Readiness to Change and Reasons for Intended Reduction of Alcohol Consumption in Emergency Department versus Trauma Population

Abstract

IntroductionThe primary objective was to identify the most common reasons for intending to cut back on alcohol use, in emergency department (ED) and trauma patient populations. The secondary objective was to determine the association between reason to cut back on alcohol and education level.MethodsWe conducted the study at a level one trauma center in California between 2008 and 2012. This was a retrospective analysis of data collected from computerized alcohol screening and intervention (CASI). We excluded patients who drank too little, and those whose scores were consistent with dependency (Alcohol Use Disorders Identification Test [AUDIT]>19). The CASI database includes the patient’s age, gender, language, education level, an AUDIT score (1–40 scale), a readiness to change score (1–10), and the option to choose any of 10 “reasons to cut back” on their alcohol consumption.ResultsFrom 10,537 patients, 1,202 met criteria for the study (848 ED, 354 trauma). Overall, the most common reasons cited for cutting back on alcohol were “To avoid health problems” (68.5%), “To avoid getting a DUI” (43.6%), “It could save me money” (42.0%), and “To avoid situations where I could get hurt” (41.0%). Trauma patients cited the following reasons significantly more than ED patients: “To avoid situations where I could get hurt” (46.3% versus 38.8%, respectively), “So I can be in control of my behavior” (40.7% versus 32.2%), and “My partner or spouse wants me to stop” (20.1% versus 15.0%). Additionally, those patients who cited “To avoid health problems” reported 1.2 points higher than average (p<0.001) on the 10-point readiness to change scale. Those who have completed some college or an associate degree cited “To avoid health problems” less often than high school graduates (odds ratio [OR] 0.45), while they cited “To avoid situations where I could get hurt” (OR 2.5) and “To avoid being in a car crash caused by alcohol use” (OR 3.8) more often than high school graduates.ConclusionHealth, injury, finances, and legal issues remain top concerns for patients, while trauma patients specifically had proportionately more concerns with situations where they could get hurt.

Predictors of and reasons for attempts to reduce alcohol intake: A population survey of adults in England

“…However, diagnosis of an alcohol related disorder which is symptomless may not be a potent trigger [ 36 ]. The next most commonly reported reasons include trying to avoid drink driving, to save money and to prevent injury (41%) [ 37 ]. For women in particular, weight-loss and restricting calorie intake appear to promote abstinence [ 38 ].…”

Emergency physician screening and management of trauma patients with alcohol involvement

“…Patients report a plethora of differing motivating factors to reduce their drinking habits. [ 12 ] Ideally, clinicians must also identify and manage the highly prevalent mental health and social issues that exist in many problem drinkers, as these can reduce chances of successful therapy. [ 13 ] It is probably merely repetitive communication with patients from health professionals that can lead to long-term reduction in drinking patterns.…”

Razones para cambiar el consumo de alcohol en universitarios

“…Se exploraron mediante una pregunta abierta: En caso de haber dejado de beber ¿qué te llevó a dejar de consumir alcohol?, se permitió indicar más de una razón. Las categorías surgieron sobre la base de las respuestas, y luego fueron cotejadas con las categorías desarrolladas en otros estudios (véase Amodeo & Kurtz, 1998;Dawson, 1994, Harrison et al, 2014Matzger et al, 2005) en un proceso iterativo que intentó preservar el máximo de variabilidad. Para evaluar las 16 categorías creadas (ver Tabla 2), dos investigadores (KC y AL) codificaron independientemente las primeras respuestas dadas por cada participante.…”

“…Y aún las personas que sí han realizado un tratamiento, tienen diferentes razones o motivos para dejar el consumo (Dawson, 1994). Por otro lado, estas razones se han visto relacionadas con conceptos que conllevan a la reducción del consumo perjudicial, como la disposición al cambio (Harrison et al, 2014), con otros factores psicológicos como los estados de ánimo (O'Hara, Armeli, & Tennen, 2014); y con el sexo, ya que las razones por las cuales las mujeres y los varones aumentan o disminuyen el consumo presentarían diferencias (Britton & Bell, 2015;Vladimirov et al, 2016).…”

“…En cuanto a las poblaciones estudiadas, la información proviene mayormente de personas con dependencia, ya en tratamiento o con recuperación natural (Amodeo & Kurtz, 1998;Carballo et al, 2014;Cunningham et al, 2005a;Harrison et al, 2014); de personas con un consumo excesivo que desearían cambiar su consumo o que lo hicieron (Cunningham et al, 2005a;Harrison et al, 2014;Matzger et al, 2005); y en menor medida de personas que se abstienen del consumo de alcohol (Epler et al, 2009), siendo que las razones por las cuales las personas se vuelven abstemias puede ser de importancia para entender cómo cambiar la cultura de consumo actual (Herring, Bayley, & Hurcombe, 2014).…”