• 【与为癌症患者实施戒烟临床试验有关的问题。】 复制标题 收藏 收藏
    DOI:10.1007/s10552-008-9222-x 复制DOI
    作者列表:Martinez E,Tatum KL,Weber DM,Kuzla N,Pendley A,Campbell K,Ridge JA,Langer C,Miyamoto C,Schnoll RA
    BACKGROUND & AIMS: :Given high rates of smoking among cancer patients, smoking cessation treatment is crucial; yet limited data exist to guide integration of such trials into the oncologic context. In order to determine the feasibility of conducting smoking cessation clinical trials with cancer patients, screening and baseline data from a large randomized placebo-controlled pharmacotherapy trial were analyzed. Descriptive statistics and regression analyses were used to compare enrollees to decliners, describe program enrollees, and assess correlates of confidence in quitting smoking. Out of 14,514 screened patients, 263 (<2%) were eligible; 43 (16%) refused enrollment. Among the eligible patients, 220 (84%) enrolled. Enrollment barriers included smoking rate, medical history/contraindicated medication, lack of interest, and language. Compared to enrollees, decliners were more likely to have advanced cancer. The trial enrolled a sample of 67 (>30%) African Americans; participants had extensive smoking histories; many were highly nicotine dependent; and participants consumed about seven alcoholic beverages/week on average. Head and neck and breast cancer were the most common tumors. About 52 (25%) reported depressive symptoms. A higher level of confidence to quit smoking was related to lower depression and lower tumor stage. Integrating a smoking cessation clinical trial into the oncologic setting is challenging, yet feasible. Recruitment strategies are needed for patients with advanced disease and specific cancers. Once enrolled, addressing participant's depressive symptoms is critical for promoting cessation.
    背景与目标: : 鉴于癌症患者的吸烟率很高,戒烟治疗至关重要; 然而,有限的数据可以指导将此类试验纳入肿瘤学领域。为了确定对癌症患者进行戒烟临床试验的可行性,对一项大型随机安慰剂对照药物治疗试验的筛查和基线数据进行了分析。描述性统计和回归分析用于比较参与者与下降者,描述计划参与者并评估戒烟信心的相关性。在14,514名筛查患者中,263名 (<2% 名) 符合条件; 43名 (16% 名) 拒绝入组。在符合条件的患者中,220 (84%) 入组。入学障碍包括吸烟率,病史/禁忌用药,缺乏兴趣和语言。与参保人相比,下跌股更有可能患有晚期癌症。该试验纳入了67名 (>30% 名) 非裔美国人的样本; 参与者有广泛的吸烟史; 许多人高度依赖尼古丁; 参与者平均每周饮用约7种酒精饮料。头颈部和乳腺癌是最常见的肿瘤。约52例 (25%) 报告了抑郁症状。较高的戒烟信心水平与较低的抑郁和较低的肿瘤分期有关。将戒烟临床试验纳入肿瘤学环境是具有挑战性的,但可行的。晚期疾病和特定癌症患者需要招募策略。一旦入组,解决参与者的抑郁症状对于促进戒烟至关重要。
  • 【戒烟和痴呆症的荟萃分析: 性别重要吗?】 复制标题 收藏 收藏
    DOI:10.1093/geronb/gbw158 复制DOI
    作者列表:Baines N,Au B,Rapoport MJ,Naglie G,Tierney MC
    BACKGROUND & AIMS: Objectives:The number of drivers with dementia is expected to increase over the coming decades. Because dementia is associated with a higher risk of crashes, driving cessation becomes inevitable as the disease progresses, but many people with dementia resist stopping to drive. This meta-analysis examines whether there are sex differences in the prevalence and incidence of driving cessation among drivers with dementia and compares the pattern of sex differences in drivers with dementia to those without dementia. Method:MEDLINE, PsycINFO, Scopus, and CINAHL were searched in July 2015 for observational studies of sex differences in driving cessation. Meta-analyses were performed using a random-effects model. Results:Twenty studies provided data on sex differences in driving cessation in older adults with or without dementia. Driving cessation was significantly more prevalent in women with dementia than men (odds ratio [OR] = 2.11, 95% confidence interval [CI] = 1.50-2.98), and the same pattern was found in women without dementia (OR = 2.74, 95% CI = 1.85-4.06). Discussion:Our findings suggest that the patterns of driving cessation differ between men and women with dementia, and this may have implications for sex-specific approaches designed to support drivers with dementia both before and after driving cessation.
