When pregnant patients disclose substance use

Missed opportunities for behavioral change counseling

Judy C. Chang, Diane Dado, Richard Frankel, Keri L. Rodriguez, Susan Zickmund, Bruce S. Ling, Robert M. Arnold

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: The first obstetric visit is an opportunity to provide counseling to women with substance abuse risks, including smoking, drug use, and alcohol use. Little is known about how obstetric care providers and patients discuss these issues. Our objective was to examine patient-provider communication about substance use behaviors during these visits. Methods: We audio-taped and transcribed verbatim first prenatal visits in an outpatient hospital clinic, then qualitatively analyzed them for content and process of communication using modified grounded theory methods. Results: Twenty-nine providers (21 residents, 5 midwives, 3 nurse practitioners) and 51 patients participated. Twenty-five patients were smokers, 4 used alcohol, and 11 used drugs. Provider responses to smoking disclosures included discussions of risks, encouragement to quit-cut down, affirmation of attempts to quit-cut down, and referral to smoking cessation programs. Responses to alcohol or drug disclosures included only a general statement regarding risks and referral to genetics. Conclusion: Providers were less attentive to alcohol and drugs than smoking where they had pre-established patterns of response. Practice implications: Providers should discuss behavioral change strategies and motivations with pregnant patients who use drugs and/or alcohol as well as those who smoke.

Original languageEnglish
Pages (from-to)394-401
Number of pages8
JournalPatient Education and Counseling
Volume72
Issue number3
DOIs
StatePublished - Sep 2008

Fingerprint

Counseling
Alcohols
Pharmaceutical Preparations
Smoking
Disclosure
Obstetrics
Referral and Consultation
Communication
Hospital Outpatient Clinics
Nurse Practitioners
Midwifery
Smoking Cessation
Smoke
Substance-Related Disorders
Motivation
Patient Care

Keywords

  • Obstetrics
  • Practitioner-patient interaction
  • Prenatal care
  • Qualitative research
  • Risk communication
  • Substance-use

ASJC Scopus subject areas

  • Medicine(all)

Cite this

When pregnant patients disclose substance use : Missed opportunities for behavioral change counseling. / Chang, Judy C.; Dado, Diane; Frankel, Richard; Rodriguez, Keri L.; Zickmund, Susan; Ling, Bruce S.; Arnold, Robert M.

In: Patient Education and Counseling, Vol. 72, No. 3, 09.2008, p. 394-401.

Research output: Contribution to journalArticle

Chang, Judy C. ; Dado, Diane ; Frankel, Richard ; Rodriguez, Keri L. ; Zickmund, Susan ; Ling, Bruce S. ; Arnold, Robert M. / When pregnant patients disclose substance use : Missed opportunities for behavioral change counseling. In: Patient Education and Counseling. 2008 ; Vol. 72, No. 3. pp. 394-401.
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