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1.
OBJECTIVE: To identify perceived needs among nurses in providing their patients with smoking cessation support in a Japanese hospital. SUBJECTS: Thirty-three female nurses who were interested in providing their patients with smoking cessation support in the hospital setting participated in focus group interviews. They conducted six focus group interviews segmented by age, working conditions (e.g., outpatient or inpatient sections) and occupational class (e.g., administrative post or not). DESIGN: An experienced researcher moderated two focus groups and another researcher who received training moderated four focus groups. At least two observers hand-recorded participants' conversations in each group and all groups were also tape-recorded. Moderators and observers analyzed the focus group data together. RESULTS: We found that smoking cessation counseling or health education on effects of smoking to be rarely conducted in the hospital. The study participants ordinarily just told patients to stop smoking. They mentioned several barriers to conducting smoking cessation support and suggested a number of ideas to promote this aim in the hospital. CONCLUSIONS: The focus group interview is an effective means to determine the needs and interests of Japanese health professionals. Nurses have many opinions and insights for supporting smoking patients. To introduce a smoking cessation program into hospitals, there are various problems that should be solved. First, nurses and other health professionals should have accurate knowledge, positive attitudes and appropriate skills for smoking cessation support. Second, smoking cessation support should be programmed as part of treatment or nursing. Third, healthcare professionals, especially doctors, should collaborate in supporting patients to stop smoking. Fourth, the hospital environment should be modified to promote smoking cessation. Finally, hospitals should develop a consensus among all staff about the importance of smoking cessation support and smoking control activities. As the result, multidimensional strategies are needed to effectively promote smoking cessation support in the hospital setting.  相似文献   

2.

Aim

The aims of this study were to examine tobacco use prevalence, knowledge and attitudes, and tobacco cessation training among students attending Italian medical schools using the Global Health Professions Student Survey approach and to identify possible factors associated with smoking status.

Subjects and Methods

A multicentre cross-sectional pilot study was carried out in five Italian Schools of Medicine from March to April 2009. Questionnaires were administered in anonymous, voluntary and self-administered form to third year students attending medical schools. The outcome measure was ??being a current smoker??. A logistic regression was used to evaluate possible factors associated with smoking status.

Results

The prevalence of current smokers was 31.4%. More than half considered health professionals as models for patients, and around 90% thought health professionals have a role in giving advice or information about smoking cessation. Only 5.8% of responders had received smoking cessation training during medical school. Medical students who considered healthcare professionals as behavioural models had lower likelihood of smoking (OR?=?0.52).

Conclusions

Given the high prevalence of smokers among medical students and the poorness of smoking cessation programmes, it is important to create tobacco control training programmes addressed to healthcare students.  相似文献   

3.
OBJECTIVE--To assess the effectiveness of interventions that train healthcare professionals in methods for improving the quality of care delivered to patients who smoke. DESIGN--Systematic literature review. SETTING--Primary care medical and dental practices in the United States and Canada. Patients were recruited opportunistically. SUBJECTS--878 healthcare professionals and 11,228 patients who smoked and were identified in eight randomised controlled trials. In each of these trials healthcare professionals received formal training in smoking cessation, and their performance was compared with that of a control group. MAIN MEASURES--Point prevalence rates of abstinence from smoking at six or 12 months in patients who were smokers at baseline. Rates of performance of tasks of smoking cessation by healthcare professionals, including offering counselling, setting dates to stop smoking, giving follow up appointments, distributing self help materials, and recommending nicotine gum. METHODS--Trials were identified by multiple methods. Data were abstracted according to predetermined criteria by two observers. When possible, meta-analysis was performed using a fixed effects model and the results were subjected to sensitivity analysis. RESULTS--Healthcare professionals who had received training were significantly more likely to perform tasks of smoking cessation than untrained controls. There was a modest increase in the odds of stopping smoking for smokers attending health professionals who had received training compared with patients attending control practitioners (odds ratio 1.35 (95% confidence interval 1.09 to 1.68)). This result was not robust to sensitivity analysis. The effects of training were increased if prompts and reminders were used. There was no definite benefit found for more intensive forms of counselling compared with minimal contact strategies. CONCLUSIONS--Training health professionals to provide smoking cessation interventions had a measurable impact on professional performance. A modest, but non-robust, effect on patient outcome was also found, suggesting that training alone is unlikely to be an effective strategy for improving quality of care, unless organisational and other factors are also considered.  相似文献   

