BACKGROUND:General practitioners' (GPs) negative beliefs about smoking cessation services may act as barriers to them recommending such services to smokers motivated to stop smoking. METHODS:In Study 1, 25 GPs from 16 practices across London were interviewed in this qualitative study. Framework analysis was used to identify key themes in GPs' beliefs about smoking cessation services. In Study 2, a convenience sample of 367 GPs completed an internet-based survey. Path-analysis was used to examine relationships between beliefs identified in Study 1 and intentions to recommend smoking cessation services. RESULTS:In Study 1, GPs felt that smoking cessation assistance was best provided by others. GPs favoured local services (i.e. practice nurses offering stop smoking support) over central services (i.e. offered through the Primary Care Trust), mainly because these were seen as more personalised and accessible for patients. These beliefs appeared to influence GPs' beliefs about the effectiveness of services. In Study 2, GPs' beliefs had a large effect on their intentions to recommend both central services, (f2 = .79) and local services, (f2 = 1.04). GPs' beliefs about effectiveness and cost-effectiveness were key predictors their intentions to recommend central services and local services. Beliefs about the level of personalisation offered and smokers' likelihood of attending services had indirect effects on intentions to recommend services operating via beliefs about effectiveness. CONCLUSION:GPs vary in their perceptions of the effectiveness of smoking cessation services and their intentions to recommend these services vary in line with these beliefs. Interventions aimed at increasing the likelihood with which GPs recommend these services may therefore be more effective if they addressed these beliefs.

译文

背景:全科医生对戒烟服务的消极信念可能会阻碍他们向有志于戒烟的吸烟者推荐此类服务。
方法:在这项定性研究中,研究1采访了伦敦16家医院的25名全科医生。框架分析用于确定全科医生对戒烟服务的信念中的关键主题。在研究2中,一个367名GP的便利样本完成了一项基于Internet的调查。路径分析用于检验研究1中确定的信念与推荐戒烟服务的意图之间的关系。
结果:在研究1中,家庭医生认为其他人最好提供戒烟帮助。全科医生相对于中央服务(即通过初级保健基金会提供的服务)偏爱本地服务(即提供戒烟支持的执业护士),主要是因为这些服务被视为对患者更具个性化和可及性。这些信念似乎影响了全科医生对服务有效性的信念。在研究2中,GP的信念对推荐中央服务(f2 = .79)和本地服务(f2 = 1.04)的意图产生了很大影响。全科医生对有效性和成本效益的信念是他们打算推荐中央服务和本地服务的主要预测指标。关于提供的个性化水平的信念以及吸烟者参加服务的可能性,通过对有效性的信念对推荐服务的意图产生了间接影响。
结论:全科医生对戒烟服务有效性的看法各不相同,因此推荐这些服务的意图也因这些信念而异。因此,如果他们解决了这些信念,旨在增加全科医生推荐这些服务可能性的干预措施可能会更加有效。

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