| A. IMPORTANCE AND CONFIDENCE |
Importance: appraisal of the Importance of each aspect of alcohol intervention counseling in assisting patients who drink.
Confidence: appraisal of how confident you are that you could successfully perform each aspect of counseling for patients who drink. |
10 - Point Rulers
Using a ruler, each of the following 10 aspects of SBI for Alcohol is examined for both the perceived importance and the perceived confidence of performing:
Asking a patient how much and how often they drink. Classifying patients as at-risk, problem drinkers, or dependent drinkers based on the AUDIT score. Using information about the patient’s drinking habits to provide feedback. Reviewing any previous alcohol-related problems. Reviewing possible reasons for decreasing alcohol use. Asking patients if they want to decrease their risk. Providing advice regarding appropriate drinking limits. Contracting with patient to cut back or accept referral. Giving patient a brochure or manual. Recommending a return visit to discuss patient progress in reducing alcohol use.
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B. DECISIONAL BALANCE: |
Cognitive appraisal/evaluation of positives (pros) and negatives (cons) of a behavior and reasons to change/not change behavior |
A 14-item, 5-point Likert scale
Using response categories from “Not Important” to “Extremely Important” clinicians indicate the importance of the “pros” and the “cons” in making a decision to discuss alcohol use with each of their patients.
Pros:
Discussing patients’ alcohol use could help reduce risky drinking Discussing their alcohol use could improve my patients’ health. Helping patients overcome problem drinking creates a stronger doctor patient relationship. Discussing their alcohol use could improve my patients’ work productivity Discussing their alcohol use could improve patients’ family and personal relationships. Discussing patients’ alcohol use with them could help reduce health care costs Discussing alcohol use with my patients could prevent future health problems.
Cons:
I will lose patients if I talk to them about their alcohol use. I am too busy to have time to talk to patients about their alcohol use. I prefer to diagnose and treat patient’s primary health issues rather than give preventive advice, such as brief alcohol use interventions I do not have adequate training to deal with patients who are at-risk drinkers. Discussing alcohol issues is uncomfortable for me. I will upset my patients if I talk to them about their alcohol use My talking with a patient about alcohol use is unlikely to make a difference in his/her drinking
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| C. STAGES OF CHANGE |
Precontemplation - individuals do not recognize a need to change;
Contemplation- marked by growing concern and weighing of the risks and rewards of changing;
Preparation-individuals make commitment to change and initiate plans;
Action -steps taken to implement the plan and adopt the behavior;
Maintenance- the new behavior becomes normative. |
Algorithm
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Do you currently discuss alcohol consumption with each patient who drinks more than the NIAAA suggested limits for at-risk drinking?
(Yes, No)
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Do you intend to discuss alcohol consumption with each patient who drinks more than the NIAAA suggested limits for at-risk drinking in the future?
(Yes, No)
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Do you intend to discuss alcohol consumption with each patient who drinks more than the NIAAA suggested limits for at-risk drinking within the next 30 days?
(Yes, No)
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Have you been discussing alcohol consumption with each patient who drinks more than the NIAAA suggested limits for at-risk drinking for at least 6 months?
(Yes, No)
1- No; 2 – No; 3 – No; 4 – No = Precontemplation 1- No; 2 – Yes; 3 – No; 4 – No = Contemplation 1- No; 2 – Yes; 3 – Yes; 4 – No = Preparation 1- Yes; 2 – Yes; 3 – Yes; 4 – No = Action 1- Yes; 2 – Yes; 3 – Yes; 4 – Yes = Maintenance
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