O'Loughlin J, Makni H, Tremblay M, Lacroix C, Gervais A, Déry V, Meshefedjian G, Paradis G
Direction de la santé publique, Régie régionale de la santé et des services sociaux de Montréal-Centre, 1301 Sherbrooke Est, Montréal, Québec.
Prev Med. 2001 Dec;33(6):627-38. doi: 10.1006/pmed.2001.0937.
Despite the cost-effectiveness of physician smoking cessation counseling, many physicians do not adhere to current clinical practice guidelines.
A cross-sectional mail survey was conducted in a random sample of general practitioners in Montreal to document cessation-counseling practices and identify correlates of these activities.
Of 440 eligible general practitioners, 337 (77%) completed the questionnaire. Despite favorable beliefs/attitudes about cessation counseling, only 10.5% of general practitioners provided "thorough" counseling. While high proportions of general practitioners ascertained smoking status and encouraged patients to quit, relatively few offered adjunct support (i.e., for patients preparing to quit, 49.8% offered follow-up visits; 42.5% offered educational material; 20% referred patients to community resources). Correlates of counseling completeness included high self-efficacy to provide counseling (odds ratio (OR) = 2.0, 95% confidence interval (1.1-3.6)) and favorable beliefs/attitudes about counseling (OR = 3.6 (2.0-6.4)). Correlates of ascertaining smoking status included female gender (OR = 2.3 (1.5-3.5)), high self-efficacy (OR = 3.5 (2.0-5.9)), and favorable beliefs/attitudes (OR = 2.7 (1.6-4.5)). Correlates of offering adjunct support included female gender (OR = 1.9 (1.1-3.2)), awareness of stages of change (OR = 2.4 (1.3-4.4)), and knowledge of community resources to help patients quit (OR = 2.3 (1.3-3.9)).
Support, training, and intervention programs to overcome lack of awareness and knowledge, unfavorable beliefs/attitudes, and low self-efficacy could increase and enhance cessation counseling practices among general practitioners.
尽管医生进行戒烟咨询具有成本效益，但许多医生并未遵循当前的临床实践指南。
对蒙特利尔的全科医生进行随机抽样的横断面邮件调查，以记录戒烟咨询实践并确定这些活动的相关因素。
在440名符合条件的全科医生中，337名（77%）完成了问卷。尽管对戒烟咨询有积极的信念/态度，但只有10.5%的全科医生提供了“全面”的咨询。虽然很大比例的全科医生确定了吸烟状况并鼓励患者戒烟，但提供辅助支持的相对较少（即，对于准备戒烟的患者，49.8%提供随访；42.5%提供教育材料；20%将患者转介至社区资源）。咨询完整性的相关因素包括提供咨询的高自我效能感（优势比（OR）=2.0，95%置信区间（1.1 - 3.6））以及对咨询的积极信念/态度（OR = 3.6（2.0 - 6.4））。确定吸烟状况的相关因素包括女性（OR = 2.3（1.5 - 3.5））、高自我效能感（OR = 3.5（2.0 - 5.9））以及积极信念/态度（OR = 2.7（1.6 - 4.5））。提供辅助支持的相关因素包括女性（OR = 1.9（1.1 - 3.2））、对改变阶段的认识（OR = 2.4（1.3 - 4.4））以及对帮助患者戒烟的社区资源的了解（OR = 2.3（1.3 - 3.9））。
旨在克服意识和知识不足、消极信念/态度以及低自我效能感的支持、培训和干预项目，可增加并加强全科医生的戒烟咨询实践。
