National survey of US health professionals' smoking prevalence, cessation practices, and beliefs
National survey of US health professionals' smoking prevalence, cessation practices, and beliefs
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DOI：
10.1093/ntr/ntq071
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发表时间：
2010-07-01
影响因子：
4.7
通讯作者：
Schroeder, Steven A.
中科院分区：
文献类型：
--
作者：
Tong, Elisa K.;Strouse, Richard;Schroeder, Steven A.
烟草依赖治疗工作主要集中在初级保健医生（PCP），但有证据表明，他们不足以帮助大多数吸烟者戒烟。其他卫生专业人员也经常遇到吸烟者，但他们的吸烟率，戒烟实践和信念不太为人所知。这项研究包括来自7个卫生专业群体的2,804名受试者：PCP，急诊医生，精神病学家，注册护士，牙医，牙科医生和药剂师。结果包括自我报告的吸烟状况，戒烟实践和信念。多变量回归分析被用来检查与卫生专业人员（除了药剂师）自我报告的“5A”相关的因素：询问，建议，评估，协助或安排有关烟草的后续行动。卫生专业人员的吸烟率较低（< 6%），除了护士（13%）。许多卫生专业人员报告说，询问（87.3%-99.5%）和建议（65.6%-94.9%）吸烟，但更少评估吸烟者的兴趣（38.7%-84.8%），协助（16.4%-63.7%）和安排随访（1.3%-23.1%）。控制健康专业人员和实践人口统计学，因素正相关的多变量分析与自我报告执行多个组件的5A的包括公共卫生服务指南的认识，有戒烟培训，并认为治疗是一个重要的专业责任。负面关联包括健康专业人员目前是吸烟者，不是PCP，询问患者是否吸烟时感到不舒服，认为咨询不是一种适当的服务，以及报告竞争优先事项。确定的共同障碍和促进因素可能有助于为增加所有卫生专业人员参与烟草依赖治疗的战略提供信息。
Tobacco dependence treatment efforts have focused on primary care physicians (PCPs), but evidence suggests that they are insufficient to help most smokers quit. Other health professionals also frequently encounter smokers, but their smoking prevalence, cessation practices, and beliefs are less well known.The study included 2,804 subjects from seven health professional groups: PCPs, emergency medicine physicians, psychiatrists, registered nurses, dentists, dental hygienists, and pharmacists. Outcomes included self-reported smoking status, smoking cessation practices, and beliefs. Multivariate regression was used to examine factors associated with health professionals (except pharmacists) self-reportedly performing the "5 A's": asking, advising, assessing, assisting, or arranging follow-up about tobacco.Health professionals have a low smoking prevalence (< 6%), except nurses (13%). Many health professionals report asking (87.3%-99.5%) and advising (65.6%-94.9%) about smoking but much less assessing smokers' interest (38.7%-84.8%), assisting (16.4%-63.7%), and arranging follow-up (1.3%-23.1%). Controlling for health professional and practice demographics, factors positively associated in the multivariate analyses with self-reportedly performing multiple components of the 5 A's include awareness of the Public Health Service guidelines, having had cessation training, and believing that treatment was an important professional responsibility. Negative associations include the health professional being a current smoker, not being a PCP, being uncomfortable asking patients if they smoke, believing counseling was not an appropriate service, and reporting competing priorities.U.S. health professionals report not fully performing the 5 A's. The common barriers and facilitators identified may help inform strategies for increasing the involvement of all health professionals in conducting tobacco dependence treatments.