Physician counseling of pregnant women about active and secondhand smoking in Argentina
Physician counseling of pregnant women about active and secondhand smoking in Argentina
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DOI：
10.3109/00016341003739567
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发表时间：
2010-04-01
影响因子：
4.3
通讯作者：
Perez-Stable, Eliseo J.
中科院分区：
文献类型：
--
作者：
Mejia, Raul;Martinez, Valeria Guil;Perez-Stable, Eliseo J.
目标。描述医生在产前检查期间戒烟和二手烟(SHS)暴露咨询的做法。设计。横断面调查。设置。来自阿根廷三个城市的13家公立和私立医院。人口。共有300名产科/妇科医生。方法：研究方法。自填式调查包括孕期烟草使用的知识和态度、戒烟咨询的频率、类型和持续时间、咨询的障碍、沟通技能、理解水平和个人吸烟史。主要观察指标。四个项目的综合结果，每个项目代表戒烟和SHS暴露的咨询。结果。总共完成了235份问卷(78.3%)；54.5%的男性，平均年龄45岁，35%的现任吸烟者。只有22%的人接受过戒烟咨询培训，48.5%的人表示没有足够的知识提供戒烟建议。尽管88.9%的人总是或几乎总是建议女性戒烟，但75%的人认为孕妇每天吸烟最多6支是可以接受的。只有34.5%的医生“总是或几乎总是”讨论过SHS的风险。多因素Logistic回归分析显示，缺乏训练与戒烟(OR 0.18；95%CI 0.04~0.82)和SHS暴露(OR 0.27；95%CI 0.12~0.59)咨询较少有关。与从不吸烟者相比，目前吸烟者接受戒烟咨询的几率较低(OR 0.39；95%CI 0.05-0.82)。现在吸烟者比曾经吸烟者对SHS的咨询更少(OR 0.25；95%CI 0.11-0.62)。结论。在阿根廷，怀孕期间的戒烟咨询很少发生，需要干预措施来帮助医生激励和建议妇女戒烟，避免接触SHS。照顾孕妇的医生也需要戒烟。
Objective. Describe physicians' practices of smoking cessation and secondhand smoke (SHS) exposure counseling during prenatal visits. Design. Cross-sectional survey. Setting. A total of 13 public and private hospitals from three cities in Argentina. Population. A total of 300 obstetrician/gynecologists. Methods. Self-administered survey included knowledge and attitudes about tobacco use during pregnancy, frequency, type and duration of smoking cessation counseling, barriers to counseling, communication skills, level of understanding and personal smoking history. Main outcome measures. Composite outcomes of four items, each representative of counseling on smoking cessation and SHS exposure. Results. A total of 235 (78.3%) questionnaires were completed; 54.5% men, mean age 45, 35% current smokers. Only 22% had received training in smoking cessation counseling and 48.5% reported insufficient knowledge to provide smoking cessation advice. Although 88.9% always or almost always advised women to stop smoking, 75% believed it was acceptable for pregnant women to smoke up to 6 cigarettes per day. The risk of SHS exposure was 'always or almost always discussed' by only 34.5% of physicians. Multivariate logistic regression showed that lack of training was associated with less counseling about smoking cessation (OR 0.18; 95% CI 0.04-0.82) and SHS exposure (OR 0.27; 95% CI 0.12-0.59). Current compared to never smokers had lower odds of smoking cessation counseling (OR 0.39; 95% CI 0.05-0.82). Current smokers were less likely than former smokers to counsel about SHS (OR 0.25; 95% CI 0.11-0.62). Conclusions. Smoking cessation counseling during pregnancy in Argentina occurs infrequently, interventions are needed to assist physicians motivate and counsel women to quit smoking and avoid SHS exposure. Physicians taking care of pregnant women also need to quit smoking.