Linking drinking to injury – causal attribution of injury to alcohol intake among patients in a Swedish emergency room

Nilsen, Per; Holmqvist, Marika; Nordqvist, Cecilia; Bendtsen, Preben

doi:10.1080/17457300701374759

Cited by 12 publications

(10 citation statements)

References 38 publications

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“…We also examined the importance of factors associated with motivation to reduce alcohol consumption among these patients. Approximately one in seven injury patients in this study had been drinking in the 6 hours preceding the event that led to the injury (i.e., were acute drinkers), which is similar to earlier Swedish studies on non-fatal injuries (Nilsen et al, 2007b; Nordqvist et al, 2006; Romelsjö et al, 1993), but lower than most of the ED studies included in the international Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and WHO Collaborative Study on Alcohol and Injuries (Cherpitel et al, 2003; World Health Organization, 2007). Only five of these 28 studies, from 16 countries, reported a similar or lower proportion of acute drinkers, and the 2001 study from Malmö, Sweden reported 15% excluding abstainers; the same proportion found here.…”

Section: Discussionsupporting

confidence: 85%

“…Research suggests that acknowledgement of alcohol as a factor in an injury enhances willingness to change drinking behavior, possibly because the patient becomes aware of the negative consequences of their drinking (Longabaugh et al, 1995; Nilsen, et al, 2007b). The physical or mental distress of the injury and the subsequent visit to the ED or hospitalization could lead to a decrease in drinking independent of any interventions (Bombardier, et al, 1997; Bombardier & Rimmele, 1998).…”

Section: Introductionmentioning

confidence: 99%

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Acute Alcohol Consumption and Motivation to Reduce Drinking Among Injured Patients in a Swedish Emergency Department

Trinks¹,

Festin²,

Bendtsen³

et al. 2012

Journal of Addictions Nursing

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Background Injuries constitute a major public health problem. Millions of people are injured each year and acute drinking is a well-known risk factor for injuries. Research suggests that acknowledgment of alcohol as a factor in an injury enhances willingness to change drinking behavior, possibly because the patient becomes aware of the negative consequences of their drinking. Study Objectives To investigate the prevalence of acute alcohol consumption (drinking prior to the event) among injury patients and to examine the importance of factors potentially associated with motivation to reduce alcohol consumption among these patients. Methods All patients aged 18–69 years were requested to answer alcohol-related questions on a touch-screen computer. Results Fifteen percent of injured patients were categorized as acute drinkers and, of these, 64% reported that their injury was connected to alcohol. There were significant differences for all sociodemographic and drinking characteristics between acute drinkers and non-acute drinkers. Acute drinkers were categorized as risky drinkers to a much higher extent than non-acute drinkers. Acute drinkers had a considerably higher average weekly alcohol consumption and engaged far more frequently in heavy episodic drinking than non-acute drinkers. Acute drinkers were motivated to reduce their alcohol intake to a greater extent than non-acute drinkers; 51% were in the action, preparation, and contemplation stages, compared with 19% of the non-acute drinkers. Conclusion Acute drinkers had considerably more detrimental alcohol consumption than non-acute drinkers and the acute drinkers were more motivated to reduce their drinking than the non-acute drinkers.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Acute Alcohol Consumption and Motivation to Reduce Drinking Among Injured Patients in a Swedish Emergency Department

Trinks¹,

Festin²,

Bendtsen³

et al. 2012

Journal of Addictions Nursing

Self Cite

View full text Add to dashboard Cite

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“…This is consistent with research that demonstrated that injury patients who causally attribute their injury to alcohol are more motivated and likely to change their drinking behavior (Field, Hungerford, & Dunn, 2005;Nilsen, Holmqvist, Nordqvist, & Bendtsen, 2007). However, Gentilello stated that this "intervention effect" is merely temporary unless the underlying alcohol problem is addressed.…”

Section: Discussionsupporting

confidence: 78%

A systematic review of emergency care brief alcohol interventions for injury patients

Nilsén¹,

Baird²,

Mello³

et al. 2008

Journal of Substance Abuse Treatment

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183

165

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“…Patient beliefs about the role of alcohol in the event, the perceived seriousness of the event and their emotional reaction to the event are other aspects of salience that may reflect a sense of vulnerability [31], and that may subsequently prompt change and/or interact with intervention. Half of ED patients who drank prior to their injury attribute a causal association between alcohol and their injury [32], and such causal attributions are associated with motivation to change alcohol use [33,34]. Walton et al .…”

Section: Introductionmentioning

confidence: 99%

Moderators and mediators of two brief interventions for alcohol in the emergency department

et al. 2010

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Objective-Evaluate moderators and mediators of brief alcohol interventions conducted in the Emergency Department. (18-24 years; N = 172) in an Emergency Department received a motivational interview with personalized feedback (MI) or feedback only (FO), with 1-and 3-month booster sessions and 6-and 12-month follow ups. Gender, alcohol status/severity group (ALC+ Only, AUDIT+ Only, ALC+/AUDIT+), attribution of alcohol in the medical event, aversiveness of the event, perceived seriousness of the event, and baseline readiness to change alcohol use were evaluated as moderators of intervention efficacy. Readiness to change also was evaluated as a mediator of intervention efficacy, as were perceived risks/benefits of alcohol use, self-efficacy, and alcohol treatment seeking. Methods-PatientsResults-Alcohol status, attribution, and readiness moderated intervention effects such that patients who had not been drinking prior to their medical event, those who had low or medium attribution for alcohol in the event, and those who had low or medium readiness to change showed lower alcohol use 12 months after receiving MI compared to FO. In the AUDIT+ Only group those who received MI showed lower rates of alcohol-related injury at follow up than those who received FO. Patients who had been drinking prior to their precipitating event did not show different outcomes in the two interventions, regardless of AUDIT status. Gender did not moderate intervention efficacy and no significant mediation was found.Conclusions-Findings may help practitioners target patients for whom brief interventions will be most effective. More research is needed to understand how brief interventions transmit their effects. Keywords Alcohol; Brief Intervention; Emergency RoomAlcohol is one of the primary causes of injuries treated in trauma centers (1), and Emergency Department (ED) patients are up to three times more likely to report heavy drinking and negative consequences of drinking than patients in primary care settings (2).Corresponding Author: Nancy P. Barnett, Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5, Providence, RI 02912, USA, Nancy_Barnett@brown. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptMales and younger patients are more likely to have been drinking prior to treatment in an ED (3), and patients who are admitted to a trauma center with positive toxicology findings have twice the subsequent injury mortality rates than other patients (4).Use of early, brief interventions may prevent the development of more severe cases of alcohol problems (5), and may reduce the risk of future health problems or injury (6-8). The importance of treating alcohol problems among ED and trauma center patients is reflected in national recommendations (9), and a recent mandate that requires all trauma centers to provide screening and brief intervention services for alcohol problems (10). Motivational Interviewing (MI) (11) reduces drinking and/or associated problems with patients in EDs or trauma ce...

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Linking drinking to injury – causal attribution of injury to alcohol intake among patients in a Swedish emergency room

Cited by 12 publications

References 38 publications

Acute Alcohol Consumption and Motivation to Reduce Drinking Among Injured Patients in a Swedish Emergency Department

Acute Alcohol Consumption and Motivation to Reduce Drinking Among Injured Patients in a Swedish Emergency Department

A systematic review of emergency care brief alcohol interventions for injury patients

Moderators and mediators of two brief interventions for alcohol in the emergency department

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