    背景与目标:
  • 【用户对基于短信的戒烟计划NEXit干预的结构和内容的满意度。】 复制标题 收藏 收藏
    DOI:10.1186/s12889-016-3848-5 复制DOI
    作者列表:Müssener U,Bendtsen M,McCambridge J,Bendtsen P
    BACKGROUND & AIMS: BACKGROUND:Smoking is still the leading cause of preventable ill health and death. There is a limited amount of evidence for effective smoking cessation interventions among young people. To address this, a text messaging-based smoking cessation programme, the NEXit intervention, was developed. Short-term effectiveness, measured immediately after the 12-week intervention revealed that 26% of smokers in the intervention group had prolonged abstinence compared with 15% in the control group. The present study was performed to explore the users' experiences of the structure and content of the intervention in order to further develop the intervention. METHODS:Students participating in the main NEXit randomized controlled trial were invited to grade their experiences of the structure and content of the intervention after having completed follow-up. The participants received an e-mail with an electronic link to a short questionnaire. Descriptive analysis of the distribution of the responses to the questionnaire was performed. Free-text comments to 14 questions were analysed. RESULTS:The response rate for the user feedback questionnaire was 35% (n = 289/827) and 428 free-text comments were collected. The first motivational phase of the intervention was appreciated by 55% (158/289) of the participants. Most participants wanted to quit smoking immediately and only 124/289 (43%) agreed to have to decide a quit-date in the future. Most participants 199/289 (69%) found the content of the messages in the core programme to be very good or good, and the variability between content types was appreciated by 78% (224/289). Only 34% (97/289) of the participants thought that all or nearly all messages were valuable, and some mentioned that it was not really the content that mattered, but that the messages served as a reminder about the decision to quit smoking. CONCLUSIONS:The programme was largely perceived satisfactory in most aspects concerning structure and content by young people and most participants stated that they would recommend it to a friend who wants to quit smoking. The motivational phase might be worth shortening and the number of messages around the quit date itself reduced. Shorter messages seemed to be more acceptable. TRIAL REGISTRATION:ISRCTN75766527 .
    背景与目标:
  • 【在HIV阳性吸烟者中进行护士管理,同伴主导的戒烟干预的可行性。】 复制标题 收藏 收藏
    DOI:10.1016/S1055-3290(06)60353-1 复制DOI
    作者列表:Wewers ME,Neidig JL,Kihm KE
    BACKGROUND & AIMS: :The purpose of this pilot study was to examine the effectiveness of an 8-week, nurse-managed, peer-led smoking cessation intervention among HIV-positive smokers. The intervention was based on the Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline and was delivered by an ex-smoker who was HIV positive and had been trained by an advanced practice nurse to deliver cessation counseling. Eight male HIV-positive smokers were assigned to the intervention group and received (a) 21 mg nicotine patch therapy for 6 weeks, (b) weekly face-to-face or telephone counseling, and (c) skills training that included substitute strategies for dealing with not smoking. Those participants assigned to the control group received written self-help materials for smoking cessation. Abstinence rates at end of intervention and 8 months were compared between groups. At end of treatment, 62.5% of intervention group participants were biochemically confirmed as abstinent from smoking compared with 0% in the control group. Eight-month abstinence rates were 50% among the intervention group compared with 0% in the control group.
