中国全科医学 ›› 2024, Vol. 27 ›› Issue (34): 4256-4263.DOI: 10.12114/j.issn.1007-9572.2023.0775

• 论著 • 上一篇    下一篇

中国戒烟门诊医务人员戒烟行为改变技术使用情况及其与戒烟成功率的关系研究

洪秋棉1,2, 廖艳辉3, 景晓娟4, 张宁1,2,*()   

  1. 1.310058 浙江省杭州市,浙江大学医学院公共卫生学院
    2.310058 浙江省杭州市,浙江大学医学院附属第二医院临床大数据与统计中心
    3.310016 浙江省杭州市,浙江大学医学院附属邵逸夫医院精神卫生科
    4.100081 北京市,北京青年政治学院青年工作学院 北京青少年研究所
  • 收稿日期:2023-12-01 修回日期:2024-04-29 出版日期:2024-12-05 发布日期:2024-09-13
  • 通讯作者: 张宁

  • 作者贡献:

    洪秋棉负责根据研究设计进行数据整理和分析,绘制图表,报告结果并撰写论文初稿,对论文进行修订;廖艳辉、景晓娟参与论文修订;张宁提出研究问题,负责研究设计和数据收集,指导数据分析、稿件撰写和修改,对文章负责。

  • 基金资助:
    浙江省教育厅一般科研项目(Y202248593); 浙江大学"百人计划"启动经费; 浙江省智能预防医学重点实验室(2020E10004); 浙江省领军型创新创业团队(2019R01007)

The Usage of Smoking Cessation Related Behavior Change Techniques by Medical Staff in Smoking Cessation Clinics in China and Its Relationship with the Success Rate of Smoking Cessation

HONG Qiumian1,2, LIAO Yanhui3, JING Xiaojuan4, ZHANG Ning1,2,*()   

  1. 1. School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
    2. Clinical Big Data and Statistics Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China
    3. Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
    4. Beijing Youth Research Institute/Youth Work College, Beijing Youth Politics College, Beijing 100081, China
  • Received:2023-12-01 Revised:2024-04-29 Published:2024-12-05 Online:2024-09-13
  • Contact: ZHANG Ning

摘要: 背景 戒烟行为改变技术(BCTs)是指可以改变参与者吸烟行为的干预内容的明确表述,目前尚缺乏研究探索我国戒烟门诊医务人员BCTs使用现状。 目的 了解我国戒烟门诊医务人员戒烟相关BCTs使用情况,并探讨医务人员BCTs使用情况、感知效果与所在门诊戒烟成功率之间的关系。 方法 于2022年2月—2023年3月,通过"问卷星"向我国戒烟门诊医务人员发放线上问卷,调查其44项戒烟相关BCTs使用情况、感知效果、所在门诊的戒烟成功率,以及年龄、性别等人口统计学特征。采用分层线性回归模型分析医务人员BCTs使用项数、感知效果对所在门诊戒烟成功率的影响及二者间的交互作用,采用简单斜率分析进一步检验BCTs使用项数和感知效果的交互作用。 结果 共回收有效问卷285份。285名戒烟门诊医务人员平均使用BCTs项数为(29±13)项,对BCTs的感知效果平均评分为(3.15±0.96)分,所在戒烟门诊的平均戒烟成功率为(37.0±24.3)%。不同最高学历、所在门诊追踪吸烟者戒烟效果情况医务人员的BCTs使用项数、感知效果比较,差异有统计学意义(P<0.05);不同戒烟门诊工作年限、医院职务、所在门诊追踪吸烟者戒烟效果情况医务人员的所在门诊戒烟成功率比较,差异有统计学意义(P<0.05)。分层线性回归模型分析结果显示:在控制了戒烟门诊工作年限、医院职务、所在门诊是否追踪吸烟者戒烟效果3项变量后,医务人员BCTs感知效果能正向预测戒烟门诊的戒烟成功率[b(95%CI)=10.070(7.066~13.075),P<0.05],而BCTs使用项数不是戒烟门诊戒烟成功率的影响因素(P>0.05);进一步纳入BCTs使用项数×感知效果后,模型对戒烟门诊戒烟成功率的解释度增加2.2%,BCTs感知效果[b(95%CI)=11.711(8.548~14.874),P<0.05]、BCTs使用项数×感知效果[b(95%CI)=2.921(0.958~4.884),P<0.05]对戒烟成功率有正向预测作用。 结论 医务人员戒烟相关BCTs使用情况对所在门诊的戒烟成功率有明显影响,且BCTs使用项数、感知效果对戒烟成功率的影响有明显交互作用。未来需要完善戒烟门诊干预技术培训方案,实现干预技术理论到实践的转化和落实,以帮助更多的吸烟者成功戒烟。

