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

Open access


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.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 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.

Journal information
Impact Factor

IMPACT FACTOR 2017: 0.683
5-year IMPACT FACTOR: 0.752

CiteScore 2018: 0.64

SCImago Journal Rank (SJR) 2018: 0.313
Source Normalized Impact per Paper (SNIP) 2018: 0.456

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 123 81 0
PDF Downloads 52 34 0