    背景与目标: : 这项初步研究的目的是研究在HIV阳性吸烟者中进行为期8周,由护士管理,由同伴主导的戒烟干预的有效性。该干预措施基于卫生保健政策和研究机构戒烟临床实践指南,由一名HIV阳性的前吸烟者提供,并接受了高级实践护士的培训,以提供戒烟咨询。8名男性HIV阳性吸烟者被分配到干预组,接受了 (a) 21 mg尼古丁贴片治疗6周,(b) 每周面对面或电话咨询,以及 (c) 包括替代策略的技能培训不吸烟。分配到对照组的参与者收到了书面的戒烟自助材料。比较两组干预结束和8个月的禁欲率。在治疗结束时,与对照组的0% 相比,干预组参与者的62.5% 被生化确认为戒烟。与对照组的0% 相比,干预组的8个月禁欲率50%。
  • 【医生在戒烟中的作用。现在和未来的议程。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Nett LM
    BACKGROUND & AIMS: :Medical views in the United States on the effects of smoking have shifted dramatically since the published evidence in 1958 established the link between smoking and fatal disease. Today's physician should be a nonsmoking role model, whose workplace both directly and indirectly teaches smoking cessation skills. Publications on smoking cessation techniques from the National Institutes of Health along with intervention tools such as patient smoking history questionnaires are available free of charge to physicians. Patient histories are critical to the intervention process, for they provide essential clues and information about which stage in cessation of smoking the patient has already reached: precontemplation, contemplation, action, and maintenance. Different approaches and techniques are required at each stage. The most important objective for the physician with a patient at the stage of contemplating quitting is to initiate a conversation leading to a directive to quit, with benefits of quitting stressed as reinforcement. Actively motivated patients committed to quit dates may need both educational and pharmacologic support; issues such as nicotine dependence and withdrawal symptoms must be addressed. Pharmacologic therapy at this time may consist of substitution of nicotine-containing gum (nicotine polacrilex) for cigarettes. Used in sufficient, regular dosages, the nicotine gum has been found to help diminish withdrawal symptoms following smoking cessation. Other drug therapies are currently under study. For now, nicotine replacement therapy (where indicated) is to be used for at least three months, the period of greatest chance of relapse. The physician should continue to encourage patients who have quit smoking to forestall relapses, while tacitly understanding that the incidence of relapse is high in first-time quitters. Hospital inpatients provide an opportunity to initiate bedside smoking cessation programs. The hope is that, in the future, hospitals will involve the entire health team in comprehensive smoking cessation programs.
    背景与目标: : 自从已发表的证据1958年吸烟与致命疾病之间的联系以来,美国对吸烟影响的医学观点发生了巨大变化。今天的医生应该是一个不吸烟的榜样,其工作场所直接和间接教授戒烟技能。美国国立卫生研究院关于戒烟技术的出版物以及干预工具,如患者吸烟史问卷,可免费提供给医生。患者病史对于干预过程至关重要,因为它们提供了有关患者已经达到戒烟阶段的基本线索和信息: 沉思,沉思,行动和维持。每个阶段都需要不同的方法和技术。对于在考虑戒烟的阶段有患者的医生来说,最重要的目标是发起对话,导致戒烟的指令,而戒烟的好处是加强。积极主动的戒烟患者可能需要教育和药物支持; 必须解决尼古丁依赖和戒断症状等问题。此时的药物治疗可能包括用含尼古丁的口香糖 (尼古丁polacrilex) 代替香烟。尼古丁胶以足够的常规剂量使用,已发现有助于减轻戒烟后的戒断症状。目前正在研究其他药物疗法。目前,尼古丁替代疗法 (如所示) 至少要使用三个月,这是复发机会最大的时期。医生应继续鼓励戒烟的患者预防复发,同时默许首次戒烟者的复发率很高。医院住院患者提供了启动床边戒烟计划的机会。希望将来,医院将使整个卫生团队参与全面的戒烟计划。
  • 【职业健康护士在戒烟干预中的自我效能: 文献综述。】 复制标题 收藏 收藏
    DOI:10.1177/2165079920925106 复制DOI
    作者列表:Thornberry A,Garcia TJ,Peck J,Sefcik E
    BACKGROUND & AIMS: :Background: Effective smoking cessation interventions (SCIs) are indicated, particularly among the working population, where a higher than expected prevalence of smoking continues. Occupational health nurses' (OHN) self-efficacy can affect SCI but current scientific literature is limited. The purpose of this integrative literature review was to determine factors that affect OHN self-efficacy and motivation for providing SCI and to guide research needed to enhance SCI programs. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted an integrative literature review. The strategy was an electronic data search of PubMed conducted between 2013 and 2018 and included peer-reviewed manuscripts written in English that addressed self-efficacy and its relationship to SCI. Findings: In total, 15 research articles met the inclusion criteria and two referred specifically to OHNs. Common themes revealed factors which positively and negatively influenced nurses' self-efficacy, including training, academic preparation, as well as nurse attitudes and personal/social influence. Studies specific to OHNs identify self-efficacy as the most influential factor affecting nurse implementation of SCI. Organizational support and theory-based training are more effective in overcoming personal and social barriers affecting OHN self-efficacy. Conclusion/Application to Practice: The results of this review revealed attitude, innovation, perceived social influence, and self-efficacy were factors for nurses' intention to implement SCI. Changes in the organizational environment supporting cessation programs and educational development, particularly theory-based training, should be further studied. Our findings suggest that designing programs utilizing these research findings to improve OHN self-efficacy could guide changes in clinical practice for motivating smokers to quit.
