"I Smoke Like This to Suppress These Issues That Are Flaws of My Character": Challenges and Facilitators of Cessation Among Smokers With Bipolar Disorder.
"I Smoke Like This to Suppress These Issues That Are Flaws of My Character": Challenges and Facilitators of Cessation Among Smokers With Bipolar Disorder.
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“我这样吸烟是为了抑制我性格中的缺陷”：双相情感障碍吸烟者戒烟的挑战和促进因素。
DOI：
10.1080/15504263.2017.1390278
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发表时间：
2018
影响因子：
2.2
通讯作者：
Bricker,JonathanB
中科院分区：
文献类型：
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作者：
Heffner,JaimeeL;Watson,NoreenL;McClure,JenniferB;Anthenelli,RobertM;Hohl,Sarah;Bricker,JonathanB
目的：患有双相情感障碍(BD)的吸烟者戒烟成功率较低，但在当前戒烟尝试的背景下，尚无研究评估这些吸烟者的戒烟过程。为了促进更有效的干预措施的开发，我们在一项针对患有BD的吸烟者的干预研究中对戒烟的挑战和促进者进行了定性的探索。方法：受试者是成年的BD吸烟者(n=10)，他们完成了为期10周的戒烟干预，包括接受与承诺疗法(ACT)和尼古丁贴片。我们进行了半结构化访谈，重点是治疗结束时的戒烟过程，并使用归纳内容分析提取主题。结果：代表戒烟挑战的紧急主题包括社会障碍、缺乏意识、回避、适应不良信念、矛盾心理、吸烟的好处和尼古丁替代的困难。代表改变促进者的主题包括积极的治疗效果(ACT特定的、非特定的和尼古丁贴片相关的)、应对行为、戒烟原因、自我知觉的变化和社会利益。结论：结果表明需要在获得社会支持和处理社会障碍方面提供帮助，中断吸烟的自动性，扩大行为范围以处理吸烟往往可以避免的不良内部状态，防止不良适应信念干扰戒烟，在经历矛盾心理的同时采取有意义的改变行动，要么取代吸烟的好处，要么接受其损失，以及解决尼古丁替代的困难。关于戒烟促进者的发现支持了先前的定量研究结果，即ACT干预影响了基于理论的目标，并强调了咨询关系的重要性。
Objective: Smokers with bipolar disorder (BD) have low rates of successful quitting, yet no prior studies have evaluated the process of quitting among these smokers in the context of a current quit attempt. To facilitate development of more effective interventions, we conducted a qualitative exploration of challenges and facilitators of quitting in an intervention study for smokers with BD.Methods: Participants were adult daily smokers with BD (n= 10) who completed a 10-week smoking cessation intervention consisting of Acceptance and Commitment Therapy (ACT) and nicotine patch. We administered semistructured interviews focused on the quitting process at the end of treatment and used inductive content analysis to extract themes.Results: Emergent themes representing challenges of quitting included social impediments, lack of awareness, avoidance, maladaptive beliefs, ambivalence, benefits of smoking, and difficulties with nicotine replacement. Themes representing change facilitators included positive treatment effects (ACT-specific, nonspecific, and nicotine patch-related), coping behaviors, reasons to quit, changes in self-perception, and social benefits.Conclusions: Results suggest a need for assistance with obtaining social support and handling social impediments, interrupting the automaticity of smoking, expanding the behavioral repertoire to handle aversive internal states that tend to be avoided by smoking, preventing maladaptive beliefs from interfering with quitting, taking meaningful action toward change while experiencing ambivalence, either replacing the benefits of smoking or accepting their loss, and troubleshooting difficulties with nicotine replacement. Findings regarding facilitators of quitting supported previous quantitative findings that the ACT intervention impacted theory-based targets and highlighted the importance of the counseling relationship.