Individual Versus Significant-Other-Enhanced Brief Motivational Intervention for Alcohol in Emergency Care
Individual Versus Significant-Other-Enhanced Brief Motivational Intervention for Alcohol in Emergency Care
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DOI：
10.1037/a0037658
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发表时间：
2014-12-01
影响因子：
5.9
通讯作者：
Cioffi, William G.
中科院分区：
文献类型：
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作者：
Monti, Peter M.;Colby, Suzanne M.;Cioffi, William G.
目的：对酒精相关急诊科(ED)就诊的酗酒者进行简单的动机干预(BMI)，其效果好坏参半。将重要他人(SOS)包括在行为治疗中的成功表明，将SOS纳入ED传递的BMI可能被证明是有益的。这项研究调查了增强的动机干预(SOMI)与个人动机干预(IMI)在急救环境中解决酗酒问题的相对有效性。方法：ED(n=317)或创伤病房(n=89)患者被随机分配接受IMI或SOMI，并在6个月和12个月时重新评估饮酒、与酒精相关的后果和感知的酒精特定的SO支持。结果：广义估计方程分析显示，随着时间的推移，酒精消耗量和后果的减少都是一致的。在一年的随访中，SOMI状态的患者每周饮酒总量的平均降幅大于IMI状态。在SOMI患者中，比IMI患者多9.4%的患者转移到国家每周饮酒指南范围内。大量饮酒和饮酒负性后果的频度没有显示干预效果的差异。结论：在12个月时出现温和的治疗效果表明，与IMI情况相比，SOMI情况下的SO参与可能对患者饮酒产生了更持久的积极影响。关于SO参与简短治疗的含义和局限性也进行了讨论。
Objective: Effects of brief motivational interventions (BMIs) for heavy drinkers identified by alcohol-related emergency department (ED) visits are mixed. The successes of including significant others (SOs) in behavioral treatment suggest that involving SOs in ED-delivered BMI might prove beneficial. This study investigated the relative efficacy of an SO-enhanced motivational intervention (SOMI) compared with an individual motivational intervention (IMI) to address heavy drinking in emergency care settings. Method: ED (n = 317) or trauma unit (n = 89) patients were randomly assigned to receive either an IMI or an SOMI and were reassessed at 6 and 12 months for alcohol consumption, alcohol-related consequences, and perceived alcohol-specific SO support. Results: Generalized estimating equation analyses showed consistent reductions over time for both alcohol consumption and consequences. At 1-year follow-up, the average reduction in total drinks consumed per week was greater for patients in the SOMI condition than the IMI condition. In SOMI, 9.4% more patients moved to within the national guidelines for weekly drinking than did IMI patients. Frequency of heavy drinking and negative alcohol consequences showed no differential effects of intervention. Conclusions: Emergence of a modest treatment effect at 12 months suggests that SO involvement in the SOMI condition may have led to more sustained positive influence on patient drinking than in the IMI condition. Implications and limitations regarding SO involvement in brief treatment are discussed.