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Alcohol prevention in emergency care: Drinking patterns among patients and the impact of a computerized intervention in a Swedish Emergency department
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to generate knowledge about alcohol consumption among patients in a Swedish ED, the reach and effectiveness of a computerized brief intervention delivered in the ED, and factors that are associated with reduced alcohol consumption 6 months after the ED visit.

The results from the studies show that alcohol consumption was higher among patients who were injured than patients who were not injured. Injury patients had a higher weekly consumption, drank more frequently and drank higher typical quantities than non-injury patients. Patients who were categorized as acute drinkers had higher weekly alcohol consumption and were more frequently engaged in heavy episodic drinking (HED) than non-acute drinkers.

Among the patients who took part in the computerized test, more than 15% stated that they were at the preparation stage or actively motivated to change their alcohol consumption. Of the patients who were categorized as acute drinkers, 34% were at the action or preparation stage.

Among patients who were categorized as risky drinkers, 48% became non-risky drinkers at follow-up. The relative change in average weekly consumption among risky drinkers was 30% and the relative change in HED occasions per month was 37% from baseline to follow-up.

Motivated to reduce alcohol consumption at baseline, influenced by just visiting the ED, considering the alcohol-related feedback information and impact from a health care provider are independent predictors for reduced alcohol consumption.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2011. , 79 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1266
Keyword [en]
Alcohol prevention, drinking patterns, emergency department, computerized concept
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-72333ISBN: 9789173930499 (print)OAI: oai:DiVA.org:liu-72333DiVA: diva2:459188
Public defence
2011-12-12, Aulan, Universitetssjukhuset, Campus US, Linköpings Universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2011-11-25 Created: 2011-11-25 Last updated: 2017-12-08Bibliographically approved
List of papers
1. Alcohol consumption and motivation to reduce drinking among emergency care patients in Sweden.
Open this publication in new window or tab >>Alcohol consumption and motivation to reduce drinking among emergency care patients in Sweden.
2009 (English)In: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, Vol. 16, no 3, 133-41 p.Article in journal (Refereed) Published
Abstract [en]

This study compares the alcohol consumption and motivation to reduce drinking among injured and non injured patients in a Swedish emergency department (ED). Patients aged 18-69 registered at the ED triage room were requested to answer alcohol-related questions on a touch-screen computer. Injury patients drank alcohol significantly more often than patients without injuries and in a significantly higher typical quantity than non-injury patients, yielding a significantly larger average weekly consumption. However, there were no significant differences between injury and non-injury patients with regard to heavy episodic drinking. As a consequence of injury patients being younger and more often male in comparison with non-injury patients nearly all differences between the two patient groups disappeared when controlling for age and sex. There were no significant differences in motivation to reduce drinking between injury and non-injury patients. There were small differences in the drinking variables and motivation to reduce drinking between injury patients and non-injury patients.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-53084 (URN)10.1080/17457300903024087 (DOI)19941211 (PubMedID)
Available from: 2010-01-15 Created: 2010-01-15 Last updated: 2011-11-25
2. Acute Alcohol Consumption and Motivation to Reduce Drinking Among Injured Patients in a Swedish Emergency Department
Open this publication in new window or tab >>Acute Alcohol Consumption and Motivation to Reduce Drinking Among Injured Patients in a Swedish Emergency Department
Show others...
2012 (English)In: Journal on Addictions Nursing, ISSN 1088-4602, E-ISSN 1548-7148, Vol. 23, no 3, 152-158 p.Article in journal (Refereed) Published
Abstract [en]