    背景与目标: 背景: 指出了有效的戒烟干预措施 (sci),尤其是在工作人群中,吸烟率持续高于预期。职业健康护士 (OHN) 的自我效能会影响SCI,但目前的科学文献有限。这篇综合文献综述的目的是确定影响OHN自我效能感和提供SCI动机的因素,并指导增强SCI计划所需的研究。方法: 遵循系统评价和荟萃分析 (PRISMA) 指南的首选报告项目,我们进行了综合文献综述。该策略是对PubMed进行的2013年和2018进行的电子数据搜索,其中包括用英语撰写的同行评审手稿,这些手稿涉及自我效能感及其与SCI的关系。研究结果: 总共有15篇研究文章符合纳入标准,其中两篇专门针对ohn。共同的主题揭示了积极和消极影响护士自我效能感的因素,包括培训,学术准备以及护士的态度和个人/社会影响。针对ohn的研究将自我效能感确定为影响护士实施SCI的最有影响力的因素。组织支持和基于理论的培训在克服影响OHN自我效能感的个人和社会障碍方面更有效。结论/实践应用: 本综述的结果表明,态度,创新,感知的社会影响力和自我效能感是护士实施SCI意图的因素。应进一步研究支持戒烟计划和教育发展的组织环境的变化,特别是基于理论的培训。我们的发现表明,利用这些研究结果来设计提高OHN自我效能的程序可以指导临床实践的变化,以激励吸烟者戒烟。
  • 【蒙大拿州的美洲印第安大学生使用手机和计算机促进健康和戒烟。】 复制标题 收藏 收藏
    DOI:10.22605/rrh4014 复制DOI
    作者列表:Dotson JA,Nelson LA,Young SL,Buchwald D,Roll J
    BACKGROUND & AIMS: INTRODUCTION:Cell phones and personal computers have become popular mechanisms for delivering and monitoring health information and education, including the delivery of tobacco cessation education and support. Tobacco smoking is prevalent among American Indians (AIs) and Alaska Natives (ANs), with 26% AI/AN adult men smoking compared to 19% of Caucasian adult males and 22% of African American adult males. Smoking is even more prevalent in Northern Plains AI populations, with 42% of men and women reporting current smoking. The literature on the availability and use of cell phones and computers, or the acceptability of use in health promotion among AIs and ANs, is scant. The authors report findings from a survey of AI students regarding their cell phone and computer access and use. The survey was conducted to inform the development and implementation of a text messaging smoking cessation intervention modeled on a program developed and used in Australia. METHODS:A 22-item paper and pencil survey was administered to students at tribal colleges in rural Montana. The survey questions included cell phone ownership and access to service, use of cell phones and computers for health information, demographics, tobacco use habits, and interest in an intervention study. The study was reviewed and determined exempt by the institutional review boards at the tribal colleges and the lead research university. The study was conducted by researchers at the tribal colleges. Survey respondents received $10 when the survey was completed and returned. Data analysis was performed with the Statistical Package for the Social Sciences. RESULTS:Among 153 AI respondents, the mean age was 29 years, range was 18-64 years. Overall, 40% reported smoking cigarettes with a mean age of 16 years at initiation. A total of 131 participants (86%) had cell phones and, of those, 122 (93%) had unlimited text messaging. A total of 104 (68%) had smart phones (with internet access), although 40% of those with smart phones reported that internet access on their phone was very slow or location limited. A total of 146 (95%) participants reported having access to a computer, although 32% of those did not have daily access. Students aged less than 23 years were more likely to have cell phones with internet access. Cell phone ownership differed by site (93% vs 77%, p=0.007). About 60% of the respondents who smoked indicated interest in participating in the intervention study. CONCLUSIONS:This study revealed that AI tribal college students in the rural communities surveyed had less cell phone, smart phone, and computer and internet access than that reported for undergraduate