Predictors of smoking cessation group treatment engagement among veterans with serious mental illness.
Predictors of smoking cessation group treatment engagement among veterans with serious mental illness.
复制标题
患有严重精神疾病的退伍军人戒烟团体治疗参与度的预测因素。
DOI：
10.1016/j.addbeh.2017.07.005
复制
发表时间：
2017
影响因子：
4.4
通讯作者：
Bennett,MelanieE
中科院分区：
文献类型：
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作者：
Travaglini,LetitiaE;Li,Lan;Brown,ClaytonH;Bennett,MelanieE
烟草使用率，特别是卷烟的高流行率，对患有严重精神疾病的个人构成严重的健康威胁，研究表明，药物治疗和社会心理干预措施在减少这一群体的烟草使用方面是有效的。然而，很少有研究考虑重度精神分裂症患者参与戒烟治疗的预测因素。目前的研究调查了在三个退伍军人医疗中心从事心理健康服务的重度精神障碍退伍军人戒烟小组参与的预测因素。所有退伍军人都参加了一项戒烟治疗研究。在178名完成基线评估的退伍军人中，127名（83.6%）参加了治疗，定义为参加至少三次小组会议。根据以往的研究和临床专业知识，确定了五个领域（人口统计学、精神病学关注、医学关注、吸烟史和戒烟自我效能）的41个预测因子（N= 41）。使用反向消去法确定最终的多变量logistic回归模型，发现三个预测因素与治疗参与显著相关：婚姻状况（从未结过婚的个体更有可能参与治疗）；曾参与团体戒烟服务；在简易精神病学评定量表中阳性症状的严重程度更高。当纳入多变量logistic回归模型时，完整模型可以很好地区分参与者和非参与者（c统计量= 0.73）。基于这些发现的主要考虑因素是：重度精神障碍患者似乎对戒烟服务感兴趣；严重的精神症状不应该阻止治疗提供者鼓励参与戒烟服务。
High prevalence rates of tobacco use, particularly cigarettes, pose a serious health threat for individuals with serious mental illness (SMI), and research has demonstrated the effectiveness of pharmacotherapy and psychosocial interventions to reduce tobacco use in this group. However, few studies have considered predictors of tobacco cessation treatment engagement among individuals with SMI. The current study examined predictors of engagement in smoking cessation groups among veterans with SMI engaged in mental health services at three VA medical centers. All veterans were participating in a smoking cessation treatment study. Of 178 veterans who completed baseline assessments, 127 (83.6%) engaged in treatment, defined as attending at least three group sessions. Forty-one (N= 41) predictors across five domains (demographics, psychiatric concerns, medical concerns, smoking history, and self-efficacy to quit smoking) were identified based on previous research and clinical expertise. Using backward elimination to determine a final multivariable logistic regression model, three predictors were found to be significantly related to treatment engagement: marital status (never-married individuals more likely to engage); previous engagement in group smoking cessation services; and greater severity of positive symptoms on the Brief Psychiatric Rating Scale. When included in the multivariable logistic regression model, the full model discriminates between engagers and non-engagers reasonably well (c statistic = 0.73). Major considerations based on these findings are: individuals with SMI appear to be interested in smoking cessation services; and serious psychiatric symptomatology should not discourage treatment providers from encouraging engagement in smoking cessation services.