4.
Tobacco-related disease is estimated to cost the NSW health system more than $476 million in direct health care costs annually. Population-based smoking-cessation interventions, including brief intervention by health professionals, are effective and cost effective. As the prevalence of smoking in the general community declines, more highly dependent 'treatment-resistant' smokers may present a challenge to the health system. International guidelines recommend that health systems invest in training for health professionals in best practice smoking cessation. As part of the NSW Tobacco Action Plan 2005-2009, NSW Department of Health developed national competency standards in smoking cessation, designed learning and assessment materials and delivered training to more than 300 health professionals via video conference. Building the capacity of the NSW Health workforce to address smoking cessation as part of their routine practice is essential for addressing future challenges in tobacco control.  相似文献   

5.
目的了解北京市某三甲医院创建无烟医院十余年后医务人员的吸烟状况及控烟态度和临床医务人员简短戒烟干预情况,为今后医务人员控烟干预提供参考依据。方法于2017年7月采用整群抽样方法在北京市某三甲医院抽取2141名在职医务人员进行问卷调查。结果北京市某三甲医院调查的2141名医务人员中,吸烟者49人,吸烟率为2.3%;医务人员同意"应该在医院所有范围内禁止吸烟"、"医生应该是不吸烟的榜样"、"医生应主动向患者提供戒烟服务"和"吸烟成瘾是一种慢性疾病"的比例分别为96.2%、91.4%、87.7%和94.5%。1687名临床医务人员中,有63.1%的临床医务人员出诊时经常主动询问患者的吸烟情况,有82.5%的临床医务人员在知晓患者吸烟时经常建议吸烟患者戒烟,有44.6%的临床医务人员知晓医院门诊处方传送系统新增戒烟干预模块。结论北京市某三甲医院建设无烟医院十余年初见成效,医务人员吸烟率较低,控烟态度较好,但仍需采取措施加强临床医务人员简短戒烟干预的行动力。  相似文献   

6.

Background

Smoking is a major risk factor for death-related diseases. Not all healthcare professionals are following evidence-based guidelines for smoking cessation counseling in primary care settings. The WHO, Framework Convention on Tobacco Control (FCTC), and United States Public Health Service (USPHS) guidelines recommend that all healthcare professionals, including students in healthcare training programs, receive education in the management of tobacco use and dependence.

Objective

To evaluate the effect of training programs for primary healthcare physicians on the knowledge, attitude, and practice of smoking cessation counseling.

Methods

This was a pre-post intervention study. The study included 74 primary care physicians working in primary healthcare centers affiliated with the Ministry of Health and Suez Canal University Hospitals in Port Said City. The study was conducted between June 2015 and March 2016 using a structured questionnaire and observation checklist to assess counseling of patients willing to quit smoking.

Results

There were highly statistically significant improvements in the physicians’ median scores of knowledge (30%–80%), attitude (65% -100%), and practice (20%–70%) (p?<?0.001) pre-post intervention. The most frequent correct knowledge was consequences of smoking (73%–87.3%) (p?<?0.001) pre-post intervention. The most favorable attitude was the importance of smoking cessation (70.3%–100%) (p?<?0.001) pre-post intervention. The best observed correct practice was asking about smoking (70.3%–100%) (p?<?0.001) pre-post intervention.

Conclusion

Knowledge, attitude, and practice skills regarding smoking cessation counseling among primary healthcare physicians were markedly improved after implementation of the education program.
  相似文献   

