Readiness to Change of Problem Drinkers in a General Hospital

某綜合醫院問題性飲酒者之改變動機調查

陳俊興(Chun-Hsin Chen) ； 黃名琪(Ming-Chyi Huang) ； 沈武典(Winston W. Shen)

《台灣精神醫學》 20卷3期 (2006/09) Pp. 201-211

https://doi.org/10.29478/TJP.200609.0005

摘要

目的：綜合醫院住院病人常見問題性飲酒者。評估問題性飲酒者的準備改變動機對給予治療來說是相當重要的。本研究的目的是調查一所綜合醫院非精神科住院危!險性飲酒者之準備改備動機。方法：以酒精使用疾患確認測驗(Alcohol Use Disorders Identification Test, AUDIT)8分為切點，在非精神科住院病患中篩檢問題性飲酒者。以準備改變量表(Readiness to Change Questionnaire)評估問題性飲酒者之改變動機。結果：在1,171位住院病患中,1,007(86.0%)位為篩檢陰性，164(14.0%)位篩檢陽性（問題性飲酒者）。共有105問題性飲酒者完成準備改變量表，其中75 (71.4%)位準備改變階段為前思期、16(15.2%)位在沈思期、14(13.3%)位在行動期。人口學變項或是AUDIT分數與改變動機分期並無相關性。結論：在台灣綜合醫院問題性飲酒者的改變動機主要在前思期與沈思期，只有少數在行動期。我們建議在綜合醫院對問題性飲酒者進行介入時一定要將提昇動機的技巧運用在治療上，才能增進其效果。

關鍵字

問題性飲酒 ； 準備改變 ； 改變階段 ； 酒精使用疾患確認測驗

並列摘要

Background and Purpose: Problem drinking is a common problem among inpatients in general hospitals. Assessment of the readiness to change of patients with problem drinking plays the pivotal role in determining the appropriate intervention. The purpose of this study was to investigate the readiness to change among patients with problem drinking in a general hospital. Methods: Problem drinking was identified by screening nonpsychiatric inpatients using the Alcohol Use Disorders Identification Test (AUDIT) at a cutoff point of 8. The stage of readiness to change was assessed using the Readiness to Change Questionnaire (RCQ). Results: Among the 1,171 inpatients screened, 1,007 (86.0%) had a negative result and 164 (14.0%) a positive result for problem drinking. Among the 105 problem drinkers who completed the RCQ, 75 (71.4%) were classified as being in the precontemplation (PC) stage of readiness to change, 16 (15.2%) in the contemplation (C) stage, and 14 (13.3%) in the action (A) stage. Neither demographic correlates nor AUDIT scores were associated with the stage of readiness to change among patients with problem drinking. Conclusion: Patients with problem drinking identified by inpatient screening in this study from Taiwan were predominantly in the readiness to change stages of PC and C and rarely in stage A. These findings suggest that enhancing motivation should a primary focus of hospital-based therapy for patients with problem drinking.

並列關鍵字

problem drinking ； readiness to change ； stages of change ； Alcohol Use Disorders Identification Test

參考文獻

Allen JP,Litten RZ,Fertig JB,Babor TF(1997).A review of research on the Alcohol Use Disorders Identification Test (AUDIT).Alcohol Clin Exp Res.21,613-619.

Babor TF,Higgins-Biddle JC(2001).A manual for use in primary care.Geneva:World Health Organization.

Bien TH,Miller WR,Tonigan JS(1993).Brief interventions for alcohol problems: a review.Addiction.88,316-336.

Bradley KA,Bush KR,McDonell MB,Malone T,Fihn SD(1998).Screening for problem drinking: comparison of CAGE and AUDIT. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test.J Gen Intern Med.13,379-388.

Chen CC,Yeh EK,Hwu HG,Lin SK,Wang JJ,Yeh YL(1987).Drinking problem in inpatients of a general hospital: lifetime prevalence of alcohol abuse and dependence.Chinese J Psychiatry.1,166-172.