college students elsewhere in the USA. Research efforts and public health interventions must be culturally appropriate and technologically viable, therefore access to and acceptability of mobile technology must be evaluated when planning and implementing interventions for rural and other marginalized populations. The findings from this study contribute to the literature regarding the access to and acceptability of mobile technology for health promotion among AI/AN college students in rural and remote areas, and helped introduce the proposed study to the community and solicited useful data regarding tobacco prevalence and interest in tobacco research in the target population.
    背景与目标:
  • 【家庭医生和戒烟。实践、意见和障碍调查。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Mowat DL,Mecredy D,Lee F,Hajela R,Wilson R
    BACKGROUND & AIMS: OBJECTIVES:To assess what family physicians need to promote smoking cessation by looking at current knowledge, attitudes, and behaviours and to examine the barriers facing physicians in implementing an effective antismoking strategy. DESIGN:Cross-sectional study involving face-to-face interviews and mailed questionnaires. SETTING:Family practices in Kingston, Ont, and surrounding areas. PARTICIPANTS:All family physicians (n = 155) in the City of Kingston and the counties of Frontenac, Lennox, and Addington. MAIN OUTCOME MEASURES:Knowledge, attitudes, beliefs, and practices concerning smoking cessation; barriers and practices recommended in the literature. RESULTS:Response rate was 77%. Many physicians know about smoking cessation, and many actively counsel their patients to quit. Brief advice, nicotine replacement therapy, self-help materials, and follow-up appointments are the most common methods. Although many report that they are already knowledgeable, many are willing to learn more. Many physicians have unrealistically high estimates of the probability of success, and many find poor compliance among patients to be the greatest barrier. CONCLUSIONS:Family physicians in this are recognize the need to help their patients to quit and are identifying and counseling smokers in their practices. The main educational need could be to appreciate smoking as an addictive behaviour.
    背景与目标:
  • 【[干预心肌梗死患者戒烟的疗效]。】 复制标题 收藏 收藏
    DOI:10.1016/s0025-7753(00)71246-2 复制DOI
    作者列表:Moreno Ortigosa A,Ochoa Gómez FJ,Ramalle-Gómara E,Saralegui Reta I,Fernández Esteban MV,Quintana Díaz M
    BACKGROUND & AIMS: BACKGROUND:The aim of this study was to evaluate the efficacy of an structured intervention based on a medical advice versus to the ordinary anti-tobacco advice in patients with miocardial infarction who are attended in an Intensive Care Unit (ICU). PATIENTS AND METHODS:90 patients were randomly selected to receive either the specific intervention (intervention group) or the ordinary advice (control group). The medical advice was given during the ICU hospitalization and during the second, the third and the fourth week. One year later the smoking habit was evaluated. RESULTS:After one year 26 patients of the intervention group and 31 patients of the control group had stopped smoking (RR = 0.88 [CI 95% RR] 0.57 to 1.37). CONCLUSIONS:The percentage of patients who stop smoking after a miocardial infarction is high. The structured medical counselling was not effective to reduce the number of smokers at one year.
