Decisional needs of intensive care unit survivors with alcohol use disorder considering alcohol treatment: A qualitative study

IF 1.9 0 PSYCHOLOGY, CLINICAL
Kelsey Hills-Dunlap , Christopher E. Knoepke , Daniel D. Matlock , Ellen L. Burnham , Marc Moss , Sarah E. Jolley , Caroline K. Tietbohl
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Abstract

Introduction

Alcohol use disorder (AUD) is a common and serious medical condition with substantial global public health impact, and it is prevalent among patients admitted to intensive care units (ICUs) in the United States. Many ICU survivors with AUD report motivation to change their drinking, however, few receive alcohol treatment. We sought to understand the decision support needs of ICU survivors with AUD when faced with choices about alcohol treatment options.

Methods

In this qualitative study, we completed 17 semi-structured interviews with hospitalized patients with AUD recruited from two urban hospitals in the United States after an alcohol-related ICU admission. We used a reflexive thematic analysis and a deductive and inductive coding approach, with a-priori codes developed from the Ottawa Decision Support Framework.

Results

Participants described any prior experience with alcohol treatment decisions and their current decision-making process regarding engagement with alcohol treatment after ICU admission. In our analysis, we developed four themes and associated subthemes: (1) Decisional needs included knowledge of alcohol's impact on health issues, awareness of treatment options, and trust in the recovery process; (2) Priorities regarding treatment options centered on cost, lifestyle integration, and personal experiences with addiction among treatment program staff; (3) Values regarding the decision making process included a sense of autonomy, relatedness to information providers, and productive involvement of social supports; (4) Decision aids should incorporate video formats to deliver transparent information regarding alcohol treatment options.

Conclusions

Decisional needs of ICU survivors with AUD who are considering alcohol treatment reflect the importance of patient-centered information and consideration of patient preferences and values in alcohol treatment decisions. These findings will inform the development of an alcohol treatment decision aid to address these decisional needs and facilitate engagement with alcohol treatment for ICU survivors with AUD.
重症监护病房酒精使用障碍幸存者考虑酒精治疗的决策需要:一项定性研究。
酒精使用障碍(AUD)是一种常见且严重的医疗状况,具有重大的全球公共卫生影响,在美国重症监护病房(icu)住院的患者中很普遍。许多患有AUD的ICU幸存者报告有改变饮酒习惯的动机,然而,很少有人接受酒精治疗。我们试图了解患有AUD的ICU幸存者在面对酒精治疗选择时的决策支持需求。方法:在这项定性研究中,我们完成了17例半结构化访谈,访谈对象是来自美国两家城市医院因酒精相关的ICU住院的AUD患者。我们使用了反思性主题分析和演绎和归纳编码方法,以及从渥太华决策支持框架开发的先验代码。结果:参与者描述了任何先前的酒精治疗决策经验,以及他们在ICU入院后关于酒精治疗的当前决策过程。在我们的分析中,我们制定了四个主题和相关的次级主题:(1)决策需求包括酒精对健康问题影响的知识、对治疗方案的认识以及对康复过程的信任;(2)治疗方案的优先选择集中在成本、生活方式整合和治疗项目人员的个人成瘾经历;(3)关于决策过程的价值观包括自主意识、与信息提供者的关系和社会支持的生产性参与;(4)辅助决策工具应采用视频格式,提供有关酒精治疗方案的透明信息。结论:考虑酒精治疗的AUD ICU幸存者的决策需求反映了在酒精治疗决策中以患者为中心的信息和考虑患者偏好和价值观的重要性。这些发现将为酒精治疗决策辅助的发展提供信息,以解决这些决策需求,并促进患有AUD的ICU幸存者参与酒精治疗。
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来源期刊
Journal of substance use and addiction treatment
Journal of substance use and addiction treatment Biological Psychiatry, Neuroscience (General), Psychiatry and Mental Health, Psychology (General)
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