助产士进行家庭式动机性访谈以帮助怀孕吸烟者戒烟或减少吸烟量的随机对照试验。
Randomised controlled trial of home based motivational interviewing by midwives to help pregnant smokers quit or cut down.
作者信息
Tappin D M, Lumsden M A, Gilmour W H, Crawford F, McIntyre D, Stone D H, Webber R, MacIndoe S, Mohammed E
机构信息
Paediatric Epidemiology and Community Health Unit, Department of Child Health, Division of Developmental Medicine, University of Glasgow, Yorkhill, Glasgow G3 8SJ.
出版信息
BMJ. 2005 Aug 13;331(7513):373-7. doi: 10.1136/bmj.331.7513.373.
OBJECTIVE
To determine whether motivational interviewing--a behavioural therapy for addictions-provided at home by specially trained midwives helps pregnant smokers to quit.
DESIGN
Randomised controlled non-blinded trial analysed by intention to treat.
SETTING
Clinics attached to two maternity hospitals in Glasgow.
PARTICIPANTS
762/1684 pregnant women who were regular smokers at antenatal booking: 351 in intervention group and 411 in control group.
INTERVENTIONS
All women received standard health promotion information. Women in the intervention group were offered motivational interviewing at home. All interviews were recorded.
MAIN OUTCOME MEASURES
Self reported smoking cessation verified by plasma or salivary cotinine concentration.
RESULTS
17/351 (4.8%) women in the intervention group stopped smoking (according to self report and serum cotinine concentration < 13.7 ng/ml) compared with 19/411(4.6%) in the control group. Fifteen (4.2%) women in the intervention group cut down (self report and cotinine concentration less than half that at booking) compared with 26 (6.3%) in the control group. Fewer women in the intervention group reported smoking more (18 (5.1%) v 44 (10.7%); relative risk 0.48, 95% confidence interval 0.28 to 0.81). Birth weight did not differ significantly (mean 3078 g v 3048 g).
CONCLUSION
Good quality motivational interviewing did not significantly increase smoking cessation among pregnant women.
目的
确定由经过专门培训的助产士在家中提供的动机性访谈（一种成瘾行为疗法）是否有助于怀孕吸烟者戒烟。
设计
按意向性分析的随机对照非盲试验。
地点
格拉斯哥两家妇产医院附属的诊所。
参与者
1684名在产前登记时为经常吸烟者的孕妇中的762名：干预组351名，对照组411名。
干预措施
所有女性均获得标准的健康促进信息。干预组的女性在家中接受动机性访谈。所有访谈均进行录音。
主要观察指标
通过血浆或唾液可替宁浓度验证的自我报告戒烟情况。
结果
干预组中有17/351（4.8%）的女性戒烟（根据自我报告且血清可替宁浓度<13.7 ng/ml），而对照组为19/411（4.6%）。干预组中有15名（4.2%）女性减少吸烟量（自我报告且可替宁浓度低于登记时的一半），而对照组为26名（6.3%）。干预组中报告吸烟量增加的女性较少（18名（5.1%）对44名（10.7%）；相对风险0.48，95%置信区间0.28至0.81）。出生体重无显著差异（平均3078 g对3048 g）。
结论
高质量的动机性访谈并未显著提高孕妇的戒烟率。
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