Determinants for Utilization of Alcohol Use Screening Tool by Nurses at Mathari Hospital, Nairobi City County, Kenya
DOI:
https://doi.org/10.53819/81018102t6019Abstract
The purpose of this study was to evaluate determinants for utilization of alcohol use screening tools by nurses at Mathari Hospital. The study employed analytical cross sectional study design. Participants were practising nurses deployed at Mathari Hospital. 159 respondents formed the sample size. The study utilised simple random sampling. The average age for most nurses was 42 (10.6) years, had 18 (10.6) years’ experience in nursing profession, had 10 (8.1) years’ experience in mental health and psychiatry nursing. Majority (98.1%, 156) of the nurses had cared for a patient with potentially harmful alcohol use and initiated screening for alcohol use on the patient (56.6%, 90). The findings revealed that majority of the nurses were female (76.1%), Christians (97.5%), diploma holders (47.8%), aged was 42 years, 18 years’ experience in nursing profession, and 10 years’ experience in mental health and psychiatry nursing. In addition, education level of nurses was positively and significantly (r=0.164, p=0.039) related with utilization of SBIRT screening tool. The respondents highlighted the following as key enabling factors: Management support (52.8%), motivation (51.6%), Champion (44.7%) and training (44.7%). Management support was positively and significantly (r=0.322, p=0.000) related with utilization of SBIRT screening tool. Identified barriers to utilization of the SBIRT screening tool were nurses’ own alcohol use (44%), competency gaps (32.7%) and lack of knowledge (49.7%). Nurse’s characteristics had a positive and significant influence on the utilization of alcohol use screening tool (β = 0.612, p= 0.000) at 95% confidence interval. Enabling factors had a positive and significant influence on utilization of alcohol use screening tool (β = 0.226, P= 0.061) at 90% confidence interval. Barriers had a negative and significant influence on utilization of alcohol use screening tool (β = -0.261, P= 0.065) at 95% confidence interval. The adjusted R squared (0.243) revealed that jointly, nurses’ characteristics, enabling factors and barriers explain 24.3% of variations in the utilization of alcohol use screening tool. Enabling factors were observed to have a positive and significant relationship with utilization of alcohol use screening tool (r=0.359, P=0.000) at 99% confidence interval. Barriers have a negative and significant relationship with utilization of alcohol use screening tool (r= -0.132, P=0.097) at 95% confidence interval. The three determinants (nurses’ characteristics, enabling factors, and barriers) only explained eighteen percent of changes in utilization of SBIRT suggesting the existence of other factors that may account for changes in utilization of the screening tool.
Keywords: Screening tool, alcohol use, SBIRT, barriers, enabling factors, nurse’s characteristics
References
Babor, T. F., Del Boca, F., & Bray, J. W. (2017). Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA’s SBIRT initiative for substance abuse policy and practice. Addiction, 112(3), 110–117. https://doi.org/10.1111/add.13675
Berglund, M., Thelander, S., & Jonsson, E. (2004). Treating Alcohol and Drug Abuse: An Evidence Based Review. In Treating Alcohol and Drug Abuse: An Evidence Based Review. https://doi.org/10.1002/3527601465
Broyles, L. M., Rodriguez, K. L., Kraemer, K. L., Sevick, M. A., Price, P. A., & Gordon, A. J. (2012). A qualitative study of anticipated barriers and facilitators to the implementation of nurse-delivered alcohol screening, brief intervention, and referral to treatment for hospitalized patients in a Veterans Affairs medical center. Addiction Science and Clinical Practice, 7(1), 1–20. https://doi.org/10.1186/1940-0640-7-7
Derges, J., Kidger, J., Fox, F., Campbell, R., Kaner, E., & Hickman, M. (2017a). Alcohol screening and brief interventions for adults and young people in health and community-based settings: A qualitative systematic literature review. BMC Public Health, 17(1). https://doi.org/10.1186/s12889-017-4476-4
Derges, J., Kidger, J., Fox, F., Campbell, R., Kaner, E., & Hickman, M. (2017b). Alcohol screening and brief interventions for adults and young people in health and community-based settings: A qualitative systematic literature review. BMC Public Health, 17(1), 1–12. https://doi.org/10.1186/s12889-017-4476-4
Donovan, D. M., Bogenschutz, M. P., Perl, H., Forcehimes, A., Adinoff, B., Mandler, R., … Walker, R. (2012). Study design to examine the potential role of assessment reactivity in the Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED) protocol. Addiction Science and Clinical Practice, 7(1), 1–11. https://doi.org/10.1186/1940-0640-7-16
Finn, S. (2018). Alcohol dependence : barriers to treatment and new approaches in primary care. Retrieved from https://openarchive.ki.se/xmlui/handle/10616/46271
Finnell, D. S., Nowzari, S., Reimann, B., Fischer, L., Goplerud, E., Faan, D. N. S. P. C., … Wells, G. K. (2014). Screening , Brief Intervention , and Referral to Treatment ( SBIRT ) as an Integral Part of Nursing Practice., 39(March 2019), 37–41. https://doi.org/10.1080/08897077.2014.888384
Finnell, D. S., Nowzari, S., Reimann, B., Fischer, L., Pace, E., & Goplerud, E. (2014). Screening, brief intervention, and referral to treatment (SBIRT) as an integral part of nursing practice. Substance Abuse, 35(2), 114–118. https://doi.org/10.1080/08897077.2014.888384
Fitzgerald, N., Platt, L., Heywood, S., & McCambridge, J. (2015). Large-scale implementation of alcohol brief interventions in new settings in Scotland: A qualitative interview study of a national programme. BMC Public Health, 15(1). https://doi.org/10.1186/s12889-015-1527-6
Fornili, K. (2019). Nurse-Led Program for the Early Identification of Substance Use Disorders in Primary Care dissertation. Nurse-Led Program for the Early Identification of Substance Use Disorders in Primary Care.
