Breaking the habit: a qualitative exploration of barriers and facilitators to smoking cessation in people with enduring mental health problems.
Breaking the habit: a qualitative exploration of barriers and facilitators to smoking cessation in people with enduring mental health problems.
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DOI：
10.1186/1471-2458-13-221
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发表时间：
2013-03-12
影响因子：
4.5
通讯作者：
Hunter R
中科院分区：
文献类型：
--
作者：
Kerr S;Woods C;Knussen C;Watson H;Hunter R
有心理健康问题 (MHP) 的人吸烟是一个重要的公共卫生问题，因为吸烟率比普通人群高出两到三倍。虽然有强有力的证据基础鼓励和支持更广泛的人群戒烟，但指导针对 MHP 患者制定干预措施的证据有限，包括对他们的需求的了解很少。本文介绍了理论驱动的形成性研究的结果，该研究探讨了 MHP 患者戒烟的障碍和促进因素。其目的是在 MRC 复杂干预措施开发和评估框架的指导下，收集证据，为该客户群的戒烟干预措施的设计和内容提供信息。在回顾了实证和理论文献后，并采取批判现实主义的观点，采用定性方法从主要利益相关者那里收集数据，包括具有持久 MHP 的人 (n = 27) 和经常与该客户群体接触的专业人士 (n = 54)。 MHP 参与者吸烟有很强的社会规范，大多数人对尼古丁严重上瘾。他们承认，如果戒烟，他们的身体健康将会改善，可支配收入也会增加；然而，更重要的是，如果他们试图戒烟，他们的焦虑程度会增加，他们会失去重要的应对资源，他们会放弃一些他们觉得愉快的东西，最重要的是，他们的心理健康状况会恶化。因此，戒烟的障碍超过了潜在的促进因素，因此对动机和自我效能水平产生了负面影响。专业人士鼓励戒烟尝试的潜力是显而易见的；然而，他们常常没有提出吸烟/戒烟的问题，因为他们认为这会损害他们与客户的关系。专业人士自身的吸烟状况似乎也影响了他们的健康促进作用。目前，许多鼓励和支持 MHP 患者戒烟的机会都被错过了。我们的研究结果和文献综述所提供的加深理解已被用于为该客户群量身定制戒烟干预措施的内容提出建议。
Smoking in people with mental health problems (MHPs) is an important public health concern as rates are two to three times higher than in the general population. While a strong evidence base exists to encourage and support smoking cessation in the wider population, there is limited evidence to guide the tailoring of interventions for people with MHPs, including minimal understanding of their needs. This paper presents findings from theoretically-driven formative research which explored the barriers and facilitators to smoking cessation in people with MHPs. The aim, guided by the MRC Framework for the development and evaluation of complex interventions, was to gather evidence to inform the design and content of smoking cessation interventions for this client group. Following a review of the empirical and theoretical literature, and taking a critical realist perspective, a qualitative approach was used to gather data from key stakeholders, including people with enduring MHPs (n = 27) and professionals who have regular contact with this client group (n = 54). There was a strong social norm for smoking in participants with MHPs and most were heavily addicted to nicotine. They acknowledged that their physical health would improve if they stopped smoking and their disposable income would increase; however, more important was the expectation that, if they attempted to stop smoking, their anxiety levels would increase, they would lose an important coping resource, they would have given up something they found pleasurable and, most importantly, their mental health would deteriorate. Barriers to smoking cessation therefore outweighed potential facilitators and, as a consequence, impacted negatively on levels of motivation and self-efficacy. The potential for professionals to encourage cessation attempts was apparent; however, they often failed to raise the issue of smoking/cessation as they believed it would damage their relationship with clients. The professionals’ own smoking status also appeared to influence their health promoting role. Many opportunities to encourage and support smoking cessation in people with MHPs are currently missed. The increased understanding provided by our study findings and literature review have been used to shape recommendations for the content of tailored smoking cessation interventions for this client group.
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影响因子：
10.5
作者：
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通讯作者：
McCreadie, RG
DOI：
10.1177/070674370805301107
发表时间：
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影响因子：
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