Is a cancer diagnosis a teachable moment for the patient's relative who smokes?
Is a cancer diagnosis a teachable moment for the patient's relative who smokes?
复制标题
DOI：
10.1007/s10552-013-0212-2
复制
发表时间：
2013-07-01
影响因子：
2.3
通讯作者：
Evans, Tracey
中科院分区：
文献类型：
--
作者：
Schnoll, Robert A.;Wileyto, E. Paul;Evans, Tracey
本研究调查了癌症诊断与整形外科手术，作为招募吸烟者和治疗患者亲属尼古丁依赖的可教时刻。癌症患者和宾夕法尼亚大学卫生系统的整形外科患者进行了比较，以推荐亲属参加戒烟计划，其中包括行为咨询和尼古丁贴片。主要结果是计划的注册率和戒烟率。探讨了戒烟的潜在介导因素（例如，治疗依从性、抑郁、焦虑）。二百三十四个亲戚（113名癌症患者，121名骨科患者）被认为有资格参加戒烟计划，并构成了研究样本。肿瘤患者的亲属比骨科患者的亲属更有可能参加戒烟计划。（75%对60%; OR = 1.96，95%CI 1.07-3.61，p = 0.03），但他们并不更有可能继续参加该计划（61%对52%）或戒烟（19%对26%; p> 0.05）。与骨科亲属相比，肿瘤科亲属在治疗期间表现出显著较低的尼古丁贴片依从性和显著较高的负面情绪以及抑郁和焦虑症状水平（p <0.05）。此外，与肿瘤科亲属相比，骨科亲属在吸烟的感知益处方面表现出更大的减少（p = .06），与禁欲显著相关（p = .02）。虽然家庭成员的癌症诊断可能是吸烟者参加戒烟治疗计划的一个可教的时刻，高度的心理困扰和对吸烟益处的认识以及低水平的治疗坚持可能会破坏这一人群的成功戒烟。
This study examined a cancer diagnosis, versus orthopedic surgery, as a teachable moment for recruiting smokers and treating nicotine dependence among patients' relatives.Cancer patients and, for comparison, orthopedic patients at the University of Pennsylvania Health System were approached for referrals of relatives for a smoking cessation program, which involved behavioral counseling and nicotine patches. Primary outcomes were rate of program enrollment and rate of smoking abstinence. Potential mediators of smoking cessation were explored (e.g., treatment adherence, depression, anxiety). Two hundred and thirty-four relatives (113 cancer, 121 orthopedic) were considered eligible for the cessation program and comprised the study sample.Relatives of oncology patients were significantly more likely to enroll in the smoking cessation program, vs. orthopedic relatives (75 % vs. 60 %; OR = 1.96, 95 % CI 1.07-3.61, p = .03), but they were not significantly more likely to remain in the program (61 % vs. 52 %) or quit smoking (19 % vs. 26 %; p's > .05). Compared to orthopedic relatives, oncology relatives showed significantly lower nicotine patch adherence and significantly greater levels of negative affect and depression and anxiety symptoms during treatment (p's < .05). Further, orthopedic relatives, compared to oncology relatives, showed a greater reduction in the perceived benefits of smoking (p = .06), which was significantly associated with abstinence (p = .02).While a family member's cancer diagnosis may serve as a teachable moment for a smoker to enroll in a smoking cessation treatment program, high levels of psychological distress and perceptions of the benefits of smoking and low levels of treatment adherence may undermine successful abstinence among this population.