Guassora Ann Dorrit, Tulinius Anne Charlotte
The Research Unit and Department of General Practice, Centre of Health and Society, University of Copenhagen, 5 Øster Farimagsgade, Copenhagen K, Denmark.
Patient Educ Couns. 2008 Oct;73(1):28-35. doi: 10.1016/j.pec.2008.02.020. Epub 2008 Apr 10.
To describe consultations in Danish general practice as a context for a mass strategy of smoking cessation advice.
The focus of the study was on consultations for health problems that were not related to smoking. Interviews with eleven patients and their six GPs were grounded in observation of their own consultations.
Patients and GPs agreed that the GP should adopt an attitude of moral acceptance towards patients. Ideals of moral acceptance of patients in general practice consultations were challenged by the prevailing negative moral values associated with smoking. A general aim of mutuality in the conversation in consultations could not always be achieved in smoking cessation advice. Achieving mutuality was especially a problem when smoking cessation advice was repeated at short intervals.
Two elements of Danish general practice consultations were challenged by smoking cessation advice to patients without smoking-related illness: the ideal of moral acceptance of patients in general practice consultations held by GPs and patients and the wish for mutuality in the conversation during consultations.
A conversation about smoking based on motivational interviewing would fit in the context of Danish general practice. Relieving the conversation of blocks due to moral implications, however, is still a challenge.
将丹麦全科医疗中的会诊描述为戒烟建议大规模策略的一个背景。
该研究聚焦于与吸烟无关的健康问题的会诊。对11名患者及其6名全科医生的访谈基于对他们自身会诊的观察。
患者和全科医生一致认为，全科医生应对患者采取道德接纳的态度。全科医疗会诊中对患者道德接纳的理想受到了与吸烟相关的普遍负面道德价值观的挑战。在戒烟建议中，会诊谈话中相互性的总体目标并非总能实现。当短时间内反复提出戒烟建议时，实现相互性尤其成问题。
针对无吸烟相关疾病患者的戒烟建议对丹麦全科医疗会诊的两个要素构成了挑战：全科医生和患者在全科医疗会诊中对患者道德接纳的理想，以及会诊期间谈话中对相互性达成的愿望。
基于动机性访谈的关于吸烟的谈话适合丹麦全科医疗的背景。然而，消除因道德影响而产生的谈话障碍仍是一项挑战。
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