views of nurses to the conduct of a randomised controlled trial of problem drinkers in an accident and emergency department
The views of nurses to the conduct of a randomised controlled trial of problem drinkers in an accident and emergency department
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DOI：
10.1016/s0020-7489(98)00054-6
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发表时间：
1999-02-01
影响因子：
8.1
通讯作者：
Short, N
中科院分区：
文献类型：
--
作者：
Brooker, C;Peters, J;Short, N
特伦特地区卫生局于1995年资助了一项研究，培训事故和紧急（A&E）部门的护士对所有成年与会者进行酒精问题筛查，以确定问题饮酒者的样本参加随机对照试验（RCT）。在随机对照试验中，确定的饮酒者被分配到健康教育加简短的咨询干预，或作为对照，仅健康教育。尽管在研究的招募阶段有16654人参加了A&E，但只有20%的参加者接受了筛选，其中19%被CAGE筛选问卷确定为问题饮酒者。然而，只有不到一半的问题饮酒者得到了护士的反馈，剩下一小部分264人有资格进入RCT。该亚组中的绝大多数人拒绝在专科诊所进行初次预约，因此试验被放弃。与护士进行了一些深入的访谈，试图了解如何改善研究的整体进行。本文概述了一些细节的原因缺乏成功的研究，其中包括：一般的环境因素，无疑会导致压力和士气低落的护理团队之间，管理人员和临床护士之间的差异，在感知的价值研究和不足的初步培训计划。本文的结论是，有问题的NHS不提供一个有益的背景成功进行卫生服务研究。(C)1999 Elsevier Science Ltd.保留所有权利。
The Trent Regional Health Authority funded a study in 1995 to train nurses in an accident and emergency (A&E) department to screen all adult attendees for alcohol problems with a view to identifying a sample of problem drinkers to participate in a randomised controlled trial (RCT). In the RCT identified drinkers were to be assigned either to health education plus brief counselling intervention or, as controls, to health education alone. Despite 16 654 attendance's at A&E during the recruitment phase of the study only 20% of attendees were screened of whom a further 19% were identified as problem drinkers by the CAGE screening questionnaire. Less than half of the problem drinkers were however, provided with feedback by the nurses, leaving a small group of 264 eligible for entry to the RCT. The great majority of this subgroup refused an initial appointment at the specialist clinic and so the trial was abandoned. A number of in-depth interviews were undertaken with the nurses in an attempt to understand ways in which the overall conduct of the study might have been improved. This paper outlines in some detail some of the reasons for the lack of success with the study which include; general environmental factors that undoubtedly led to stress and poor morale amongst the nursing team, the differences in perception between managers and clinical nurses concerning the value of research and the inadequacy of the initial training programme. The paper concludes that there are problems in the NHS which do not provide a helpful backcloth to the successful conduct of health services research. (C) 1999 Elsevier Science Ltd. All rights reserved.