Collins Bradley N, Levin Kenneth P, Bryant-Stephens Tyra
Health Behavior Research Clinic, Department of Public Health, Temple University, Pennsylania 19122, USA.
J Pediatr. 2007 May;150(5):547-52. doi: 10.1016/j.jpeds.2007.01.006.
To assess pediatric resident and preceptor environmental tobacco smoke (ETS)-reduction practices and attitudes to inform the development of resident tobacco intervention training.
Pediatricians in a teaching hospital anonymously completed a 65-item survey.
Residents' and preceptors' (n = 93) ETS actions were generally similar. Pediatricians inconsistently intervened across treatment settings and when treating different ETS-related illnesses (eg, 60% "always" assessed during asthma visits, 13% during otitis visits). Less than 50% "always" explained ETS risks to smoking parents and less than 33% "always" advised about creating smoke-free homes. Most pediatricians reported negative attitudes toward smoking parents; however, attitudes were not related to actions. Most frequently cited barriers to ETS action were lack of time and low confidence in effectiveness.
Understanding barriers to ETS intervention could promote transdisciplinary (TD) training and intervention approaches that effectively promote pediatrician advice while offloading the time burden of intensive smoking intervention. ETS intervention training should foster pediatrician confidence and TD relationships with affiliated health professionals who could facilitate intervention, referral, and follow-up necessary to sustain smoking behavior change.
评估儿科住院医师和带教老师减少环境烟草烟雾（ETS）的行为及态度，为住院医师烟草干预培训的开展提供参考。
一家教学医院的儿科医生匿名完成了一项包含65个条目的调查。
住院医师和带教老师（n = 93）的ETS相关行为总体相似。儿科医生在不同治疗场景以及治疗不同的ETS相关疾病时干预情况不一致（例如，60%在哮喘就诊时“总是”进行评估，13%在中耳炎就诊时进行评估）。不到50%的医生“总是”向吸烟的家长解释ETS的风险，不到33%的医生“总是”建议创建无烟家庭。大多数儿科医生表示对吸烟家长持负面态度；然而，态度与行为并无关联。最常被提及的ETS干预障碍是时间不足和对干预效果缺乏信心。
了解ETS干预的障碍有助于推动跨学科（TD）培训和干预方法，从而在减轻密集吸烟干预时间负担的同时，有效地促进儿科医生提供相关建议。ETS干预培训应增强儿科医生的信心，并促进其与附属健康专业人员建立TD关系，这些专业人员可协助进行干预、转诊以及维持吸烟行为改变所需的随访。
