Factors Influencing whether Nurses Talk to Somatic Patients about their Alcohol Consumption

Open access

Abstract

AIM – Many Danes drink so much that it is detrimental to their health. As they are at risk of suffering diseases which can lead to hospitalisation on somatic wards, hospitals are ideal arenas for identifying individuals whose alcohol consumption is excessive. However, literature points out that this identification rarely takes place in hospitals, and literature further suggests that the staff experience barriers to talking about alcohol use with their patients. The primary aim of this study is to identify potential factors that influence whether or not nurses talk to patients about their alcohol consumption on somatic wards. Secondarily, we wish to examine whether a screening project may affect the nurses’ readiness to talk about alcohol use with their patients.

METHODS – A Glaserian Grounded Theory Method was used to collect and analyse data in this qualitative study. Semi-structured one-to-one interviews were conducted with seven nurses from somatic departments at two Danish hospitals. All seven nurses were already taking part in an alcohol screening project.

RESULTS – In the analysis of the interview material, four categories emerged: The Nurse, The Patient, The Ward and The Relay Study.

CONCLUSION – We identified a series of barriers and promoting factors for nurses to talk about alcohol use with patients in a hospital setting. The barriers and promoting factors emerged within four categories: The Nurse, The Patient, The Ward, and The Relay Study. The most important barrier to talking to patients about alcohol seemed to be factors within the nurses themselves, in particular personal experiences, lack of knowledge and lack of confidence. We found, however, that by participating in a screening project the nurses seemed to overcome some of these barriers.

Aabel, M. K., & Sundhedsstyrelsen. (2013). Forebyggelsespakke – alkohol [Prevention packet: Alcohol]. Retrieved from http://hdl.handle.net/109.1.3/6984fbf2-746f-4da0-96d7-23b6ec1ae9d1

Aalto, M., Pekuri, P., & Seppä, K. (2003). Obstacles to carrying out brief intervention for heavy drinkers in primary health care: A focus group study. Drug and Alcohol Review, 22(2), 169–173. doi:10.1080/09595230100100606

Anderson, S., Eadie, D. R., MacKintosh, A. M., & Haw, S. (2001). Management of alcohol misuse in Scotland: The role of A&E nurses. Accident and Emergency Nursing, 9(2), 92–100. doi:10.1054/aaen.2000.0210

Babor, T. F., de la Fuente, J. R., Saunders, J., & Grant, M. (1989). AUDIT, The alcohol use disorders identification test: Guidelines for use in primary health care. Geneva: World Health Organization.

Bagh, J. (2008). Sygeplejersker skal spille en aktiv rolle i alkoholforebyggelse [Nurses must play an active role in alcoholism prevention]. Sygeplejersken, 108(11), 48–51. Retrieved fromhttp://www.sygeplejersken.dk/sygeplejersken/default.asp?intArticleID=17046&menu=195009

Berglund, M., Thelander, S., Salaspuro, M., Franck, J., Andreasson, S., & Ojehagen, A. (2003). Treatment of alcohol abuse: An evidence-based review. Alcoholism: Clinical and Experimental Reseach, 27(10), 1645–1656. doi:10.1097/01.alc.0000090144.99832.19

Bjerregaard, L. B. (2011). Alcohol consumption habits in parents with hospitalized children: Parents’ and staff members’ perception and experience from a screening and brief intervention study including motivational interviewing and CAGE-C. Doctoral dissertation. Odense: Enheden for Sygeplejeforskning, Syddansk Universitet.

Bjerregaard, L., Rubak, S., Høst, A., & Wagner, L. (2012). Alcohol consumption patterns among parents of hospitalized children: Findings from a brief intervention study. International Nursing Review, 59(1), 132–138. doi:10.1111/j.1466-7657.2011.00930.x

Broyles, L. M., Rosenberger, E., Hanusa, B. H., Kraemer, K. L., & Gordon, A. J. (2012). Hospitalized patients’ acceptability of nurse-delivered screening, brief intervention, and referral to treatment. Alcoholism: Clinical and Experimental Research, 36(4), 725–731. doi:10.1111/j.1530-0277.2011.01651.x

Broyles, L. M., Gordon, A. J., Rodriguez, K. L., Hanusa, B. H., Kengor, C., & Kraemer, K. L. (2013). Evaluation of a pilot training program in alcohol screening, brief intervention, and referral to treatment for nurses in inpatient settings. Journal of Addictions Nursing, 24(1), 8–19. doi:10.1097/JAN.0b013e31828767ef

Coder, B., Freyer-Adam, J., Bischof, G., Pockrandt, C., Hartmann, B., Rumpf, H. J., . . . Hapke, U. (2008). Alcohol problem drinking among general hospital inpatients in northeastern Germany. General Hospital Psychiatry, 30(2), 147–154. doi:10.1016/j.genhosppsych.2007.10.007

Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches (Fourth edition, international student edition). Los Angeles, California: SAGE.

