OBJECTIVES:To determine communication strategies associated with smoking cessation in the National Health Service community pharmacy Stop Smoking programme. SETTING:11 community pharmacies in three inner east London boroughs. PARTICIPANTS:9 stop smoking advisers and 16 pairs of smokers who either quit or did not quit at 4 weeks, matched on gender, ethnicity, age and smoking intensity. METHOD:1-3 audio-recorded consultations between an adviser and each pair member over 5-6 weeks were analysed using a mixed-method approach. First a content analysis was based on deductive coding drawn from a theme-oriented discourse analysis approach and the Roter Interaction Analysis System. Core themes were identified through this quantification to explore in detail the qualitative differences and similarities between quitters and non-quitters. RESULTS:Quantitative analysis revealed advisers used a core set of counselling strategies that privileged the 'voice of medicine' and often omitted explicit motivational interviewing. Smokers tended to quit when these core strategies were augmented by supportive talk, clear permission for smokers to seek additional support from the adviser between consultations, encouragement for smokers to use willpower. The thematic analysis highlighted the choices made by advisers as to which strategies to adopt and the impacts on smokers. The first theme 'Negotiating the smoker-adviser relationship' referred to adviser judgements about the likelihood the smoker would quit. The second theme, 'Roles of the adviser and smoker in the quit attempt', focused on advisers' counselling strategies, while the third theme, 'Smoker and adviser misalignment on reasons for smoking, relapsing and quitting', concerned inconsistencies in the implementation of National Centre for Smoking Cessation and Training recommendations. DISCUSSION:Advisers in community pharmacies should use the advantages of their familiarity with smokers to ensure appropriate delivery of patient-centred counselling strategies and reflect on the impact on their counselling of early judgements of smoker success.

译文

目的:确定国家卫生局社区药房“戒烟计划”中与戒烟相关的沟通策略。
地点:伦敦东部三个内部行政区的11家社区药房。
参与者:9名戒烟顾问和16对在4周内戒烟或未戒烟的吸烟者,其性别,种族,年龄和吸烟强度均相匹配。
方法:采用混合方法分析顾问和每对成员在5-6周内进行的1-3次录音咨询。首先,内容分析是基于演绎编码的,该演绎编码是从主题主题的话语分析方法和Roter交互分析系统中提取的。通过量化确定了核心主题,以详细探讨退出者与非退出者之间的质性差异和相似性。
结果:定量分析显示,顾问使用了一套核心的咨询策略,这些策略优先考虑“医学之声”,并且常常省略了明确的动机性面试。当支持性谈话增强了这些核心策略时,吸烟者倾向于戒烟,明确允许吸烟者在两次咨询之间寻求顾问的更多支持,鼓励吸烟者使用意志力。专题分析着重介绍了顾问在采用哪种策略以及对吸烟者的影响方面做出的选择。第一个主题“协商吸烟者与顾问的关系”指的是顾问对吸烟者戒烟可能性的判断。第二个主题是“戒烟过程中的顾问和吸烟者的角色”,其重点是顾问的咨询策略,而第三个主题是“吸烟者和顾问在吸烟,复发和戒烟的原因上的失调”,涉及实施中的不一致之处国家吸烟戒烟和培训中心的建议。
讨论:社区药房的顾问应利用其熟悉吸烟者的优势,以确保适当提供以患者为中心的咨询策略,并反思对吸烟者成功的早期判断对其咨询的影响。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录