Factors influencing whether nurses talk to somatic patients about their alcohol consumption

Abstract

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.

Systematic Review of Clinician‐Reported Barriers to Provision of Brief Advice for Alcohol Intake in Hospital Inpatient and Emergency Settings

“…Self-completed questionnaire on practices, self-efficacy in alcohol counseling, and knowledge on health impacts of excessive alcohol consumption. Quantitative study (Bernstein et al, 2007;Broyles et al, 2012;Cunningham et al, 2010;Danielsson et al, 1999;Garnett et al, 2016;Gentilello et al, 2005;Graham et al, 2000;Griffiths et al, 2007;Hellum et al, 2016;Indig et al, 2009;Jun et al, 2019;Lee et al, 2015;Staton et al, 2018;Tsai, 2009;Weiland et al, 2008) 15 (60%) High confidence 15 studies with moderate methodological limitations. Data from 6 countries across 5 continents, predominantly in North America.…”

“…Patient presentation/condition (e.g., time of injury, limited patient history, patient physical/mental condition, drunken state, unconscious state) (Anderson et al, 2001;Cunningham et al, 2010;D esy and Perhats, 2008;Freeman et al, 2011;Garnett et al, 2016;Graham et al, 2000;Groves et al, 2010;Hellum et al, 2016;Indig et al, 2009;Tsai, 2009;Weiland et al, 2008) 11 (44%) High confidence 11 studies with minor methodological limitations. Data from 7 countries across 5 continents, predominantly in North America.…”

“…Lack of privacy (Broyles et al, 2012;D esy and Perhats, 2008;Freeman et al, 2011;Garnett et al, 2016;Graham et al, 2000;Hellum et al, 2016;Tsai, 2009;Whitty et al, 2016) 8 (32%) High confidence 8 studies with minor methodological limitations. Data from 5 countries across 4 continents, predominantly in North America.…”

Lifestyle factors in somatic patients with and without potential alcohol problems

“…They are neither offered help in relation to their alcohol consumption nor offered referral to treatment elsewhere as harmful use of alcohol has proven to be relatively difficult for staff to address (Hellum et al 2016). Further, patients might be hesitant to talk about their alcohol consumption because of fear of stigmatization.…”

“…Further, patients might be hesitant to talk about their alcohol consumption because of fear of stigmatization. As such, there seems to be a level of stigma and taboo related to harmful alcohol intake that tends to hinder preventive alcohol interventions (Hellum et al 2016). In most societies, professionals find it easier to address and offer helpful advice in relation all other unhealthy lifestyles except for alcohol abuse.…”