7.
黑龙江省医务人员吸烟相关情况调查   总被引:2,自引:0,他引:2  
目的了解医务人员吸烟和被动吸烟情况及医务人员提供戒烟服务的能力,为提高卫生工作者的控烟工作能力制定合理的培训计划。方法采用整群分层抽样的方法对12家1054名医务人员进行问卷调查,对所得资料进行分析。结果男性医务人员现在吸烟人数为93人,现在吸烟率为30.6%;吸烟年龄在10年以上者45人(48.4%);戒烟成功人数为18人,占男性医务人员5.9%;93名吸烟男性中,近期有戒烟打算的只有43人(46.2%)。遭受被动吸烟的人有666人(63.2%),男性和女性分别为226人和440人。对吸烟、被动吸烟与疾病关系的知晓情况较好,但对烟草知识正确认知情况较差,各级别医院的知晓情况各不相同,在对烟草知识、吸烟与疾病、被动吸烟与疾病项目中,一级医院知晓率最高,分别为73.1%、93.7%、93.5%;其次为二级医院,分别是63.6%、86.0%、92.1%;最低的是三级医院,分别为60.4%、84.2%、89.4%。随着医院级别增高,知晓率反而降低。在472名出诊的业务科室人员中,253名业务科室人员表示出诊时经常询问病人的吸烟情况,有442人会建议吸烟病人戒烟。结论应加强对医务人员控烟知识及戒烟帮助方法的普及与培训。  相似文献   

8.
BackgroundTobacco smoking rates are significantly higher in people with common mental illness compared to those without. Smoking cessation treatment could be offered as part of usual outpatient psychological care, but currently is not.ObjectiveTo understand patient and health care professionals'' views about integrating smoking cessation treatment into outpatient psychological services for common mental illness.DesignQualitative in‐depth interviews, with thematic analysis.ParticipantsEleven Improving Access to Psychological Therapies (IAPT) psychological wellbeing practitioners (PWPs), six IAPT patients, and six stop smoking advisors were recruited from English smoking cessation, and IAPT services.ResultsPatients reported psychological benefits from smoking, and also described smoking as a form of self‐harm. Stop smoking advisors displayed therapeutic pessimism and stigmatizing attitudes towards helping people with mental illness to quit smoking. PWPs have positive attitudes towards smoking cessation treatment for people with common mental illness. PWPs and patients accept evidence that smoking tobacco may harm mental health, and quitting might benefit mental health. PWPs report expertise in helping people with common mental illness to make behavioural changes in the face of mood disturbances and low motivation. PWPs felt confident in offering smoking cessation treatments to patients, but suggested a caseload reduction may be required to deliver smoking cessation support in IAPT.ConclusionsIAPT appears to be a natural environment for smoking cessation treatment. PWPs may need additional training, and a caseload reduction. Integration of smoking cessation treatment into IAPT services should be tested in a pilot and feasibility study.Patient or public contributionService users and members of the public were involved in study design and interpretation of data.  相似文献   

9.
This article describes the health effects of smoking and smoking cessation. The doctor’s office provides advantages for the counseling and treatment of smokers, such as continuous patient contacts, the option to address smoking in the context of smoking-related diseases, ubiquitous and low-threshold access to health care, therefore, offering equal access to lower socioeconomic classes. However, barriers exist for the implementation of smoking-related counseling in private practice due to the lack of reimbursement, insufficient qualification, lack of available time as well as lack of patients’ motivation. Moreover, in the German healthcare system tobacco dependency has not yet been acknowledged as a treatment-demanding disease. Existing obstacles should be overcome by adjustment of reimbursement schemes for private practice and hospitals as well as reimbursement for smoking cessation medication proven to be effective for tobacco-dependent smokers. The German Medical Association has established a training program for doctors who want to become active in smoking cessation and has developed printed material for the counseling of smokers in private practice.  相似文献   

10.
Summary Objectives: To collect information from third year medical students attending Croatian medical schools on prevalence of cigarette smoking and other tobacco use, exposure to secondhand smoke, desire to quit using tobacco, attitudes and training concerning counselling patients on tobacco cessation. Methods: Global Health Professionals Survey (GHPS) was conducted in 2005 in all four Croatian medical schools with a census of third year medical students (404 out of 409, response rate 98.5 %) using an anonymous, confi dential and self-reported questionnaire. Results: More than two thirds (67.4 %) of medical students in Croatia have ever smoked cigarettes, and over one third (36.6 %) are smoking cigarettes currently. Half of the medical students (50.4 %) report exposure to second hand smoke at home. Less than a third of current smokers (30.9 %) have received cessation assistance when they tried to quit. Conclusions: Our findings indicate significant tobacco use among medical students in Croatia. There is an urgent need to reduce this harmful behaviour through more comprehensive public health initiatives, provision of support for cessation among health professionals who smoke and provision of training to health professionals to assist their patients with cessation. Submitted: 09 February 2007; Revised: 06 June 2007; Accepted: 03 January 2008  相似文献   