    背景与目标:
  • 【医生参与患者戒烟过程。对4,643名比利时医生进行的1998调查结果。】 复制标题 收藏 收藏
    DOI:10.1080/17843286.2000.11754309 复制DOI
    作者列表:Prignot J,Bartsch P,Vermeire P,Jamart J,Wanlin M,Uydebrouck M,Thijs J
    BACKGROUND & AIMS: :This report relates to the 1,667 responses to a selfadministered mail-back questionnaire sent by BELTA to a sample of 4,643 physicians (17.3% current smokers) who are in professional contact with patients (response rate: 35.9%). Links between active smoking and disease are considered as well-demonstrated by 98.8% physicians and for passive smoking by 85.3%, for foetal consequences of smoking during pregnancy by 96.4%. Nicotine dependence is admitted by 83.3%. Interaction of smoking with drug metabolism is insufficiently known. Modulation of the specific approach of smoking cessation, according to the various stages of the cessation cycle, to the level of nicotine dependence and to the psychological status of the smoker is not sufficiently perceived by the physicians. Patient's smoking status is systematically determined by less than half the physicians, of whom nearly 90% claim to inform their smoking patients on smoking-related risks, and 84.2% to tackle the problem of cessation. The intervention is mostly limited to a firm advice, completed by nicotine replacement for a maximum of 50% of smokers (especially gum and patch). Referral to specialized structures is unfrequent (between 10 and 20%). Follow up after cessation is clearly deficient. In this retrospective study of their activity patterns, physicians' reports may reflect their intentions rather than their actual practices. We conclude that smoking issues and cessation techniques should be more intensively taught both at graduate and postgraduate levels, in order to obtain a more active behaviour of health professionals against smoking.
    背景与目标: : 本报告涉及对BELTA发送给与患者有专业接触的4,643医生 (17.3% 目前的吸烟者) 样本的自我管理的回邮问卷的1,667答复 (回复率: 35.9%)。98.8% 医生认为主动吸烟与疾病之间的联系以及85.3% 被动吸烟以及96.4% 怀孕期间吸烟的胎儿后果都得到充分证明。83.3% 承认尼古丁依赖。吸烟与药物代谢的相互作用尚不清楚。根据戒烟周期的各个阶段,对尼古丁依赖水平和吸烟者的心理状况的特定戒烟方法的调节没有被医生充分感知。患者的吸烟状况由不到一半的医生系统地确定,其中近90% 名医生声称告知吸烟患者与吸烟有关的风险,并84.2% 解决戒烟问题。干预主要限于坚定的建议,由尼古丁替代完成,最多50% 的吸烟者 (尤其是口香糖和贴片)。转介到专门结构是不频繁的 (10到20% 之间)。戒烟后的随访明显不足。在对他们的活动模式进行的回顾性研究中,医生的报告可能反映了他们的意图,而不是他们的实际做法。我们得出的结论是,应该在研究生和研究生阶段更深入地教授吸烟问题和戒烟技巧,以使卫生专业人员更加积极地反对吸烟。
  • 【为学龄吸烟者设计戒烟服务: 一项调查和定性研究。】 复制标题 收藏 收藏
    DOI:10.1080/14622200600789817 复制DOI
    作者列表:Molyneux A,Lewis S,Coleman T,McNeill A,Godfrey C,Madeley R,Britton J
    BACKGROUND & AIMS: :To identify the preferred design characteristics of smoking cessation services for school-age smokers, we conducted focus groups with teenage smokers motivated to stop smoking. We surveyed all pupils in years 9-11 (aged 13-16) in a random sample of 10 schools in Nottinghamshire, United Kingdom, to elicit details of smoking behavior, and conducted 25 focus groups in 6 schools with current smokers who wanted to stop smoking. Of 4,065 pupils surveyed, 888 (22%) were current smokers, and 438 (50% of smokers) wanted to quit smoking. We sampled 226 of these individuals for focus group studies, and 135 (60%) participated. These participants were motivated to quit, and almost all had tried to do so but had found it too difficult. Many were aware of smoking cessation methods but had low perceptions of their effectiveness based on their own or others' poor experiences of these interventions, and few were aware of the possibility of professional cessation support. Given clear, nondirective information about interventions, participants reported a preference for confidential, nonjudgmental services delivered during school time by a trained counselor, allowed the option to attend with friends, and offered nicotine replacement therapy (NRT). School-age smokers in Nottinghamshire, United Kingdom, who are motivated to stop smoking have low knowledge and opinions of smoking cessation interventions. Our findings indicate that young smokers would favor school-based services offering confidential professional counseling and NRT.
