PRIMARY AND SECONDARY PREVENTION OF ALCOHOL-PROBLEMS - US INTERNIST ATTITUDES AND PRACTICES
PRIMARY AND SECONDARY PREVENTION OF ALCOHOL-PROBLEMS - US INTERNIST ATTITUDES AND PRACTICES
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DOI：
10.1007/bf02600228
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发表时间：
1995-02-01
影响因子：
5.7
通讯作者：
LARSON, EB
中科院分区：
文献类型：
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作者：
BRADLEY, KA;CURRY, SJ;LARSON, EB
目的：描述内科医生参与酒精相关问题的初级和二级预防，并评估预防实践与培训、态度和工作模式之间的关系。设计：横断面调查。随机抽取了152名在美国大陆从事初级保健的内科医生，他们年龄小于或等于65岁，从美国医学会的主名单中选出。10人不合格; 99（70%）的其余142内科医生完成了问卷调查。主要结果measurements：作者评价了内科医生的预防措施，包括频率与他们评估患者的饮酒量，并建议患者饮酒的安全水平。作者还评估了内科医生的意见，酒精消费的安全水平，培训和态度，建议患者的安全水平的消费，和工作pattern.RESULTS：百分之九十四的受访者认为他们有责任建议所有患者的酒精消费的安全水平（初级预防），虽然只有30%经常/总是这样做。80%的人经常/总是建议每天喝三杯或三杯以上的患者饮酒的安全水平（二级预防），但许多人（45%）没有经常询问患者每天喝多少酒。预防措施与内科医生进行初级保健的小时数/周呈正相关，并与他们对饮酒预防建议的有效性的信念呈正相关。内科医生认为他们有责任对酒精相关问题进行一级预防，但只有少数人积极实践。相比之下，许多内科医生进行二级预防，为每天饮酒三杯或三杯以上的患者提供安全饮酒的建议。然而，由于对酒精消费水平的筛查不全面，这种二级预防的有效性有限。
OBJECTIVE: To describe internists' involvement in primary and secondary prevention of alcohol-related problems, and to evaluate relationships between preventive practices and training, attitudes, and work patterns.DESIGN: Cross-sectional survey.PARTICIPANTS: A random sample of 152 board-certified internists, less than or equal to 65 years old, who practiced primary care in the continental United States, was selected from the American Medical Association's master list. Ten were ineligible; 99 (70%) of the remaining 142 internists completed questionnaires.MAIN OUTCOME MEASURES: The authors evaluated the internists' preventive practices, including the frequency with which they assessed patients' alcohol consumption and advised patients about safe levels of alcohol consumption. The authors also evaluated the internists' opinions about safe levels of alcohol consumption, training and attitudes regarding advising patients about safe levels of consumption, and work patterns.RESULTS: Ninety-four percent of the respondents believed they had a responsibility to advise all patients about safe levels of alcohol consumption (primary prevention), though only 30% often/always did so. Eighty percent often/always advised patients who drank three or more drinks daily about safe levels of alcohol consumption (secondary prevention), but many (45%) did not routinely ask patients how much they drank daily. Preventive practices correlated positively with the number of hours/week internists practiced primary care, and with their belief in the effectiveness of preventive advice about alcohol consumption.CONCLUSIONS: Internists believe they have a responsibility for primary prevention of alcohol-related problems, but only a minority actively practice it. In contrast, many internists practice secondary prevention, offering advice about safe alcohol consumption to patients who drink three or more drinks daily. The effectiveness of such secondary prevention is limited, however, by incomplete screening regarding level of alcohol consumption.