Knowledge gaps about smoking cessation in hospitalized patients and their doctors
Knowledge gaps about smoking cessation in hospitalized patients and their doctors
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DOI：
10.1177/1741826710389370
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发表时间：
2011-04-01
影响因子：
--
通讯作者：
Pipe, Andrew
中科院分区：
文献类型：
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作者：
Raupach, Tobias;Merker, Jacqueline;Pipe, Andrew
背景：住院是戒烟支持的合适时机；医院医生提供的戒烟干预措施是有效的。虽然全科医生和门诊病人对戒烟的知识和态度已经进行了详细的研究，但住院病人戒烟计划受到的关注较少。设计：对德国哥廷根大学医院的医生和住院病人进行问卷调查。方法：所有159名直接参与内科和外科病房床边护理的医生都收到了一份三页的问卷，调查吸烟状况、吸烟导致的发病率和死亡率的知识，以及他们对实现长期戒烟方法有效性的了解。确定了向吸烟患者提供咨询和戒烟服务的障碍。随机选择1000名内科病房（N = 400）和外科病房（N = 600）的患者填写类似的问卷。结果：77名医生（有效率48.4%）和675名患者（67.5%）完成问卷调查。患者和医生都低估了吸烟导致的与吸烟有关的癌症和慢性阻塞性肺病的风险。此外，在两个人群中都注意到对戒烟方法有效性的严重误解，“意志力”被认为是实现戒断最有效的方法。只有三分之一的吸烟患者回忆曾被建议戒烟。医生们认为，缺乏时间是给吸烟患者提供咨询的主要障碍。结论：这些发现表明，在德国一家大型大学医院住院的吸烟者可能不按照国际指导方针治疗。
Background: Hospitalization is an opportune time for smoking cessation support; cessation interventions delivered by hospital physicians are effective. While general practitioners' and outpatients' knowledge and attitudes towards smoking cessation have been studied in great detail, in-patient cessation programmes have received less attention.Design: Questionnaire-based survey of a convenience sample of hospital physicians and in-patients at Gottingen University Hospital, Germany.Methods: All 159 physicians directly involved in bedside care on medical and surgical wards received a three-page questionnaire examining smoking status, knowledge of smoking-attributable morbidity and mortality, and their understanding of the effectiveness of methods to achieve long-term smoking cessation. Perceived barriers to the delivery of counselling and cessation services to smoking patients were identified. One thousand randomly selected patients on medical (N = 400) and surgical (N = 600) wards were invited to complete a similar questionnaire.Results: Seventy-seven physicians (response rate 48.4%) and 675 patients (67.5%) completed the questionnaire. Patients and physicians alike underestimated the smoking-attributable risk of developing smoking-related cancers and chronic obstructive lung disease. In addition, severe misperceptions regarding the effectiveness of cessation methods were noted in both populations with 'willpower' being thought to be most effective in achieving abstinence. Only one-third of smoking patients recalled having been counselled to quit. Physicians identified lack of time as a central barrier to counselling smoking patients.Conclusions: These findings suggest that hospitalized smokers in a large German university hospital might not be treated according to international guidelines.