Tobacco Intervention Practices of Primary Care Physicians Treating Lower Socioeconomic Status Patients
Tobacco Intervention Practices of Primary Care Physicians Treating Lower Socioeconomic Status Patients
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DOI：
10.1097/maj.0b013e3182302749
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发表时间：
2012-05-01
影响因子：
3.1
通讯作者：
Barone, Claudia
中科院分区：
文献类型：
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作者：
Sheffer, Christine E.;Anders, Michael;Barone, Claudia
烟草使用在很大程度上造成了总体社会经济健康差距，医生是有关有效戒烟方法的主要信息来源。本研究调查了阿肯色州初级保健医生的烟草干预实践，他们治疗了高比例的低社会经济地位患者。超过70%的受访者患者享受医疗补助和/或医疗保险，或在没有医疗保险的情况下支付初级保健服务费用。尽管医生积极性很高，认为戒烟非常重要，但74%的人没有接受过任何形式的烟草依赖治疗培训，对阿肯色州免费治疗服务的熟悉程度也很低。年轻的非白人医生和接受过任何类型治疗烟草依赖培训的医生报告说，他们的态度更积极，干预行为更频繁，对治疗服务更熟悉。更频繁地看到烟草使用对患者健康的影响，以及对治疗的知识、准备和有效性的增加，与提供戒烟帮助的频率更高有关。更频繁地看到烟草使用对患者的影响，以及对治疗服务的熟悉程度增加，与将患者转介到治疗服务的频率更高有关。这些发现表明，培训经验可以提高医生对烟草使用的多种后果的认识，并增加知识、准备、治疗的感知有效性和对治疗服务的熟悉程度，这将增加医生帮助和转诊这一重要患者群体的频率。
Tobacco use greatly contributes to overall socioeconomic health disparities, and physicians are a major source of information about effective methods for tobacco cessation. This study examined the tobacco intervention practices of primary care physicians in Arkansas who treat a high proportion of lower socioeconomic status patients. More than 70% of respondents' patients were covered by Medicaid and/or Medicare or paid for primary care services without health insurance. Although physicians were highly motivated and considered cessation to be very important, 74% had no training of any kind in the treatment of tobacco dependence and familiarity with the free treatment services in Arkansas was low. Younger and nonwhite physicians and physicians with any type of training in treating tobacco dependence reported more positive attitudes, more frequent intervention behaviors and more familiarity with treatment services. More frequently seeing the effects of tobacco use on the health of patients as well as increased knowledge, preparedness, and perceived effectiveness of treatments were related to a higher frequency of providing cessation assistance. More frequently seeing the effects of tobacco use on patients, as well as increased familiarity with treatment services were related to a higher frequency of referring patients to treatment services. These findings suggest that training experiences that increase physician awareness of the multiplicity of consequences of tobacco use as well as increase knowledge, preparedness, perceived effectiveness of treatments and familiarity with treatment services will increase the frequency with which physicians assist and refer this important patient population.