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- Johansson, Kjell, 1956-, et al.
(författare)
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Advice to patients in Swedish primary care regarding alcohol and other lifestyle habits : how patients report the actions of GPs in relation to their own expectations and satisfaction with the consultation
- 2005
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 15:6, s. 615-620
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lifestyle advice given by general practitioners (GPs) may be a cost-effective means of health promotion; however, it is not fully put into routine practice. The aim of this study was to explore to what extent GPs' patients expect and receive advice concerning alcohol, tobacco, exercise and diet in relation to sociodemographic characteristics, type of visit and patient satisfaction.Methods: A postal questionnaire was sent to a representative sample (n = 9750) of patients who had consulted GPs in a county in Sweden. The response rate was 69% (n = 6734).Results: Exercise was the most (16%) and alcohol the least (5%) common type of advice. The patients received advice more often than they expected in all areas except alcohol. The patients reported the highest rate of unfulfilled advice expectation and the lowest rate of unexpected advice in the case of alcohol. Male gender, poorer self-rated health and scheduled appointment were independent predictors of all types of advice. Continuity of GP contact was only favourable for exercise and diet advice. The patients who received advice were more satisfied with their visit to the doctor.Conclusions: A tertiary preventive perspective guides GPs' practice of giving advice. Male patients with advanced illnesses are given priority. Women and patients with long-term risk habits are more neglected. The GPs tend to misjudge the expectations and needs of their patients and are too restrained in their counselling practice. Alcohol is the most disregarded area of advice in proportion to the patients' expectations and needs.
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- Johansson, Kjell, 1956-, et al.
(författare)
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Early intervention for problem drinkers : readiness to participate among general practitioners and nurses in Swedish primary health care
- 2002
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 37:1, s. 38-42
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Tidskriftsartikel (refereegranskat)abstract
- An exploration was made of attitudes and practices of general practitioners (GPs) and nurses concerning early identification of, and intervention for, alcohol-related problems. Sixty-five GPs and 141 nurses in 19 primary health centres in a county in southern Sweden answered a 28-item questionnaire before implementation of an intervention programme. The questionnaire covered experiences with patients with alcohol-related health problems, knowledge and perceived capacity concerning early identification and intervention, attitudes towards the role of primary care staff in early identification and intervention and current intervention methods in use at the health centre. Self-reported frequency of asking about alcohol use was higher among GPs than nurses. Both groups reported more frequently asking about alcohol consumption in cases where they believed that the health status was influenced by alcohol. For both professions, knowledge and skills concerning identification were rated as better understood than that concerning intervention methods. Nurses rated their knowledge and skills less confidently than GPs. The overall attitude was fairly positive towards early identification and intervention, but nurses were more worried than GPs that patients would react negatively to questions about alcohol. Attitudes, self-rated capacity, and practice were related. The low level of early identification and intervention in primary care appears to be related more to insufficient practical skills than to attitudes. Nurses appear to be an unexploited resource, in need of training and support. Nurses may need to be convinced that an active role does not interfere with the nurse-patient relationship. Building teams of GPs and nurses in primary care might enhance the dissemination of alcohol prevention into regular practice.
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- Johansson, Kjell, 1956-, et al.
(författare)
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Factors influencing GPs' decisions regarding screening for high alcohol consumption : a focus group study in Swedish primary care
- 2005
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Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 119:9, s. 781-788
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this study was to explore factors that influence general practitioners' (GPs') decisions regarding screening for high alcohol consumption.Methods GPs working at three primary healthcare centres in Sweden participated in focus group interviews. The interviews were recorded and transcribed verbatim, and a deductive framework approach was used for the analysis.Results The majority of the participating GPs did not believe in asking all patients about their alcohol consumption. Reported factors that influenced how many and which patients were questioned about alcohol consumption were time, age of the patient, consultation setting, patient–physician relationship, what symptoms the patient presented with, and knowledge of measures if patients appear to have a high alcohol consumption. Thus, alcohol screening and intervention were not performed in all patient groups as was originally intended, but were performed in limited groups of patients such as those with alcohol-related symptoms.Conclusions Although the number of participants in this study was small and the conclusions cannot be generalized, the results provide some valuable insights into why GPs are hesitant to engage in screening for high alcohol consumption. Since prevention of alcohol-related health problems is an important public health issue, many different screening and intervention strategies have to be formulated and evaluated in order to reach patients with both hazardous and harmful alcohol consumption within the healthcare system. Screening all consecutive patients for a limited period or screening patient groups known to include a fairly high frequency of high alcohol consumers are two ways of limiting the time requirements and increasing role legitimacy. Still, there is a need for a broader public health strategy involving many players in the community in alcohol preventive measures, especially in more primary preventive approaches.
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- Johansson, Kjell, 1956-, et al.
(författare)
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Under what circumstances are nurses willing to engage in brief alcohol interventions? : a qualitative study from primary care in Swedena
- 2005
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Ingår i: Addictive Behaviours. - : Elsevier BV. - 0306-4603 .- 1873-6327. ; 30:5, s. 1049-1053
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Tidskriftsartikel (refereegranskat)abstract
- To improve alcohol prevention in primary health care, it has been suggested that primary care nurses are an under-utilised resource. The aim of this study was to identify under what circumstances primary care nurses in Sweden are willing to engage in alcohol prevention. All nurses at three primary health care centres in Östergötland, Sweden were invited to participate in focus group interviews; 26 nurses participated. The nurses considered primary health care to be just one among other sectors within the community with responsibility for alcohol prevention. The role of health care in alcohol prevention was perceived to be important but mainly secondary preventive. The nurses felt justified screening all patients' alcohol habits only when they could refer to an obligation or a time-limited project. Otherwise, they mainly wanted to engage in screening patients with alcohol-related symptoms or diagnoses and other risk groups. Reasons for refraining from alcohol screening and intervention included lack of self-efficacy, time consumption and fear of harming their relationship with the patient. New strategies for alcohol prevention in primary care are discussed.
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