Crotty, M. (1998). The foundations of social research: Meaning and perspective in the research process. London: SAGE.

Elmeland, K. (2015). Mennesker med alkoholproblemer: Baggrund, belastning, behandling [People with alcohol problems: Background, burden and treatment]. København: Nyt Nordisk Forlag i samarbejde med Dansk Sygeplejeråd.

Elmeland, K. (2016). Historisk udvikling [Historical development]. In U. Becker. & J. S. Tolstrup (Eds.), Alkohol: Brug, konsekvenser og behandling [Alcohol: Use, consequenses and treatment] (pp. 15–31). København: Munksgaard.

Emmons, K. M., & Goldstein, M. G. (1992). Smokers who are hospitalized: A window of opportunity for cessation interventions. Preventive Medicine, 21(2), 262–269.

Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1995). The prevalence and risk factors associated with abusive or hazardous alcohol consumption in 16-year-olds. Addiction, 90(7), 935–946. doi:10.1080/09652149541725

Forebyggelse, M. f. s. o. (2010). Bekendtgørelse af sundhedsloven [Declaration of health legislation]. Retrieved from https://www.retsinformation.dk/forms/r0710.aspx?id=152710#Kap35

Geirsson, M., Bendtsen, P., & Spak, F. (2005). Attitudes of Swedish general practitioners and nurses to working with lifestyle change, with special reference to alcohol consumption. Alcohol and Alcoholism, 40(5), 388–393. doi:10.1093/alcalc/agh185

Glaser, B. G. (1978). Theoretical sensitivity. Mill Valley, California: Sociology Press.

Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine de Gruyter.

Griffiths, R. D., Stone, A., Tran, D. T., Fernandez, R. S., & Ford, K. (2007). Drink a little; take a few drugs: Do nurses have knowledge to identify and manage in-patients at risk of drugs and alcohol? Drug and Alcohol Review, 26(5), 545–552. doi:10.1080/09595230701499167

Grimshaw, J. M., & Russell, I. T. (1993). Effect of clinical guidelines on medical practice: A systematic review of rigorous evaluations. Lancet, 342(8883), 1317–1322.

Groves, P., Pick, S., Davis, P., Cloudesley, R., Cooke, R., Forsythe, M., & Pilling, S. (2010). Routine alcohol screening and brief interventions in general hospital in-patient wards: Acceptability and barriers. Drugs: Education, Prevention and Policy, 17(1), 55–71. doi:10.3109/09687630802088208

Hansen, A. B., Hvidtfeldt, U. A., Gronbaek, M., Becker, U., Nielsen, A. S., & Tolstrup, J. S. (2011). The number of persons with alcohol problems in the Danish population. Scandinavian Journal of Public Health, 39(2), 128–136. doi:10.1177/1403494810393556

Hoffmann, E. (2006). Fyldt med modsætninger: En interviewundersøgelse af sygeplejerskens holdninger til patienter med alkoholmisbrug [Filled with opposites: an interview research on the attitudes of nurses to patients with alcohol abuse]. Århus: Afdeling for Sygeplejevidenskab, Aarhus Universitet.

Hvidtfeld, U. A., Hansen, A. B. G., Grønbæk, M., & Tolstrup, J. S. (2008). Alkoholforbrug i Danmark: kvantificering og karakteristik af storforbrugere og afhængige [Alcohol use in Denmark: a quantification and characterisation of heavy users and the addictives]. København: Statens Institut for Folkesundhed. Retrieved from http://www.si-folkesundhed.dk/upload/alkoholforbrug_i_danmark_001.pdf

Johansson, K., Akerlind, I., & Bendtsen, P. (2005). Under what circumstances are nurses willing to engage in brief alcohol interventions? A qualitative study from primary care in Sweden. Addictive Behaviors, 30(5), 1049–1053. doi:10.1016/j.addbeh.2004.09.008

Johnson, M., Jackson, R., Guillaume, L., Meier, P., & Goyder, E. (2011). Barriers and facilitators to implementing screening and brief intervention for alcohol misuse: A systematic review of qualitative evidence. Journal of Public Health (Oxf), 33(3), 412–421. doi:10.1093/pubmed/fdq095