    背景与目标: : 为了确定针对学龄吸烟者的戒烟服务的首选设计特征,我们对有戒烟动机的青少年吸烟者进行了重点小组。我们在英国诺丁汉郡10所学校的随机抽样中调查了9-11岁 (13-16岁) 的所有学生,以了解吸烟行为的细节,并在6所希望戒烟的学校中进行了25个焦点小组。在接受调查的4,065名学生中,888 (22%) 是目前的吸烟者,438 (吸烟者的50%) 想戒烟。我们对其中的226个人进行了抽样,以进行重点小组研究,135 (60%) 参加了研究。这些参与者都有退出的动机,几乎所有人都试图这样做,但发现这太困难了。许多人知道戒烟方法,但基于自己或他人对这些干预措施的不良经验,对其有效性的认识较低,很少有人知道专业戒烟支持的可能性。鉴于有关干预措施的清晰,非指导性信息,参与者报告倾向于在学校期间由训练有素的辅导员提供机密,非判断性服务,允许选择与朋友一起参加,并提供尼古丁替代疗法 (NRT)。在英国诺丁汉郡,有戒烟动机的学龄吸烟者对戒烟干预措施的了解和看法较低。我们的发现表明,年轻吸烟者会喜欢提供机密专业咨询和NRT的校本服务。
  • 【与使用自动戒烟干预措施相关的因素: eQuit研究的结果。】 复制标题 收藏 收藏
    DOI:10.1093/her/cys104 复制DOI
    作者列表:Balmford J,Borland R,Benda P,Howard S
    BACKGROUND & AIMS: :The aim was to better understand structural factors associated with uptake of automated tailored interventions for smoking cessation. In a prospective randomized controlled trial with interventions only offered, not mandated, participants were randomized based on the following: web-based expert system (QuitCoach); text messaging program (onQ); both as an integrated package; the choice of using either or both; or a control condition informed of a static website (not considered here). Participants were 3530 smokers or recent quitters recruited from two sources; those seeking smoking cessation information, mostly recruited over the phone, and a cold-contacted group recruited from an Internet panel. More participants (60.1%) initially accepted the intervention they had been offered than used it (42.5%). Uptake of each intervention differed substantially by both recruitment source and modality (phone or web). onQ was a little more popular overall, especially in the information seeker sample. Highest overall intervention uptake occurred in the choice condition. A web-based intervention is most attractive if the offer to use is made by web, whereas a phone-based intervention is more likely to be used if the offer is made over the phone. Providing automated interventions on multiple platforms allows for maximal choice and greatest overall use of some form of help.
    背景与目标: : 目的是更好地了解与接受自动定制戒烟干预措施相关的结构因素。在一项前瞻性随机对照试验中,仅提供干预措施,而不是强制要求,参与者根据以下内容进行随机分配: 基于网络的专家系统 (QuitCoach); 文本消息程序 (onQ); 两者都作为一个集成包; 选择使用其中之一或两者; 或通知静态网站的控制条件 (此处不考虑)。参与者是从两个来源招募的3530名吸烟者或最近的戒烟者; 那些寻求戒烟信息的人,主要是通过电话招募的,以及一个从互联网小组招募的冷接触小组。最初接受干预的参与者 (60.1%) 多于使用干预 (42.5%)。每种干预措施的采用在招聘来源和方式 (电话或网络) 上都有很大差异。onQ总体上更受欢迎,尤其是在信息寻求者样本中。在选择条件下,总体干预吸收率最高。如果要约是通过web进行的,则基于web的干预最有吸引力,而如果要约是通过电话进行的,则更有可能使用基于电话的干预。在多个平台上提供自动干预可以最大程度地选择和最大程度地使用某种形式的帮助。
  • 【与向孕妇提供戒烟支持相关的因素-澳大利亚新南威尔士州助产士的横断面调查。】 复制标题 收藏 收藏
    DOI:10.1186/s12884-020-02912-0 复制DOI
    作者列表:Passey ME,Longman JM,Adams C,Johnston JJ,Simms J,Rolfe M
    BACKGROUND & AIMS: BACKGROUND:Smoking is the most important preventable cause of adverse pregnancy outcomes, but provision of smoking cessation support (SCS) to pregnant women is poor. We examined the association between midwives' implementation of SCS (5As - Ask, Advise, Assess, Assist, Arrange follow-up) and reported barriers/enablers to implementation. METHODS:On-line anonymous survey of midwives providing antenatal care in New South Wales (NSW), Australia, assessing provision of the 5As and barriers/enablers to their implementation, using the Theoretical Domains Framework (TDF). Factor analyses identified constructs underlying the 5As; and barriers/enablers. Multivariate general linear models examined relationships between the barrier/enabler factors and the 5As