Sciamanna C N, Hoch J S, Duke G C, Fogle M N, Ford D E
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Gen Intern Med. 2000 Jan;15(1):16-23. doi: 10.1046/j.1525-1497.2000.11198.x.
To compare the predictive validity of several measures of motivation to quit smoking among inpatients enrolled in a smoking cessation program.
Data collected during face-to-face counseling sessions included a standard measure of motivation to quit (stage of readiness [Stage]: precontemplation, contemplation, or preparation) and four items with responses grouped in three categories: "How much do you want to quit smoking" (Want), "How likely is it that you will stay off cigarettes after you leave the hospital" (Likely), "Rate your confidence on a scale from 0 to 100 about successfully quitting in the next month" (Confidence), and a counselor assessment in response to the question, "How motivated is this patient to quit?" (Motivation). Patients were classified as nonsmokers if they reported not smoking at both the 6-month and 12-month interviews. All patients lost to follow-up were considered smokers.
At 1 year, the smoking cessation rate was 22. 5%. Each measure of motivation to quit was independently associated with cessation ( p <.001) when added individually to an adjusted model. Likely was most closely associated with cessation and Stage was least. Likely had a sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio of 70.2%, 68.1%, 39.3%, 88.6%, and 2.2, respectively.
The motivation of inpatient smokers to quit may be as easily and as accurately predicted with a single question as with the series of questions that are typically used.
比较参加戒烟项目的住院患者中几种戒烟动机测量方法的预测效度。
在面对面咨询过程中收集的数据包括一种标准的戒烟动机测量方法（准备阶段[阶段]：未考虑、考虑或准备）以及四个项目，其回答分为三类：“你有多想戒烟”（意愿）、“你出院后戒烟的可能性有多大”（可能性）、“在0到100的范围内对你在下个月成功戒烟的信心进行评分”（信心），以及咨询师对“该患者戒烟的积极性有多高？”这个问题的评估（积极性）。如果患者在6个月和12个月的访谈中均报告不吸烟，则被归类为非吸烟者。所有失访的患者均被视为吸烟者。
1年后，戒烟率为22.5%。当将每种戒烟动机测量方法单独添加到调整模型中时，均与戒烟独立相关（p<.001）。可能性与戒烟的相关性最强，阶段与戒烟的相关性最弱。可能性的灵敏度、特异度、阳性预测值、阴性预测值和似然比分别为70.2%、68.1%、39.3%、88.6%和2.2。
与通常使用的一系列问题相比，用一个问题就能同样轻松且准确地预测住院吸烟者的戒烟动机。
