Effectiveness of training health professionals to provide smoking cessation interventions: systematic review of randomised controlled trials.
Effectiveness of training health professionals to provide smoking cessation interventions: systematic review of randomised controlled trials.
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培训卫生专业人员提供戒烟干预措施的有效性：随机对照试验的系统评价。
DOI：
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Godfrey Fowler
中科院分区：
文献类型：
--
作者：
C. Silagy;Tim Lancaster;Stephen Gray;Godfrey Fowler
目的--评估对卫生保健专业人员进行培训的干预措施的有效性，以提高向吸烟患者提供的护理质量。设计--系统的文献综述。背景--美国和加拿大的初级保健医疗和牙科诊所。患者被机会性地招募。受试者--878名医疗保健专业人员和11,228名吸烟患者，他们在8项随机对照试验中被确定。在每一项试验中，医疗保健专业人员都接受了正规的戒烟培训，并将他们的表现与对照组进行了比较。主要指标--基线吸烟者在6个月或12个月时戒烟的点流行率。医疗保健专业人员完成戒烟任务的比率，包括提供咨询、确定戒烟日期、进行后续预约、分发自助材料和推荐尼古丁口香糖。方法：采用多种方法对试验进行鉴定。数据由两名观察员根据预先确定的标准提取。在可能的情况下，使用固定效应模型进行荟萃分析，并对结果进行敏感性分析。结果--与未经培训的对照组相比，接受过培训的卫生保健专业人员更有可能执行戒烟任务。接受过培训的健康专业人员的吸烟者与接受对照医生治疗的患者相比，戒烟的几率略有增加(优势比1.35(95%可信区间1.09至1.68))。这一结果对敏感性分析并不可靠。如果使用提示和提醒，培训的效果会更好。与最低限度的接触策略相比，更密集的咨询形式并没有明确的好处。结论--培训健康专业人员提供戒烟干预对职业表现有可衡量的影响。研究还发现，除非组织和其他因素也被考虑在内，否则单靠培训不太可能是提高护理质量的有效策略，这对患者的预后有一定的影响。
OBJECTIVE--To assess the effectiveness of interventions that train healthcare professionals in methods for improving the quality of care delivered to patients who smoke. DESIGN--Systematic literature review. SETTING--Primary care medical and dental practices in the United States and Canada. Patients were recruited opportunistically. SUBJECTS--878 healthcare professionals and 11,228 patients who smoked and were identified in eight randomised controlled trials. In each of these trials healthcare professionals received formal training in smoking cessation, and their performance was compared with that of a control group. MAIN MEASURES--Point prevalence rates of abstinence from smoking at six or 12 months in patients who were smokers at baseline. Rates of performance of tasks of smoking cessation by healthcare professionals, including offering counselling, setting dates to stop smoking, giving follow up appointments, distributing self help materials, and recommending nicotine gum. METHODS--Trials were identified by multiple methods. Data were abstracted according to predetermined criteria by two observers. When possible, meta-analysis was performed using a fixed effects model and the results were subjected to sensitivity analysis. RESULTS--Healthcare professionals who had received training were significantly more likely to perform tasks of smoking cessation than untrained controls. There was a modest increase in the odds of stopping smoking for smokers attending health professionals who had received training compared with patients attending control practitioners (odds ratio 1.35 (95% confidence interval 1.09 to 1.68)). This result was not robust to sensitivity analysis. The effects of training were increased if prompts and reminders were used. There was no definite benefit found for more intensive forms of counselling compared with minimal contact strategies. CONCLUSIONS--Training health professionals to provide smoking cessation interventions had a measurable impact on professional performance. A modest, but non-robust, effect on patient outcome was also found, suggesting that training alone is unlikely to be an effective strategy for improving quality of care, unless organisational and other factors are also considered.
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DOI：
--
发表时间：
1988
期刊：
JAMA
影响因子：
--
作者：
Wilson,DM;Taylor,DW;Gilbert,JR;Best,JA;Lindsay,EA;Willms,DG;Singer,J
通讯作者：
Singer,J
培训产科和家庭医生在产前护理期间提供戒烟建议。
影响因子：
9.8
作者：
Secker-Walker,RH;Solomon,LJ;Flynn,BS;LePage,SS;Crammond,JE;Worden,JK;Mead,PB
通讯作者：
Mead,PB
一项旨在增加医生吸烟干预的随机试验。
DOI：
--
发表时间：
1989
期刊：
JAMA
影响因子：
--
作者：
Kottke,TE;Brekke,ML;Solberg,LI;Hughes,JR
通讯作者：
Hughes,JR
DOI：
10.1001/jama.1988.03720190050031
发表时间：
1988-05-20
影响因子：
120.7
作者：
KOTTKE, TE;BATTISTA, RN;BREKKE, ML
通讯作者：
BREKKE, ML
影响因子：
5.9
作者：
PROCHASKA, JO;DICLEMENTE, CC
通讯作者：
DICLEMENTE, CC