Varona Patricia, Bonet Mariano, Fernandez Niurys, Canizares Mayile, Roche René García, Ibarra Anna Maria, Wielgosz Andreas
National Institute of Hygiene, Epidemiology and Microbiology, Havana, Cuba.
J Urban Health. 2005 Mar;82(1):71-5. doi: 10.1093/jurban/jti009. Epub 2005 Feb 28.
Physicians have an important responsibility for addressing smoking cessation and prevention with their patients. The objective of this study was to describe the use of physician counseling for the prevention and control of smoking and to predict its use according to physician characteristics. A cross-sectional survey of a random sample of 121 family physicians in one municipality of the city of Havana was used to address sociodemographic factors, years of practice in the community, smoking status, use of physician counseling in daily practice (ask, advise, and assist), and the role of physician counseling as an intervention. Summary statistics were used as well as canonical and discriminant analyses. The prevalence of smoking among the physicians was 18%. The smoking status of patients was determined "almost always" by 32% of doctors. Twenty-five percent asked their patients whether they intended to stop smoking; 35% recommended smoking cessation; and 38% gave advice on how to achieve this. More than half (58%) explored factors that might influence cessation in their patients, and 12% reported doing this "frequently." Physician characteristics were associated significantly with preventive behavior, with community involvement, and with the perceived value of physician counseling and smoking status. Physician responses were associated with actual practice in 82% of the cases. Predisposing, facilitating, and reinforcing factors for preventive behavior were strong determinants of active involvement by physicians in daily practice. Training of health professionals must include smoking cessation.
医生在与患者讨论戒烟和预防吸烟方面负有重要责任。本研究的目的是描述医生咨询在吸烟预防和控制中的应用，并根据医生的特征预测其使用情况。对哈瓦那市一个城区的121名家庭医生随机样本进行横断面调查，以探讨社会人口学因素、在社区的执业年限、吸烟状况、日常实践中医生咨询的使用情况（询问、建议和协助）以及医生咨询作为一种干预措施的作用。使用了汇总统计以及典型分析和判别分析。医生中吸烟的患病率为18%。32%的医生“几乎总是”确定患者的吸烟状况。25%的医生询问患者是否打算戒烟；35%的医生建议戒烟；38%的医生就如何实现戒烟提供建议。超过一半（58%）的医生探究了可能影响患者戒烟的因素，12%的医生报告“经常”这样做。医生的特征与预防行为、社区参与以及医生咨询的感知价值和吸烟状况显著相关。在82%的案例中，医生的反应与实际做法相关。预防行为的诱发因素、促进因素和强化因素是医生在日常实践中积极参与的有力决定因素。卫生专业人员的培训必须包括戒烟内容。
