Adolescent alcohol use and misuse The influence of perceived family socialization factors

SIGLEAvailable from British Library Document Supply Centre-DSC:DX209988 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Clinical guideline for nurse-led early extubation after coronary artery bypass: an evaluation.

AIM: This paper is a report of an investigation of the development, implementation and outcomes of a clinical guideline for nurse-led early extubation of adult coronary artery bypass graft patients. BACKGROUND: Healthcare knowledge translation and utilization is an emerging but under-developed research area. The complex context for guideline development and use is methodologically challenging for robust and rigorous evaluation. This study contributes one such evaluation. METHODS: This was a mixed methods evaluation, with a dominant quantitative study with a secondary qualitative study in a single UK cardiac surgery centre. An interrupted time series study (N = 567 elective coronary artery bypass graft patients) with concurrent within person controls was used to measure the impact of the guideline on the primary outcome: time to extubation. Semi-structured interviews with 11 clinical staff, informed by applied practitioner ethnography, explored the process of guideline development and implementation. The data were collected between January 2001 and January 2003. RESULTS: There was no change in the interrupted time series study primary outcome as a consequence of the guideline implementation. The qualitative study identified three themes: context, process and tensions highlighting that the guideline did not require clinicians to change their practice, although it may have helped maintain practice through its educative role. CONCLUSION: Further investigation and development of appropriate methods to capture the dynamism in healthcare contexts and its impact on guideline implementation seems warranted. Multi-site mixed methods investigations and programmes of research exploring knowledge translation and utilization initiatives, such as guideline implementation, are needed

Adolescent alcohol use and family influences: attributive statements by teenage drinkers

Although it is now well established that the majority of young people are introduced to alcohol within the family, further understanding is needed of teenagers' own perceptions of drinking behaviour. As part of a large scale regional survey, young people reported on aspects of their drinking behaviour. This article presents the results of a qualitative analysis of detailed attributive statements made by one randomly chosen group of 15–16-year-olds. These statements were made at the end of a questionnaire about young people, alcohol and family life, and the statements reflect these issues. On the whole, this sample of adolescents reported drinking sensibly and appropriately, and did not see their drinking as a deviant behaviour. They also commented on several important intra-familial factors. The positive role of parental knowledge and sanction, and also of appropriate parental and family drinking, seem important for the development of sensible adolescent alcohol use. Furthermore, the potential negative influence of poor family relationships was highlighted. These family factors are consistent with quantitative data supporting the family socialization theory of adolescent alcohol use. Family social learning and family process seem to be important influences on adolescent alcohol use, and may provide an important base and focus for alcohol education, intervention and treatment strategies

Age differences in alcohol prototype perceptions and willingness to drink in UK adolescents

Using the prototype willingness model (PWM) as a framework, this study sought to explore the relationship between prototype perceptions, willingness and alcohol consumption in a sample of adolescents in the United Kingdom (UK). Adolescents aged 11–17 were asked about their alcohol prototype perceptions, willingness to drink, intentions, alcohol consumption, drunkenness and harms using a cross-sectional online survey. Participants were recruited through opportunity sampling via schools and parents. The survey was completed by 178 respondents (51% female; 91 aged 11–15, 87 aged 16–17). Multivariate analysis revealed significant differences between participants aged 11–15 and 16–17 on PWM measures, even when experience with drinking was accounted for (p < .001). There were significant interactions (p < .001) between age and prototype perceptions; younger participants rated non-drinker prototypes as more favourable and more similar to the self than 16- and 17-year-old participants. Willingness and intentions interacted with age; both measures were similar in 16- and 17-year-olds, whereas younger participants scored significantly higher on willingness than intentions (p < .001). Three distinct scales of prototype descriptions were identified in principal components analysis. Characteristics related to sociability significantly predicted willingness to drink alcohol in the sample (p < .001). This study extends previous research by demonstrating that the PWM can provide a theoretical explanation of adolescent drinking in the UK. The results suggest that 11- to 15-year-olds may be the most suitable age for an intervention that targets alcohol prototypes, with a focus on sociability characteristics

Substance use and young people: the potential of technology

There is widespread concern about alcohol and drug use and abuse among young people in the United Kingdom, Europe and the United States. Evaluations of current drug and alcohol education approaches have mixed findings and some methodological difficulties. This paper reports on exploratory research to explore the potential of technology to provide information and support to young people regarding substance use and abuse. Eight focus groups were conducted with young people (n = 78) and three with key informants (n = 22). The findings revealed that technology has potential to provide information on this topic, and that young people are critical of some of the more traditional methods of provision. The young people were prepared to experiment with technology, felt competent to do so, and made suggestions of information they would like. These findings are discussed and recommendations made for future research in the area