Gitatui, M., Kimani, S., Muniu, S., & Okube, O. (2019). Determinants of harmful use of alcohol among urban slum dwelling adults in Kenya. African Health Sciences, 19(4), 2906–2925. https://doi.org/10.4314/ahs.v19i4.12
Goplerud, Eric, McPherson, T. (2015). Implementation Barriers To and Facilitators of Screening, Brief Intervention, Referral, and Treatment (Sbirt) in Federally Qualified Health Centers (Fqhcs). (March).
Hargraves, D., White, C., Frederick, R., Cinibulk, M., Peters, M., Young, A., & Elder, N. (2017). Implementing SBIRT (Screening, Brief Intervention and Referral to Treatment) in primary care: Lessons learned from a multipractice evaluation portfolio. Public Health Reviews, 38(1), 1–8. https://doi.org/10.1186/s40985-017-0077-0
Hellum, R., Bjerregaard, L., & Nielsen, A. S. (2016). Factors Influencing whether Nurses Talk to Somatic Patients about their Alcohol Consumption. NAD Nordic Studies on Alcohol and Drugs, 33(4), 415–436. https://doi.org/10.1515/nsad-2016-0034
Journal, E., & Issn, M. (2011). Drinking Culture and Alcohol Management in Kenya: An Ethical Perspective. European Journal of Business and Management, 3(4), 132–146. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.923.5700&rep=rep1&type=pdf
Keen, A., & Newhouse, R. (n.d.). Descriptive Evaluation of SBIRT Adoption , Implementation , and Delivery across a Health System. 1–14.
Mellor, D., McCabe, M., Ricciardelli, L. A., Brumby, S., Head, A., Mercer-Grant, C., & Kennedy, A. (2013). Evaluation of an alcohol intervention training program for nurses in rural Australia. Journal of Research in Nursing, 18(6), 561–575. https://doi.org/10.1177/1744987112465883
Ministry Of Health. (2017). The national protocol for treatment of substance use disorders in kenya 2017. The National Protocol for Treatment of Substance Use Disorders in Kenya 2017, 3–4.
Muthoni, M. G. (2016a). Effects of alcohol and drug abuse training on attitude owards Alcohol Screening And Brief Intervention among Nurses at Embu Level Five Hospital.
Muthoni, M. G. (2016b). Effects Of Alcohol And Drug Abuse Training On Attitude Towards Alcohol Screening And Brief Intervention Among Nurses At Embu Level Five Hospital.
Ndegwa, S. (2017). Factors influencing Alcohol Use among University Students in a Kenyan University Stephen Ndegwa, PhD., Alice Munene, PsyD., and Rebecca Oladipo, PhD., Daystar University. Journal of African Clinical Psychology, 1, 102–117.
Neft, M. W., Mitchell, A. M., Puskar, K., Fioravanti, M., Hagle, H., Lindsay, D., & O’Donnell, J. M. (2018). Interprofessional education for teaching Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use. Journal of Interprofessional Education and Practice, 10, 12–14. https://doi.org/10.1016/j.xjep.2017.10.004
New Hampshire Charitable Foundation. (2016). Screen and Intervene: SBIRT Play Book. www.nhcent(October).
Ozechowski, T. J., Becker, S. J., & Hogue, A. (2016). SBIRT-A: Adapting SBIRT to Maximize Developmental Fit for Adolescents in Primary Care. Journal of Substance Abuse Treatment, 62(2016), 28–37. https://doi.org/10.1016/j.jsat.2015.10.006
Prendergast, M. L., & Cartier, J. J. (2013). Screening, brief intervention, and referral to treatment (SBIRT) for offenders: Protocol for a pragmatic randomized trial. Addiction Science and Clinical Practice, 8(1), 1–10. https://doi.org/10.1186/1940-0640-8-16
WHO. (2018). Global status report on alcohol and health 2018. In Global status report on alcohol (Vol. 65). https://doi.org/10.1037/cou0000248