11.
王彦  白丽霞  赵静  孙培源 《现代预防医学》2007,34(22):4334-4336
[目的]了解北京市海淀区医务人员吸烟和控烟能力现状,为开展医务人员戒烟活动,提高控烟服务能力提供科学依据。[方法]采用系统抽样方法,调查6家医院的医务人员。[结果]现吸烟率9.7%,男性吸烟率39.8%。吸烟者主要是临床一线的中年医生,且为中、高级职称的医院内业务骨干。43.3%的医务人员在吸烟区吸烟。71.2%的医务人员没有接受过戒烟方面的培训。大多数的医务人员对控烟态度积极。27.9%的医务人员能根据患者的吸烟情况为其制定戒烟计划。87.9%的医务人员提醒过吸烟的患者戒烟,但吸烟的医务人员提醒患者戒烟的比例低于从不吸烟的医务人员。[结论]开展控烟系列培训提高医务人员整体的控烟能力。运用行政干预与健康教育相结合的手段促使吸烟的医务人员戒烟。  相似文献   

12.
The aim of the post-graduate degree course on tobacco and smoking cessation is to train professionals who have dedicated themselves to the fight against tobacco and smoking. An educational assessment of the degree programme was carried out in order to evaluate its impact on practice. A questionnaire was mailed to 60 students registered in the programme at Strasbourg University between 1997 and 2002 (with a response rate of 71.6%). The evaluation was able to shed light on the strengths and weaknesses of the teaching in the programme and the level of student satisfaction. The tobacco control and smoking cessation interventions of the students before and after completing the course were compared in order to assess the impact on their professional practice. The programme's participants came from a variety of professions including medical doctors (74.4%), paramedical staff (16.3%) and other professions (6.9%). The students acknowledged the course's high level of quality (the teachers were appreciated, and the programme was comprehensive). The structure of the course was operational; however, the students admitted that they felt that the practical application and the interactive aspects of the learning (such as case studies, role playing, training in a specific smoking cessation intervention were insufficient. They also noted a lack of emphasis on treatments that do not rely on pharmacotherapy such as behavioural therapy and psychological support. Tobacco cessation related problems or side effects of quitting like weight gain, anxiety or insomnia were not appropriately developed. The majority of students were very satisfied with the theoretical basis of the curriculum and with their internship in a tobacco cessation consultation intervention. Today, 69% of the students trained are working in smoking cessation and tobacco control. They have been able to diversify their activities, going from prevention to tobacco cessation, and vice versa. Course tracks focusing on pregnant women, adolescents and behavioural therapies have now been introduced into the degree programme. In terms of further investing in the improvement of skills and competencies, the programme could better respond to the students' needs by taking into account the development of interactive teaching methods such as role playing and workshops.  相似文献   

13.
14.
目的:调查甘肃省医疗卫生机构从业人员控烟相关知识、态度、行为现状,分析其在创建无烟医疗卫生系统和参与、引领社会控烟等方面作用的发挥及其存在的问题,为进一步开展医疗卫生专业机构控烟工作与完善控烟策略提供依据。方法:采用分层整群抽样的方法确定34家医疗卫生机构,使用自行设计的问卷,对各级各类医疗卫生机构从业人员进行现场自填法调查其控烟相关的知识、态度、行为。结果:甘肃省医疗卫生从业人员对烟草危害缺乏深度和广度认识,虽在控烟态度上较积极,但控烟的综合服务能力不足,对受众戒烟帮助的方式方法欠规范。Logistic回归分析显示,影响医务人员控烟能力的主要因素为自身吸烟情况、劝阻吸烟行为、询问吸烟情况。结论:对医疗卫生从业人群进行针对性的烟草知识和戒烟技能培训,降低该人群吸烟率,增强行政后勤管理人员控烟意识,是建设无烟医疗卫生系统、引领社会控烟的关键环节。  相似文献   

