Perceptions of problem-drinker patients' family members about their own hazardous-drinking behaviours in Chinese general hospitals: a qualitative study

Predicting Hazardous Alcohol Drinking Behaviors in Family Members of Hazardous Alcohol-Drinker Patients

Family members of hazardous or harmful alcohol drinkers suffer many consequences of their relative’s alcohol-drinking behaviors and risk developing their own hazardous alcohol drinking behaviors. Studies of alcohol-related healthcare problems have mainly focused on patients, with few studies on their family members. This cross-sectional study explored factors predicting hazardous alcohol drinking behaviors in family members of hazardous alcohol-drinker patients. Participants were recruited from four randomly chosen hospitals in Taiwan. Data were collected using self-report questionnaires on family members’ alcohol use, perceived stress, coping mechanisms, social support, health, quality of life, protective factors against hazardous alcohol drinking, facilitative factors for hazardous alcohol drinking, and demographics. The 318 family members who participated in this study were divided by their Chinese-version Alcohol Use Disorders Identification Test scores into two groups: hazardous alcohol drinkers (score ≥ 8) and non-hazardous alcohol drinkers (score < 8). Significant factors predicting hazardous alcohol drinking behaviors were found by logistic regression to be the frequency of using general coping mechanisms (OR = 1.29, p < 0.01), the frequency of using strategies to cope with patients’ drinking-related behaviors (OR = 0.89, p < 0.01), factors protecting against hazardous alcohol drinking (OR = 0.76, p < 0.01) and factors facilitating hazardous alcohol drinking (OR = 1.52, p < 0.01). Interventions should be designed for family members of hazardous alcohol drinkers to address these four significant predictors.

Screening, Diagnosis, and Management of Patients With Alcohol Use Disorders at Bwindi Community Hospital, Uganda

Introduction: The harmful use of alcohol is a growing global public health concern, with Sub-Saharan Africa at particular risk. A large proportion of adults in Uganda consume alcohol and the country has a high prevalence of alcohol use disorders (AUD), almost double that for the African region as a whole. Bwindi Community Hospital, in rural western Uganda, recently introduced a program of screening, diagnosis and management of AUD and we assessed how this worked.

Methods: This was a cross-sectional study in three departments (out-patients, adult in-patients and sexual & reproductive health) of Bwindi Community Hospital assessing numbers of patients screened, diagnosed and treated with AUD between January 2014 and June 2017. Data sources included the hospital electronic data base and departmental case files. Frequencies and proportions are reported and odds ratios used to compare specific factors associated with medical interventions.

Results: Altogether, 82,819 patients attended or were admitted to hospital, of whom 8,627 (10.4%) were screened and 273 (3.2%) diagnosed with AUD. The adult in-patient department recorded the largest number with AUD (n = 206) as well as a consistent increase in numbers in the last 18 months of the study. Of those with AUD, there were 230 (84%) males, 130 (48%) aged 36–60 years, and 131 (48%) with medical non-alcohol related diagnostic categories. Medical/supportive interventions included guidance and counselling to 168 (62%), community social support to 90 (33%), mental health service referrals for 75 (27%), detoxification for 60 (22%) and referral to Alcoholics Anonymous for 41 (15%). There were 36 (15%) patients who received no medical/supportive interventions, with significantly higher proportions in patients with surgical alcohol-related disease and pregnancy-related conditions (P < 0.05).

Conclusion: Bwindi Community Hospital has implemented a program for AUD in three departments, with most individuals screened and managed in the adult in-patient department. While a variety of interventions were given to those with AUD, 15% received no intervention and this deficiency must be addressed. Program performance could improve through better screening processes, ensuring that 100% of those with AUD receive a medical/supportive intervention and raising public awareness.