Aims: To provide insight into patient experiences of a general hospital-based alcohol specialist nurse intervention during alcohol detoxification, experiences of alcohol specialist nurse hospital-based follow-up appointments (Pathway A) as well as the experiences of patients who did not have access to this additional help post detoxification (Pathway B).
Design: A longitudinal qualitative study.
Methods: A thematic analysis of semi-structured interviews (2016-2017) with 24 patient participants (N = 12 in each pathway; purposive selection) 1-4 weeks post-detoxification and at 3 and 6 months, to identify patient experiences of these interventions.
Results: Participants gave accounts of how 'empathic' and 'straight talking' interactions with alcohol specialist nurses during detoxification helped them to 'open up' and orient towards change. After detoxification follow-up, outpatient appointments in the hospital setting were seen as supporting change in early recovery and engagement with a wider range of services. Those with no access to nurse follow-up described experiencing a 'void' in available help. Participants in both groups described barriers to engagement with community alcohol services, peer groups and access to help for mild-moderate mental health problems.
Conclusion: Patient accounts indicate alcohol specialist nurse interventions during and after unplanned detoxification in a hospital setting can help orient patients towards change and support early recovery.
Impact: Providing alcohol specialist nurse interventions in general hospitals offers one route to initiating recovery in alcohol-dependent patients. This has potential to improve the lives of those affected and to reduce related demands on hospital services, but further research is needed.
目的: 深入了解酒精戒毒期间, 综合医院酒精专科护士对患者采取的干预措施, 综合医院酒精专科护士随访坐诊的经历 (途径A) 以及未获得此类额外援助的患者的戒毒后经历 (途径B) 。 设计: 一项纵向定性研究。 方法: 开展主题分析, 对戒毒后1-4周、3个月和6个月的24名病患参与者进行半结构化访谈 (2016年-2017年) , 以确定患者对此类干预措施的体验。 结果: 参与者讲述戒毒期间其与酒精专科护士的“同理经历”和“直接”互动, 以及此类互动如何帮助其“敞开心扉”并适应相关变化。如果在戒毒随访后预约医院门诊, 即可视为支持早期康复变更和参与更广泛的服务。无法获得护士随访的患者表示, 尽管已获得帮助, 其内心仍感觉“空虚”。两组参与者都对参与社区酒精服务、同龄人群体和获得轻度-中度精神健康问题援助时遇到的障碍进行描述。 结论: 据患者描述, 如已在医院进行计划外解毒, 则在此期间和之后, 酒精专科护士可采取干预措施, 以帮助患者适应改变并对其早期康复予以支持。 影响: 酒精专科护士在综合医院内部采取干预措施, 从而帮助酒精依赖患者康复。此做法可能改善受影响者的生活, 减少对医院服务的相关需求, 然而, 仍应进一步展开研究。.
Keywords: advanced practice; alcohol specialist nurse; alcohol treatment; alcoholism; care pathways; clinical nurse specialist; nurse interventions; nurse-patient relationships; nursing; patient perspectives.
© 2021 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd Ltd.