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Gepubliceerd in: Verslaving 2/2014

01-06-2014 | Methodiek in praktijk

Met vallen en opstaan: alcohol aanpakken op de spoed

Auteurs: David Möbius, Tom Defillet, Koen Titeca, Geert Gunst, Karolina Kindt, Bart Rens

Gepubliceerd in: Verslaving | Uitgave 2/2014

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Samenvatting

Deze bijdrage beschrijft de ervaringen en resultaten van een proefproject waarbij op basis van wetenschappelijke literatuur een interventie werd ontwikkeld voor alcoholgebruik bij patiënten die zich aanmelden op de spoeddienst van een algemeen ziekenhuis. Deze interventie bestaat uit een screening, een kort feedbackgesprek en een eventuele doorverwijzing naar de alcohol- en drugshulpverlening (SBIRT). Het proefproject toonde aan dat er heel wat factoren zijn die de implementatie van dergelijke interventies kunnen belemmeren. Het gaat dan om zowel organisatorische, personeels- als patiëntgerelateerde factoren. Sensibiliseren van het spoedpersoneel over het nut en de meerwaarde van screening en kortdurende interventies op spoeddiensten vormt hiertoe een eerste stap.
Voetnoten
1
Recentelijk werden in Den Haag de resultaten gepresenteerd van een random gecontroleerd onderzoek bij meer dan twintigduizend gescreende patiënten bij de spoedeisende hulp van Medisch Centrum Haaglanden, dat aantoonde dat een korte interventie bij mensen met een hoge AUDIT-score een sterk effect had op de alcoholconsumptie na drie maanden. Zie https://​www.​mchaaglanden.​nl/​home/​laatste-nieuws/​goede-resultatenalcoho​lscreening-op-seh-van-mch-westeinde.​htm.
 
2
De inhoud van de meeste kortdurende interventies is samen te vatten met het acroniem FRAMES (Miller & Rollnick, 2002; Van Emst, 1997): Feedback, Responsibility, Advice, Menu, Empathy en Self-efficacy.
 
3
De eerste drie vragen van het ontwikkelde instrument zijn afkomstig uit de AUDIT-C, een verkorte vragenlijst die gebaseerd is op de volledige AUDIT. De AUDIT bestaat uit tien vragen en werd door de World Health Organization ontwikkeld en gevalideerd. Zowel de AUDIT als de AUDIT-C werden getest in spoeddiensten. De AUDIT-C wordt als een van de beste korte instrumenten beschreven. Een nadeel van de AUDIT-C is echter dat valspositieven niet uitgesloten kunnen worden. De Paddington Alcohol Test (PAT) werd ontwikkeld in 1996 en is pragmatisch gegroeid tot een instrument bruikbaar voor het personeel van spoedafdelingen om patiënten te screenen op hun alcoholgebruik. De PAT is een hulpmiddel om de link te leggen tussen de reden van aanmelding op de spoedafdeling en alcoholmisbruik. Eerder onderzoek toont aan dat het maken van deze link ervoor zorgt dat minder patiënten zich later opnieuw moeten aanmelden op de spoedafdeling. Nadeel voor gebruik van de PAT is dat deze speciaal ontwikkeld werd voor gebruik in Groot-Brittannieë. Consumptiehoeveelheden zijn bijvoorbeeld uitgedrukt in ‘cans’ of ‘pints’, wat het scoren moeilijk maakt in Belgische context. Daarom werd de PAT enigszins aangepast, om gebruik in de Belgische context mogelijk te maken (Modified Paddington Alcohol Test ofwel M-PAT).
 
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Metagegevens
Titel
Met vallen en opstaan: alcohol aanpakken op de spoed
Auteurs
David Möbius
Tom Defillet
Koen Titeca
Geert Gunst
Karolina Kindt
Bart Rens
Publicatiedatum
01-06-2014
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Verslaving / Uitgave 2/2014
Print ISSN: 1574-1842
Elektronisch ISSN: 1875-7073
DOI
https://doi.org/10.1007/s12501-014-0015-5

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Verslaving 2/2014 Naar de uitgave