Minimal interventions for problem drinkers : a study of effectiveness and an analysis of the nurse's role
The study described in this thesis consists of two main parts. The first was a study of brief interventions for problem drinking. 998 general hospital in-patients, who were receiving treatment for conditions which were not primarily alcohol-related, were screened to identify potential problem drinkers. 24.5% reported levels of alcohol consumption which were in excess of the recommended "sensible limits" as suggested by the Health Education Authority (1989). 15% were regular consumers of alcohol who had not previously received treatment for an alcohol problem. The potential problem drinkers were assigned to one of four experimental groups. Patients in one group received a health education booklet about the effects of alcohol and how to reduce consumption to within recommended sensible limits. The second group were given this information verbally. The third group were given both the booklet and the verbal advice. The fourth group received no intervention. Follow-up data were collected one year later, at which time the mean level of alcohol consumption reported by the entire sample was significantly less than at entry to the study. This was also the case for the mean number of alcohol-related problems. These reductions were supported by reductions in the mean levels of ganima-glutamyl transferase and aspartate transferase but not in mean erythrocyte volume. No statistically significant treatment effects were found for any of the outcome variables. The second part of the study was a descriptive survey of nurses' practice of assessing patients' alcohol consumption. The nurses were also asked about their knowledge of factors which are necessary to enable them to give appropriate advice to problem drinkers. The results suggested that, although nurses acknowledged such a role, limitations in their knowledge prevented them from being effective in both detecting problem drinkers and in delivering health education.