Factors Affecting Women's Disclosure of Alcohol Misuse in Primary Care: A Qualitative Study with U.S. Military Veterans

Cucciare, Michael A.; Lewis, Eleanor T.; Hoggatt, Katherine J.; Bean-Mayberry, Bevanne; Timko, Christine; Durazo, Eva M; Jamison, Andrea L.; Frayne, Susan M.

doi:10.1016/j.whi.2015.07.010

Cited by 22 publications

(18 citation statements)

References 28 publications

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“…Besides, moral support from their spouse, family, and friends, who also use T&CM and perceived the benefits of these practices, encouraged them to tell their doctors pertaining to the issue of advantages and disadvantages of these practices. This is in line with the other study, where support from family (parent, spouse, and/or sibling) or other close persons (friend) was found to have a positive impact on their decision to confide in doctor [ 18 ].…”

Section: Discussionsupporting

confidence: 92%

“…In this study, we found that several themes cited by participants evidenced some degree of conceptual overlap with one another. For instance, doctor's behaviours, along with participants' behaviour such as emotional reactions and intrapersonal trust regarding the doctor, might affect the quality of the doctor-patient relationship, which was reported to influence disclosure [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Patient’s Decision to Disclose the Use of Traditional and Complementary Medicine to Medical Doctor: A Descriptive Phenomenology Study

Kelak

Cheah

Safii

2018

Evidence-Based Complementary and Alternative Medicine

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Nondisclosure of traditional and complementary medicine (T&CM) use may cause individual to be at risk of undue harm. This study aimed to explore patient's experience and views on their decision to disclose the use of T&CM to the doctor. An exploratory qualitative study using in-depth interview involving 10 primary care clinics attendees in Kuching was conducted. The results indicated that disclosure of T&CM use will motivate them to get information, increase doctor's awareness, and get support from family and friends for disclosure. Fear of negative relationship and negative response from doctors was a barrier for disclosure. Doctor's interpersonal and communication skills of being involved, treating patients respectfully, listening attentively, respecting privacy, and taking time for the patient were a critical component for disclosure. Intrapersonal trust regarding doctor influences their satisfaction on healthcare. Women are more open and receptive to a health concern and expressing negative emotions and tend to share problems, whereas men always described themselves as healthy, tended to keep their own personal feeling to themselves, and tended to not share. The doctor should consider gender differences in disclosure, their attitude towards T&CM use, and gained patient's trust in the delivery of healthcare services. Good interpersonal and communication skills must be maintained between doctor and patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Patient’s Decision to Disclose the Use of Traditional and Complementary Medicine to Medical Doctor: A Descriptive Phenomenology Study

Kelak

Cheah

Safii

2018

Evidence-Based Complementary and Alternative Medicine

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“…Our study also supports previous evidence showing that whilst patients are aware of current UK guidelines [48,49], real-world perceptions of 'how much is too much' often diverge from epidemiological constructs of risk [27,28,[50][51][52]. As such, we further highlight how lifestyle behaviours, and the knowledge, attitudes and beliefs that inform such activities, are heavily sociallysituated [53].…”

Section: Discussionsupporting

confidence: 88%

“…Previous surveys of attitudes towards alcohol and other lifestyle risk factors being raised by healthcare providers suggest that people are generally willing to discuss their drinking with clinicians [19][20][21][22][23]. Yet whilst qualitative research exploring patients' views on alcohol screening and brief advice has been published, previous studies have either explored patients' hypothetical perspectives on discussing alcohol with their healthcare provider [24][25][26], or focussed on the views of specific patient groups such as heavy drinkers [27] or women veterans [28]. As such, there is limited evidence of patients' real world experiences of discussing their own alcohol consumption as part of routine consultations.…”

Section: Introductionmentioning

confidence: 99%

Patients’ experiences of alcohol screening and advice in primary care: a qualitative study

et al. 2020

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Background: Despite evidence supporting the effectiveness of alcohol screening and brief advice to reduce heavy drinking, implementation in primary healthcare remains limited. The challenges that clinicians experience when delivering such interventions are well-known, but we have little understanding of the patient perspective. We used Normalization Process Theory (NPT) informed interviews to explore patients' views on alcohol screening and brief advice in routine primary healthcare. Methods: Semi-structured qualitative interviews with 22 primary care patients who had been screened for heavy drinking and/or received brief alcohol advice were analysed thematically, informed by Normalisation Process Theory constructs (coherence, cognitive participation, collective action, reflexive monitoring). Results: We found mixed understanding of the adverse health consequences of heavy drinking, particularly longerterm risks. There was some awareness of current alcohol guidelines but these were viewed flexibly, depending on the individual drinker and drinking context. Most described alcohol screening as routine, with clinicians viewed as trustworthy and objective. Patients enacted a range of self-regulatory techniques to limit their drinking but perceived such strategies as learned through experience rather than based on clinical advice. However, most saw alcohol advice as a valuable component of preventative healthcare, especially those experiencing co-occurring health conditions. Conclusions: Despite strong acceptance of the screening role played by primary care clinicians, patients have less confidence in the effectiveness of alcohol advice. Primary care-based alcohol brief advice needs to reflect how individuals actually drink, and harness strategies that patients already commonly employ, such as self-regulation, to boost its relevance.

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“…These tools and strategies might include taking advantage of co-located mental health professionals, using readily available VA web materials on the potential effects of alcohol use on mental health conditions and vice versa, and consulting with mental health treatment staff on how to best counsel women who may be engaging in problematic drinking and who have mental health comorbidities. Treatments tailored to women with these comorbidities are available, and the best method of linkage to these treatments is an important area for future research (Cucciare et al , 2013; 2014).…”

Section: Barriersmentioning

confidence: 99%

Providers’ perceptions of barriers and facilitators to disclosure of alcohol use by women veterans

Abraham

Lewis

Drummond

et al. 2016

Prim Health Care Res Dev

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Providers (n=14) were recruited from primary care at two veterans Administration Women's Health Clinics in California, United States. An open-ended interview guide was developed from domains of the consolidated framework for implementation science. Interviews elicited primary care providers' perspectives on barriers and facilitators to women veterans' (who may or may not be using alcohol in harmful ways) disclosure of alcohol use during routine clinic visits. Interview data were analyzed deductively using a combination of template analysis and matrix analysis. Findings Participants reported six barriers and five facilitators that they perceived affect women veteran's decision to accurately disclose alcohol use during screenings and openness to discussing harmful drinking with a primary care provider. The most commonly described barriers to disclosure were stigma, shame, and discomfort, and co-occuring mental health concerns, while building strong therapeutic relationships and using probes to 'dig deeper' were most often described as facilitators. Findings from this study may enhance provider-patient discussions about alcohol use and help primary care providers to better identify problematic drinking among women veterans, ultimately improving patient outcomes.

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Factors Affecting Women's Disclosure of Alcohol Misuse in Primary Care: A Qualitative Study with U.S. Military Veterans

Cited by 22 publications

References 28 publications

Patient’s Decision to Disclose the Use of Traditional and Complementary Medicine to Medical Doctor: A Descriptive Phenomenology Study

Patient’s Decision to Disclose the Use of Traditional and Complementary Medicine to Medical Doctor: A Descriptive Phenomenology Study

Patients’ experiences of alcohol screening and advice in primary care: a qualitative study

Providers’ perceptions of barriers and facilitators to disclosure of alcohol use by women veterans

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