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Asking patients about their drinking: A national survey among primary health care physicians and nurses in Sweden
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. (Landstinget i Östergötland; Local Health Care Services in the West of Östergötland; Department of Acute Internal Medicine MH; Närsjukvården i västra Östergötland; Akutmottagningen LiM)
Department of Social Medicine, Institute of Community Medicine, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Centre for Social Research on Alcohol and Drugs, Stockholm, Sweden.
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2008 (English)In: Addictive Behaviors, ISSN 0306-4603, Vol. 33, no 2, 301-314 p.Article in journal (Refereed) Published
Abstract [en]

Aims: To investigate the extent to which Swedish primary health care (PHC) general practitioners (GPs) and nurses discuss alcohol issues with their patients, their reasons for and against addressing alcohol issues, their perceived importance of these issues, and factors that could facilitate increased alcohol intervention activity among the PHC professionals.

Methods: All Swedish GPs and nurses who have the authority to issue prescriptions were surveyed with a postal questionnaire. The questionnaire was returned by 1821 GPs (47% response rate) and 3125 nurses (55% response rate).

Results: Fifty percent of the GPs and 28% of the nurses stated that they “frequently” discussed alcohol with their patients. The two most common reasons for asking patients about their drinking were that the GPs and nurses considered it part of their routines and the belief that the patient had alcohol-related symptoms. GPs said that improved opportunities for referral to specialists and provision of more knowledge about counselling techniques for use when alcohol-related symptoms are evident were the most important facilitators to increased intervention activity. Concerning the nurses, 93% stated that more time devoted to health-oriented work could facilitate increased alcohol intervention activity.

Conclusions: The findings highlight a considerable gap between the recognition of the significance of the alcohol problem and Swedish PHC intervention activity.

Place, publisher, year, edition, pages
2008. Vol. 33, no 2, 301-314 p.
Keyword [en]
Primary health care; Alcohol intervention; Risk consumption
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-16799DOI: 10.1016/j.addbeh.2007.09.021PubMedID: 18029104OAI: oai:DiVA.org:liu-16799DiVA: diva2:174167
Available from: 2009-02-19 Created: 2009-02-19 Last updated: 2009-08-18Bibliographically approved
In thesis
1. Addressing Alcohol: Alcohol Prevention in Swedish Primary and Maternity Health Care and Occupational Health Services
Open this publication in new window or tab >>Addressing Alcohol: Alcohol Prevention in Swedish Primary and Maternity Health Care and Occupational Health Services
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Att tala om alkohol
Abstract [en]

Alcohol consumption in Sweden has reached its highest levels of the past 100 years in the wake of the country’s entry into the European Union in 1995. Increased alcohol prevention efforts in Swedish health care settings have been given high priority by the authorities. The Swedish parliament’s national action plan up to 2010 emphasises that public health must be protected by achieving reductions in alcohol consumption and limiting the negative physical, psychological, and social effects of alcohol.

This thesis aims to investigate various aspects related to the current alcoholpreventive activity in 2006 among health care professionals in three important health care settings: primary health care (PHC), occupational health services (OHS), and maternity health care (MHC). The thesis includes four studies based on a total population mail questionnaire survey.

Results from the studies show that alcohol issues in both PHC and OHS were addressed less frequently than all other lifestyle issues, i.e. smoking, physical activity, overweight, and stress. Important barriers to alcohol-preventive activity in these settings were perceived lack of time, scepticism regarding the effectiveness of addressing the issue of alcohol, fear of potentially negative patient responses, uncertainty about how to ask, uncertainty about how to give advice regarding alcohol, and uncertainty concerning where to refer the patient.

OHS professionals generally considered themselves more skilful than their PHC counterparts in achieving change in patients’ alcohol habits and more knowledgeable about providing advice to patients with risky alcohol consumption. The overall frequency of initiating discussions about alcohol with patients in PHC and OHS was positively associated with self-assessed skills, knowledge, and education for all professional categories.

Slightly more than one-third of the MHC midwives used a questionnaire to assess the woman’s alcohol intake before the pregnancy; AUDIT was the most commonly used questionnaire. Their perceived knowledge concerning alcohol and pregnancy matters was generally high, but the midwives considered themselves less proficient at detecting pregnant women with risky alcohol consumption before the pregnancy.

MHC midwives had participated in more continuing professional education in handling risky drinking than all other categories investigated. PHC nurses was the category that had the highest proportion of professionals who lacked education in handling risky drinking. Professionals in PHC, OHS, and MHC to a large extent believed that provision of more knowledge about counselling techniques to use when alcohol-related symptoms are evident could facilitate increased alcohol intervention activity.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 97 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1094
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16815 (URN)978-91-7393-714-6 (ISBN)
Public defence
2009-03-06, Hälsans hus, ingång 16, Campus US, Linköpings Universitet , Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2009-02-19 Created: 2009-02-19 Last updated: 2009-04-17Bibliographically approved

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Holmqvist, MarikaBendtsen, PrebenNilsen, Per

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