Alonso Fernández M, Salvadores Rubio J J, Gonzalvo Rodríguez C, García Lavandera J, López Sampedro P, Peñacoba Maestre D
Area Sanitaria VIII de Asturias. España.
Aten Primaria. 2003 Mar 15;31(4):269-71. doi: 10.1016/s0212-6567(03)79170-7.
Tobacco dependency is now beginning to be seen as a chronic disease. The scientific evidence of the damage it causes and the existence of efficient interventions mean it has to be tackled. In Health Area VIII of Asturias a plan to aid smokers was initiated in 1998. Now we want to extend this to patients who are going to have scheduled surgery, since it has been demonstrated that tobacco increases post-operative complications. In addition, having to confront surgery may be a reason for trying to give up tobacco.
Patients who are going to undergo surgery will be questioned and counselled on their tobacco habit during the pre-operative period. They will do the Richmond test and will be referred to the health centre if their score is >= 7.Interventions. The family doctor assesses the smokers' dependency and motivation, and offers them personalised treatment to give up. During their time in hospital, a nurse backs up their non-smoking. Once discharged, they are monitored periodically in primary care.
At the same time as the annual evaluation of the service portfolio, the number of smokers who underwent surgery and were counselled, visited on the ward and monitored in primary care will be measured. The number of patients still not smoking at one month, six months and twelve months will be recorded.
Lack of finance for the treatment may be one of the limitations of the programme. Although there are experiences in other countries of interventions in smokers who are going to have surgery, we have found no similar programme here.
烟草依赖如今开始被视作一种慢性病。其造成损害的科学证据以及有效干预措施的存在意味着必须对其加以应对。在阿斯图里亚斯的第八健康区,1998年启动了一项帮助吸烟者的计划。现在我们想将此计划扩展至即将接受择期手术的患者,因为已有证据表明烟草会增加术后并发症。此外,不得不面对手术可能成为尝试戒烟的一个理由。
即将接受手术的患者在术前阶段将接受关于其吸烟习惯的询问并得到咨询。他们将进行里士满测试,如果得分>=7,将被转介至健康中心。干预措施。家庭医生评估吸烟者的依赖程度和动机,并为他们提供个性化的戒烟治疗。在他们住院期间,护士会支持他们戒烟。出院后,他们在初级保健机构接受定期监测。
在对服务组合进行年度评估的同时,将统计接受手术并得到咨询、在病房接受探访以及在初级保健机构接受监测的吸烟者数量。记录在1个月、6个月和12个月时仍未吸烟的患者数量。
治疗资金短缺可能是该项目的局限性之一。尽管在其他国家有针对即将接受手术的吸烟者进行干预的经验,但我们在这里尚未发现类似项目。