15.
Healthcare settings provide a major arena for administering smoking cessation interventions. However, few studies have reported differences in the frequency of practice in healthcare professionals by gender and smoking status. This might also be influenced by a difference in smoking prevalence by gender, especially in China and other developing countries. This study examined factors associated with the frequency of cessation intervention practices by smoking status among Chinese physicians in men and women. A cross-sectional survey was conducted in 2006 in physicians with direct patient contact from nine hospitals in Guangzhou with a response rate of 60.8%. Significantly more female physicians who were non-smokers (79.7%) reported "initiation and/or advice" smoking cessation interventions than male physicians who were smokers (71.2%) and non-smokers (71.6%). Factors significantly associated with "initiation and/or advice" were prior smoking cessation training (OR = 4.2, 95% CI 1.8-9.6) and lack of knowledge to help patients to quit (OR = 0.4, 95% CI 0.2-0.9) among male physicians who smoked; and organisational support (OR = 1.7, 95% CI 1.3-2.2) and successful past experience (OR = 0.4, 95% CI 0.2-1.0) among male physicians who did not smoke. Among female physicians who did not smoke, significant factors were agreeing that quitting smoking is the most cost-effective way to prevent chronic disease and cancer (OR = 3.0, 95% CI 1.4-6.1), helping patients stop smoking is part of expected role and responsibility (OR = 2.0, 95% CI 1.0-3.7), lack of knowledge to help patients to quit (OR = 0.5, 95% CI 0.2-1.0) and organisational support (OR = 1.3, 95% CI 1.0-1.6) for non-smoking female physicians. This study is the first to show that male physicians were less likely to provide smoking cessation counselling regardless of their smoking status while non-smoking female physicians were more active in advising patients on quitting. The findings highlight the need for developing tailored smoking cessation training programmes for physicians according to their smoking status and gender in China.  相似文献   

16.
目的评价简短戒烟干预技术在北京市各级综合医院门诊应用的效果。方法方便抽取北京市一级、二级、三级综合医院各1家,在一级医院全科及中医科门诊、二级和三级医院呼吸内科门诊开展为期4周的研究,期间所有门诊患者为调查对象。在门诊后1周内,对现在吸烟患者采用电话调查形式进行随访,了解简短戒烟干预技术的应用效果。结果研究共调查门诊患者2460人,其中278人现在吸烟,占11.3%。门诊后1周内成功随访了122名现在吸烟患者,成功随访率43.9%。成功随访者中14.8%的现在吸烟患者因1次简短戒烟干预发生戒烟意愿的正向改变,且具有统计学意义(z=3.551,P〈0.01)。其中,三级医院的此种改变有统计学意义(Z=3.035,P〈0.01)。有戒烟服务需求的门诊患者简短戒烟干预前后戒烟意愿的改变有统计学意义(Z=3.420,P〈0.01)。结论综合医院门诊应用简短戒烟干预技术有效果,三级医院干预效果更好。对有戒烟服务需求的门诊患者实施简短戒烟干预,效果更好。  相似文献   

17.
The aim of this study was to explore older current/former smokers' views on smoking, stopping smoking, and smoking cessation resources and services. Despite the fact that older smokers have been identified as a priority group, there is currently a dearth of age-related smoking cessation research to guide practice. The study adopted a qualitative approach and used the health belief model as a conceptual framework. Twenty current and former smokers aged>or=65 years were recruited through general practices and a forum for older adults in the West of Scotland. Data were collected using a semistructured interview schedule. The audio-taped interviews were transcribed and then analysed using content analysis procedures. Current smokers reported many positive associations with smoking, which often prevented a smoking cessation attempt. The majority were aware that smoking had damaged their health; however, some were not convinced of the association. A common view was that 'the damage was done', and therefore, there was little point in attempting to stop smoking. When suggesting a cessation attempt, while some health professionals provided good levels of support, others were reported as providing very little. Some of the participants reported that they had never been advised to stop smoking. Knowledge of local smoking cessation services was generally poor. Finally, concern was voiced regarding the perceived health risks of using nicotine replacement therapy. The main reasons why the former smokers had stopped smoking were health-related. Many had received little help and support from health professionals when attempting to stop smoking. Most of the former smokers believed that stopping smoking in later life had been beneficial to their health. In conclusion, members of the primary care team have a key role to play in encouraging older people to stop smoking. In order to function effectively, it is essential that they take account of older smokers' health beliefs and that issues, such as knowledge of smoking cessation resources, are addressed.  相似文献   

