应用5A和5R策略对肺结核门诊患者进行戒烟干预的实施效果分析

目的：针对吸烟的肺结核患者进行戒烟劝导，了解吸烟的肺结核患者对戒烟的态度、信心，评价戒烟干预效果。方法对前来就诊的肺结核患者中吸烟者应用5 A和5 R策略进行戒烟劝导，记录戒烟信心、动机分值，收集5次随访信息建立Epida-ta数据库，利用SPSS软件对数据进行分析，评价项目门诊医师劝导戒烟的效果。结果登记肺结核患者491例，其中有302例吸烟患者，可随访到的患者第2个月、第5个月、第6个月以及12个月后的戒烟率分别为32．1％、30．6％、27．9％和18．0％；第5个月、第6个月、12个月的连续3个月戒烟成功率分别为4．1％、5．0％和3．7％，采用非参数检验中的Friedman法对5次戒烟动机和信心进行比较，5次动机得分都各不相等，动机分值呈下降趋势，信心分值呈下降趋势。结论在肺结核患者接受督导治疗的同时，给予戒烟宣传、劝导的措施是可行的。

Analysis of effect of smoking cessation intervention on application 5A and 5R strategy for tuberculosis outpatients

Objective By giving advice about quitting smoking to smoking patients at county tuberculosis outpatient department,to provide the basis for establishing an effective and enforceable quitting-smoking advising model.Methods The patients who visited the tuber-culosis outpatient department were registered so that their conditions of tobacco using,attitudes and willingness to quitting could be learned a-bout.Doctors conducted smoking-control intervention by using the 5 As and 5 Rs.At the same time of issuing treatment cards,smoking cessa-tion and motivation scores and confidence scores were recorded.Information was collected in five follow-ups and a database was established with Epidata.The data was analyzed with Software SPSS,and the effect of advising quitting smoking by clinic doctors was assessed.Results The project implementation lasted one year,during which 49 1 tuberculosis patients were registered in total,and 302 of them smoked.In follow up cases,smoking-quitting rate at the second month,the fifth month,the sixth month and the twelfth month was 32.1%,30.6%,27.9%and 18.0%,respectively.Rate of quitting smoking for 3 months at the fifth month,the sixth month and the twelfth month was 4.1%,5.0% and 3.7%,respectively.Then motivation and confidence scores obtained at the five time points were compared by Friedman test respectively.It was found that motivation and confidence scores at the five time points differed from one another （P=0.019 in comparison between motiva-tion scores at the sixth month and that at the twelfth month,P=0.000 in other comparisons）.Both motivation and confidence scores showed the downtrend.Conclusion According to the domestic studies about intervention at smoking cessation clinic,the method of doctors advising smoking patients to stop by using the 5 As and 5 Rs has achieved some success.