Kääriainen, J., Sillanaukee, P., Poutanen, P., & Seppä, K. (2001). Opinions on alcohol-related issues among professionals in primary, occupational, and specialized health care. Alcohol and Alcoholism, 36(2), 141–146. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11259211

Karlsson, A., Johansson, K., Nordqvist, C., & Bendtsen, P. (2005). Feasibility of a computerized alcohol screening and personalized written advice in the ED: Opportunities and obstacles. Accident and Emergency Nursing, 13(1), 44–53. doi:http://dx.doi.org/10.1016/j.aaen.2004.10.013

Kvale, S., & Brinkmann, S. (2009). Interview: Introduktion til et håndværk [Interview: an introduction to craftsmanship] (Second edition). København: Hans Reitzel.

Lappalainen-Lehto, R., Seppä, K., & Nordback, I. (2005). Cutting down substance abuse: Present state and visions among surgeons and nurses. Addictive Behaviors, 30(5), 1013–1018. doi:10.1016/j.addbeh.2004.09.002

Lock, C. A. (2004). Screening and brief alcohol interventions: What, why, who, where and when? A review of the literature. Journal of Substance Use, 9(2), 91–101. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106671593&site=ehost-live

Mandag, M., & Trygfonden. (2009). Fremtidens alkoholpolitik: Ifølge danskerne [The future alcohol policy: according to Danes]. København: Mandag Morgen.

Miller, W. R., & Wilbourne, P. L. (2002). Mesa Grande: A methodological analysis of clinical trials of treatments for alcohol use disorders. Addiction, 97(3), 265–277.

Mundt, K., Jensen, M., Kann, A., Søgaard Nielsen, A., Grønbæk, M., & Tønnesen, H. (2003). Alkohol – forebyggelse på sygehuse Fakta, metoder og anbefalinger [Alcohol: preventation at hospitals]. Bispebjerg Hospital: Klinisk Enhed for Sygdomsforebyggelse.

Nielsen, S. D., Storgaard, H., Moesgaard, F., & Gluud, C. (1994). Prevalence of alcohol problems among adult somatic in-patients of a Copenhagen hospital. Alcohol and Alcoholism, 29(5), 583–590.

Patton, M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice. Retrieved from http://www.e17.dk/bog/629995

Room, R., Babor, T., & Rehm, J. (2005). Alcohol and public health. Lancet, 365(9458), 519–530. doi:10.1016/s0140-6736(05)17870-2

Schwarz, A. S., Bilberg, R., Bjerregaard, L., Nielsen, B., Sogaard, J., & Nielsen, A. S. (2016). Relay model for recruiting alcohol dependent patients in general hospitals: A single-blind pragmatic randomized trial. BMC Health Services Research, 16(1), 132. doi:10.1186/s12913-016-1376-8

Strauss, A. L. (1989). Qualitative analysis for social scientists. Cambridge: Cambridge University Press.

Søgaard Nielsen, A. (2004). Mødet mellem to verdener: Patienter og behandlere i alkoholmisbrugsbehandlingen [The meeting between two worlds: patients and therapists in the treatment system for alcohol dependence]. Odense: Syddansk Universitetsforlag.

Tran, D. T., Stone, A. M., Fernandez, R. S., Griffiths, R. D., & Johnson, M. (2009). Does implementation of clinical practice guidelines change nurses’ screening for alcohol and other substance use? Contemporary Nurse, 33(1), 13–19.

Urquhart, C. (2013). Grounded theory for qualitative research: A practical guide. London: SAGE.

Watson, H., Munro, A., Wilson, M., Kerr, S. M., & Godwin, J. (2009). The involvement of nurses and midwives in screening and brief interventions for hazardous and harmful use of psychoactive substances: A review of the literature. Geneva: The World Health Organization.

WHO (2013). Status report on alcohol and health in 35 European countries 2013. Copenhagen: World Health Organisation, Regional Office for Europe.

Willaing, I., & Ladelund, S. (2005). Nurse counseling of patients with an overconsumption of alcohol. Journal of Nursing Scholarship, 37(1), 30–35.

Winter, S. (2002). Explaining street-level bureaucratic behavior in social and regulatory policies. Paper presented at the annual meeting of the American Political Science Association in Boston.

Nordic Studies on Alcohol and Drugs

The Journal of Nordic Centre for Welfare and Social Issues

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