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Primärvårdsanställdas arbete enligt Nationella riktlinjer för missbruks och beroendevård. : En utvärdering på hälsocentraler i Kalmar län.

  • Magnusson, Katarina
  • Benderix, Ylva
  • Denvall, Verner
Publication Date
Jan 01, 2012
DiVA - Academic Archive On-line
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Evaluation of managers, primary care physicians and health coordinators work adapted to the National guidelines for substance abuse and addiction treatment was carried out 2012 in health centers in KalmarCounty in Sweden. The evaluation was funded by the Regional Council in KalmarCounty and implemented by LinnaeusUniversity. The evaluation aims to describe operations managers, primary care physichians and health coordinators principles and norms, using the National Guidelines for abuse and addiction treatment. Recommendations in the National guidelines to the swedish primary health care is to meet patients with risk use of alcohol and drugs with motivational interviewing. The aim is to support patients to change their habits towards a healthier lifestyle. Data collection consisted of questionnaires to operations managers and interviews with doctors and health coordinators, ie nurses with specialized training in the field. Questions were designed based on the guidelines witch are advisory in the field: the National Guidelines for substance abuse and addiction care (National Board of Health, 2007) and the regional guidelines (2010) for primary care, health centers in Kalmar County. The guidelines focus on the identification, counseling and treatment to patients at risk and abuse of alcohol and drugs. The results presented will include: Operations managers at KalmarCounty health centers experience that they have not received training in the National Guidelines to the extent they would need. Operations managers found that patients with risk and substance abuse to a greater extent are social service responsibilities, but partly also the primary care responsibilities. Doctors and health coordinators mean that it is the responsibility of health care to detect patients with risk drinking and to help patients with hazardous drinking or drug use to find the best place for treatment and care. Few managers, doctors and health coordinators knew the guidelines' recommendations for health center patients. Despite this, several health centers use procedures for the identification and treatment based on the guidelines recommendations. Some health centers offered staff training in MI, Motivational interview and used screening instruments, including alcohol consumption questions. Only health coordinators routinely used screening instruments, they were the only profession trained in this. Doctors experienced that they did not have time enough and also that it would interfere with the patients´ integrity to question them about alcohol consumption. Biological markers and screening instruments were used frequently in most health centers, and more than 50% of them were offering Motivational interviews, Relapse prevention and Cognitive behavioral therapy to the patients. Proposal for improvement area based on the results: Continued education about early detection of hazardous according to the National Guidelines for managers, doctors and health coordinators. Mandate issue for busines managers should be discussed, because prerequisites for implementation are dependent on the manager's mandate. Tutorials, method support including training to question patients about their alcohol consumption may be implemented at network meetings. Method Support / training in the use of screening instruments, lifestyle questionnaires and surveys that can facilitate on issues perceived to be taboo, such as the patient's alcohol consumption. A policy that clarifies responsibilities, which should do what when it comes to alcohol issues. Increase collaboration and delegation between health coordinators and doctors but also to another profession on some health centers, alcohol therapists. Education / training / house training on the relationship between alcohol and somatic consequences.

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