과음자들에서 그룹교육을 통한 변화준비단계의 개선
Effects of Group Education by Primary Care Physicians on the Readiness to Change in Heavy Drinkers
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
연구배경: 환자 교육을 통한 동기부여는 문제 음주자들의 행동 변화에 중요한 역할을 한다. 본 연구는 일차 진료 의사에 의한 집단 교육에 참여한 문제 음주자들의 변화 준비 단계 개선이 교육 수료 1년 후에도 지속되는지의 여부를 알아보고자 하였다. 방법: 집단 음주 교육 전 문제 음주 상태에 있으면서 숙고 전 단계와 숙고 단계에 있는 34명의 남성을 대상으로 하였다. 음주교실 수료 12주 후와 1년 후 변화 준비 단계의 개선 여부를 추적하였다. 결과: 음주 교실 참여 전의 변화 준비 단계는 ‘숙고 전 단계’ 11명, ‘숙고 단계’ 23명이었다. 음주 교실 수료 12주 후와 1년 후의 변화 준비 단계는 ‘숙고 전 단계’가 각각 2명, ‘숙고 단계’가 14명과 16명, ‘행동 단계’가 18명과 16명으로 유의하게(P<0.001) 개선되었다. 12주 후와 1년 후 문제 음주자들의 변화 준비 단계는 Family APGAR 점수가 높을수록(12주 후 교차비 1.99, 95% 신뢰구간 1.10-3.62; 1년 후 교차비 2.31, 95% 신뢰구간 1.10-4.85) 유의한 개선을 보였다. 결론: 집단 음주 교육을 받은 문제 음주자들의 변화 준비 단계 개선이 교육 1년 후에도 지속됨을 알 수 있었다.
Abstract
Background: Patient education can play an important role in motivating patients to change their problematic behavior. This study purposed to evaluate the effects of brief group education, which was performed by primary care physicians, on the improvement of the readiness to change in problem drinkers after a year from the education. Methods: A total of 34 male were followed up as the subjects who had been problem drinkers and at the stage of precontemplation or contemplation before group education. The readiness to change in the subjects was re-evaluated again 12 weeks and a year after the brief group education. Results: Before the education, 11 patients among the subjects were at the stage of precontemplation and 23 at the contemplation. The distribution was significantly changed into 2 at the stage of precontemplation, 14 at the contemplation and 18 at the action 12 weeks after the group education (P < 0.001), and into 2 at the precontemplation, 16 at the contem-plation, and 16 at the action a year after the group education (P < 0.001). The most influential factor associated with the improvement of the status of readiness to change was the family function score (after 12 weeks odds ratio 1.99, 95% CI 1.10-3.62; after a year odds ratio 2.31, 95% CI 1.10-4.85). Conclusion: Problem drinkers who had participated in the brief group education by primary care physicians showed conti-nuous improvement in the readiness to change even after a year from the education.
참고문헌 (26)
- DeLeon G, "Motivation and readiness for therapeutic community treatment among cocaine and other drug abusers", Am J Drug Alcohol Abuse, 23, pp.169~189 (1997)
- DiClemente CC, "Motivation for change and alcoholism treatment", Alcohol Health Res World, 23, pp.86~92 (1999)
- Prochaska JO, "Toward a comprehensive, trans-theoretical model of change, in Stages of change and addictive behaviors", pp.3~24 (1986), Plenum Press
- Readiness to change questionn-aire user’s manual. Technical Report 15, "Heather N", National Drug and Alcohol Research Centre, ~ (1991)
- Mullen PD, "A meta-analysis of trials evaluating. Patient education and counselling increase preventive beha-viours", Patient Educ Couns, 32, pp.157~173 (1997)
- Edwards G, "Alcoholism: a controlled trial of “treatment” and “advice”", J Stud Alcohol, 38, pp.1004~1031 (1977)
- Heather N, "Predictive validity of the readiness to change questionnaire", Addiction, 88, pp.1667~1677 (1993)
- Miller WR, "Motivational interviewing: preparing people to change addictive behavior. 1st ed" (1991), Guilford Press
- Mo-tivational enhancement therapy manual: a clinical research guide for therapists treating individuals with alcohol abuse and dependence, "Miller WR", National Institute on Alcohol Abuse and Alcoholism, ~ (1999)
- Fleming MF, "Strategies to increase alcohol screening in health care settings", Alcohol Health Res World, 21, pp.340~347 (1997)
- Park HS, "Small group patient education in primary care", J Korean Acad Fam Med, 19, pp.S317~S319 (1998)
- 정숙영, "집단 음주교육을 통한 음주행태 변화를 위한 동기부여", 가정의학회지, 29(5), pp.342~348 (2008), 대한가정의학회
- Smilkstein G, "Validity and reliability of the family APGAR as a test of family function", J Fam Pract, 15, pp.303~311 (1982)
- Saunders JB, "Development of the alcohol use disorders identification test (AUDIT): WHO collaborative projection early detection of persons with harmful alcohol consumption - II", Addiction, 88, pp.791~804 (1993)
- Rollnick S, "Development of a short ‘readiness to change questionnaire’ for use in brief, oppor-tunistic interventions among excessive drinkers", Br J Addict, 87, pp.743~754 (1992)
- Cronbach LJ, "Statistical methods applied to Rorschach scores: a review", Psychol Bull, 46, pp.393~429 (1949)
- Kim KM, "The readiness to change and insight in alcohol depen-dent patients", 박사, pp.2007
- Peterson KA, "Readiness to change and clinical suc-cess in a diabetes educational program", J Am Board Fam Pract, 15, pp.266~271 (2002)
- Borsari B, "Effects of a brief motivational intervention with college student drinkers", J Consult Clin Psychol, 68, pp.728~733 (2002)
- Carey KB, "Brief motivational interventions for heavy college drinkers: a randomized controlled trial", J Consult Clin Psychol, 74, pp.943~954 (2006)
- Kim JS, "Improvement of insight in patients with alcohol dependence by treatmen programs", J Korean Acad Fam Med, 21, pp.1180~1187 (2000)
- Jeong YH, "The factors associated with the success and attempt of smoking cessation", J Korean Acad Fam Med, 16, pp.S185~ (1995)
- 정진규, "가정의학과 외래 단기 상담 후 과음군의 음주정도 변화", 가정의학회지, 26(2), pp.32~37 (2005), 대한가정의학회
- Booth BM, "Patient factors predic-ting early alcohol-related readmissions for alcoholics: role of alcoholism severity and psychiatric co-morbidity", J Stud Alcohol, 52, pp.37~43 (1991)
- Finney JW, "The long-term course of treated alcoholism: I. Mortality, relapse and remission rates and com-parisons with community controls", J Stud Alcohol, 52, pp.44~54 (1991)
- Kim JS, "Influence of alcoholic’s insight on their abstinent outcomes for one year after discharge", J Korean Acad Fam Med, 22, pp.1052~1066 (2001)