关键词: 戒烟门诊, 行为改变技术, 使用频率, 感知效果, 戒烟成功率, 分层线性回归, 交互效应

Abstract:

Background

Smoking cessation related behavior change techniques (BCTs) are defined as interventions that can change smokers' smoking behavior. At present, there are no studies to explore the current status of BCTs usage among outpatient healthcare workers for smoking cessation in China.

Objective

The current study aims to describe the frequency and perceived effect of medical staff using BCTs in smoking cessation clinics, and to investigate the association between the usage of BCTs by medical staff and successful quitting rate among smokers in smoking cessation clinics.

Methods

From February 2022 to March 2023, online questionnaire was distributed to medical staff in smoking cessation clinics in China through "WJX" to evaluate the frequency and perceived effect of 44 smoking cessation BCTs used, the success rate of smoking cessation, as well as the demographic characteristics such as age and gender. The hierarchical linear regression model and simple slope analysis were utilized to explore the factors affecting the success rate of quitting in smoking cessation clinics and to examine the interaction between frequency and perceived effect of BCTs used for promoting smoking cessation.

Results

Two-hundred and eighty-five healthcare professionals who had experience in smoking cessation clinics over one year were included in this study. On average, it is reported that healthcare professionals have used (29±13) smoking cessation related BCTs. The perceived average score for effectiveness of BCTs used was (3.15±0.96). The self-reported average success rate of smoking cessation was (37.0±24.3) %. There were statistically significant differences in the number of BCTs used and the perceived effect of medical staff with different highest education level and whether tracking smoking cessation rate of smokers (P<0.05). There were also statistically significant differences in the smoking cessation rate among medical staff with different years of working in smoking cessation clinics, position in the hospital and whether tracking smoking cessation rate (P<0.05). The hierarchical linear regression showed that after controlling for three variables, including the years of working in the clinics, the position of the clinic staff, and whether tracking smoking cessation rates of smokers, the perceived effect of BCTs used could positively predict the success rate of smoking cessation in the smoking cessation clinic [b (95%CI) =10.070 (7.066-13.075), P<0.05]. While the number of BCTs used was not a significant factor in the success rate of smoking cessation (P>0.05). When the interaction item of BCTs used × effect perception was further included, the explanatory of the model for the success rate of smoking cessation in the smoking cessation clinic increased by 2.2%, and the perceived effect of BCTs [b (95%CI) =11.711 (8.548-14.874), P<0.05], the number of BCTs used × effect perception had a positive predictive effect on the success rate of smoking cessation [b (95%CI) =2.921 (0.958-4.884), P<0.05] .

Conclusion

The use of quitting BCTs had a significant impact on the rate of successful smoking cessation in the smoking cessation clinic, and the number of BCTs used and the perceived effect had a significant interaction effect on the success rate of smoking cessation. In the future, it is necessary to improve the training program of smoking cessation practices, and accelerate the transformation and implementation of smoking cessation related BCTs so as to help more smokers to quit smoking successfully.

Key words: Smoking cessation clinics, Behavior change techniques, Usage frequency, Perceived effect, Success rate of smoking cessation, Hierarchical linear regression, Interaction effects

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