factors. RESULTS:Of 750 midwives invited, 150 (20%) participated. Respondents more commonly reported Asking and Assessing than Advising, Assisting, or Arranging follow-up (e.g. 77% always Ask smoking status; 17% always Arrange follow-up). Three 5As factors were identified- 'Helping', 'Assessing quitting' and 'Assessing dependence'. Responses to barrier/enabler items showed greater knowledge, skills, intentions, and confidence with Assessment than Assisting; endorsement for SCS as a priority and part of midwives' professional role; and gaps in training and organisational support for SCS. Nine barrier/enabler factors were identified. Of these, the factors of 'Capability' (knowledge, skills, confidence); 'Work Environment' (service has resources, capacity, champions and values SCS) and 'Personal priority' (part of role and a priority) predicted 'Helping'. CONCLUSION:The TDF enabled systematic identification of barriers to providing SCS, and the multivariate models identified key contributors to poor implementation. Combined with qualitative data, these results have been mapped to intervention components to develop a comprehensive intervention to improve SCS.
    背景与目标:
  • 【儿童医院父母戒烟计划的成功。】 复制标题 收藏 收藏
    DOI:10.4187/respcare.06810 复制DOI
    作者列表:Sweeney L,Taylor L,Peurifoy J,Kauffman K,Napolitano N
    BACKGROUND & AIMS: BACKGROUND:Children are most affected by passive smoke and least able to avoid it. The Tobacco Dependence Program was developed to help reduce first-, second-, and thirdhand smoke exposure to our patients while they are in the hospital. METHODS:The Tobacco Dependence Program consists of a director, 3 coordinators, and 15 team members certified as tobacco treatment specialists. The program is offered to any admitted patient or his or her caregiver(s). We support participants whether their goal is to quit smoking or to abstain during the hospitalization. We provide weekly counseling and free over-the-counter nicotine replacement therapy for the entire duration of the hospitalization. The inclusion criterion for caregivers is a 7-d minimum stay. In-patients are automatically eligible. Before discharge, we provide a referral to an out-patient program. RESULTS:As of March 2019, we enrolled 138 participants, 5% were in-patients. Fifty-five percent had children who were critically ill and in the ICU: pediatric ICU/progressive care unit (PCU) 28%, neonatal ICU 19%, cardiac ICU (CICU) 9%. The ethnicity of the participants was predominately white (56%), followed by African American (33%), Hispanic (12%), and Asian (<1%). Fifty-six percent of the participants were female. Fifty-nine percent of the participants began smoking between the ages of 12 and 18 y, 21% began between the ages of 18 and 25 y, 9% began before the age of 12 y, and 7% between the ages of 25 and 35 y. Fifty percent of the survey respondents stated that they were able to quit before discharge. CONCLUSIONS:The Tobacco Dependence Program offers support to families as they begin the cessation process and provide the tools to continue a smoke-free lifestyle after discharge. The program is feasible and welcomed to assist patients and families in this process.
    背景与目标:
  • 【家禽在第一和第二产蛋年的开始时间与停止产蛋时间之间的相关性。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Harris JA,Lewis HR
    BACKGROUND & AIMS: -2
    背景与目标: -2

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