Abstract: Injuries constitute a major public health problem. Millions of people are injured each year, and acute drinking is a well-known risk factor for injuries. Research suggests that acknowledgment of alcohol as a factor in an injury enhances willingness to change drinking behavior, possibly because the patient becomes aware of the negative consequences of their drinking. This study aims to investigate the prevalence of acute alcohol consumption (drinking before the event) among injury patients and to examine the importance of factors potentially associated with motivation to reduce alcohol consumption among these patients. All patients aged 18-69 years were requested to answer alcohol-related questions on a touchscreen computer. Fifteen percent of injured patients were categorized as acute drinkers, and of these, 64% reported that their injury was connected to alcohol. There were significant differences for all sociodemographic and drinking characteristics between acute drinkers and nonacute drinkers. Acute drinkers were categorized as risky drinkers to a much higher extent than nonacute drinkers. Acute drinkers had a considerably higher average weekly alcohol consumption and engaged far more frequently in heavy episodic drinking than nonacute drinkers. Acute drinkers were motivated to reduce their alcohol intake to a greater extent than nonacute drinkers; 51% were in the action, preparation, and contemplation stages, compared with 19% of the nonacute drinkers. Acute drinkers had considerably more detrimental alcohol consumption than nonacute drinkers, and the acute drinkers were more motivated to reduce their drinking than the nonacute drinkers.

Keyword
Alcohol consumption; acute drinking; motivation to change; injured patients; emergency department
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-72331 (URN)10.1097/JAN.0b013e31826f4bbd (DOI)000321968500002 ()24335731 (PubMedID)
Available from: 2011-11-25 Created: 2011-11-25 Last updated: 2017-12-08Bibliographically approved
3. Reach and effectiveness of a computer-based alcohol intervention in a Swedish emergency room
Open this publication in new window or tab >>Reach and effectiveness of a computer-based alcohol intervention in a Swedish emergency room
2010 (English)In: International emergency nursing, ISSN 1878-013X, Vol. 18, no 3, 138-146 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: This study evaluates a computerized alcohol intervention implemented in a Swedish emergency department (ED) with regard to the effectiveness of two different types of tailored brief feedback on patients drinking patterns and the reach of the intervention. METHODS: The study was a prospective, randomized controlled trial of ED patients. The designated target population was the ED population aged 18-69 years who registered at the triage room before receiving care. Patients who were categorized as risky drinkers and completed the computerized test were randomized to either a long or a short feedback. The feedback was tailored on the basis of the individual patients responses to questions on their drinking patterns. RESULTS: The computerized intervention reached 41% of the target population. Those who completed the computerized test and received the feedback were younger than those who did not receive the intervention. Among those who could be followed up, the feedback was effective in reducing the patients weekly alcohol consumption and the number of heavy episodic drinking occasions. The long feedback was slightly more effective than the short feedback, but the differences were not statistically significant.

Keyword
Computerized intervention, Tailored feedback, Reach, Effectiveness
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-58825 (URN)10.1016/j.ienj.2009.08.004 (DOI)
Available from: 2010-08-27 Created: 2010-08-27 Last updated: 2011-11-25
4. What makes emergency department patients reduce their alcoholconsumption?: A computer-based intervention study in Sweden
Open this publication in new window or tab >>What makes emergency department patients reduce their alcoholconsumption?: A computer-based intervention study in Sweden
2011 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Objectives: This study investigates the effectiveness of a computerized emergency department intervention for alcohol consumption and identifies explanation factors associated with reduced alcohol consumption from risk to non-risk drinking.

Methods: Patients aged 18–69 years registered at the ED triage answered alcohol-related questions on a touch-screen computer. Follow-up data were collected by means of a postal questionnaire that was mailed to the patients 6 months after their ED visit.

Results: There were four independent explanations for reduced alcohol consumption: being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider. 339 patients could be followed up and of these were 97 categorized as risk drinkers at baseline and 45 became non-risk drinker 6 month later.

Conclusions: Being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider were predictors for change from risk to non-risk drinking 6 months later.

Keyword
Alcohol; brief intervention; emergency care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72332 (URN)
Available from: 2011-11-25 Created: 2011-11-25 Last updated: 2011-11-25Bibliographically approved

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