18.
Smoking is associated with common sight-threatening eye conditions. We suspected that this link was little known and it might be a potent novel health promotional tool. We therefore developed a programme ultimately aiming to reduce the burden of eye disease attributable to smoking. The programme aims were to (1) raise awareness of the link between smoking and eye disease and advocate changes in relevant policies and (2) investigate and promote change in professional practice so that smokers are identified and routinely offered smoking cessation advice/support in eyecare settings. An inter-professional team developed a programme of research and education targeting policy-makers, healthcare professionals, the public and patients. We reviewed evidence about the causal link between smoking and eye disease, researched current awareness of the link, researched current practice of eyecare health professionals, produced health education materials and campaigned for policy changes. The series of projects was completed successfully, achieving media coverage, confirming the causal link between smoking and eye disease and demonstrating low awareness of this association. Healthcare leaders and policy-makers were engaged in our programme resulting in commitment, in principle, from the UK's Chief Medical Officer and the European Commission to consider including warning labels related to blindness on cigarette packets.  相似文献   

19.
戒烟干预对吸烟者知识、态度和行为的影响   总被引:1,自引:1,他引:0       下载免费PDF全文
目的 评价戒烟干预对戒烟门诊求助者烟草相关知识、态度和行为(知、信、行)的影响。方法 以2008年10 月至2013 年8月解放军总医院戒烟门诊就医的未使用戒烟药物的吸烟者为研究对象,戒烟门诊医师首诊时为吸烟者进行≥30 min的面对面咨询和心理干预,之后1周、1个月、3个月和6个月时共进行4次随访电话干预(每次15~20 min).对照组为2012 年8月至2013 年8月解放军总医院健康医学中心某病区常规查体的吸烟者,基线和随访时均不进行干预。比较基线和1年随访时干预组和对照组烟草相关知、信、行的变化情况。结果 干预组和对照组分别纳入414例和213例研究对象。意向性分析显示,干预组1年随访烟草相关知、信方面共有5个变量的知晓/同意率高于基线。两组的1年随访时点戒烟率分别为4.7%和27.3%.logistic 多元回归分析显示,1年随访时戒烟率与暴露于戒烟干预、女性、尼古丁依赖评分低和烟草相关知识及态度正向变化(吸烟导致心脏病、应该禁止各种形式的烟草产品推广、吸烟浪费金钱和酒楼、饭店应该全面禁烟)共7个变量呈正相关,其OR值(95%CI)分别为2.85(2.00~4.07)、3.34(1.23~9.07)、2.78(1.64~4.72)、2.30(1.03~5.15)、5.33(1.47~19.32)、6.32(1.56~25.62)和10.47(2.25~48.84).结论 戒烟门诊求助者的烟草危害认知水平普遍较高,通过系统化戒烟干预,部分吸烟者知识及态度有了一定提高。烟草相关知识及态度的有益转变,有利于提高戒烟率。  相似文献   

20.
Tobacco is a major preventable cause of premature morbidity and mortality. Health professionals are uniquely positioned to provide targeted interventions and should be empowered to provide cessation counselling that influence patient smoking. A cross-sectional national survey was administered to all third year students in four disciplines at the University of Malta. The Global Health Professional Student Survey (GHPSS) questionnaire was distributed to collect standardised demographic, smoking prevalence, behavioural, and attitudinal data. 81.9% completed the questionnaire (n = 173/211). A positive significant association between tobacco smoke exposure at home and current smoking status was identified. Non-smokers regarded anti-tobacco policies more favourably than smokers, being more likely to agree with banning of tobacco sales to adolescents (OR 3.6; 95% CI: 2.5-5.3; p ≤ 0.001); and with a smoking ban in all public places (OR 8.9; 95% CI: 6.1-13.1; p ≤ 0.001). Non-smokers favoured a role for health professionals in promoting smoking cessation (OR 5.1; 95% CI: 3.1-8.5; p ≤ 0.001). Knowledge of antidepressants as tools for smoking cessation was also associated with a perceived role for skilled health professionals in cessation counselling (OR 4.9; 95% CI: 1.8-13.3; p = 0.002). Smoking negatively influences beliefs and attitudes of students toward tobacco control. There is a need to adopt a standard undergraduate curriculum containing comprehensive tobacco prevention and cessation training to improve their effectiveness as role models.  相似文献   

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