俄亥俄州阿巴拉契亚妇女中，由护士管理、由非专业人员领导的烟草戒断干预的效果。
Effectiveness of a nurse-managed, lay-led tobacco cessation intervention among ohio appalachian women.
机构信息
The Ohio State University, Columbus, 43210, USA.
出版信息
Cancer Epidemiol Biomarkers Prev. 2009 Dec;18(12):3451-8. doi: 10.1158/1055-9965.EPI-09-0952.
OBJECTIVES
The purpose of this study was to evaluate a nurse-managed, lay-led tobacco cessation intervention delivered to adult women in Ohio Appalachia.
METHODS
A randomized controlled experimental design included intervention participants (n = 147) enrolled in a nurse-managed, lay-led protocol that incorporated nicotine replacement and behavioral counseling. Control participants (n = 155) received a personalized letter from their clinic physician, who advised them to quit smoking and requested they schedule a clinic appointment to discuss cessation.
RESULTS
Self-reported and cotinine-validated quit rates were significantly higher among intervention group participants compared with control group participants at 3-and 6-month follow-up (P < 0.02). At 12 months, self-reported abstinence was 19.1% (intervention group) and 9.0% (control group), with cotinine-validated rates of 12.2% and 7.1%, respectively (P = 0.13). Prolonged abstinence rates were significantly different between groups at 3, 6, and 12 months (P < 0.02). Logistic regression analyses indicated adjusted odds of cotinine-validated quitting was associated with cigarette consumption per day (odds ratio, 0.94; 95% confidence interval, 0.89-0.99) and Center for Epidemiologic Studies Depression Scale score > or = 16 (odds ratio, 0.39; 95% confidence interval, 0.17-0.90).
CONCLUSIONS
A lay-led approach that is managed by a nurse may serve as an effective cessation strategy among this high-risk population. Additional efforts are needed to sustain long-term abstinence, even after intensive intervention.
目的
本研究旨在评估一项针对俄亥俄州阿巴拉契亚地区成年女性的、由护士管理的、由非专业人员领导的戒烟干预措施。
方法
采用随机对照实验设计，将参与研究的干预组（n=147）纳入到一个由护士管理的、以尼古丁替代疗法和行为咨询为基础的非专业人员领导的协议中。对照组（n=155）则收到其诊所医生的个性化信函，信中建议他们戒烟并要求他们预约诊所讨论戒烟事宜。
结果
与对照组相比，干预组参与者在 3 个月和 6 个月的随访中自我报告和可替宁验证的戒烟率显著更高（P < 0.02）。12 个月时，自我报告的戒烟率分别为 19.1%（干预组）和 9.0%（对照组），可替宁验证的戒烟率分别为 12.2%和 7.1%（P=0.13）。3、6 和 12 个月时，两组的长期戒烟率存在显著差异（P < 0.02）。逻辑回归分析表明，可替宁验证的戒烟与每天吸烟量（比值比，0.94；95%置信区间，0.89-0.99）和流行病学研究中心抑郁量表评分>或=16（比值比，0.39；95%置信区间，0.17-0.90）呈关联。
结论
由护士管理的、以非专业人员为主导的方法可能是针对这一高危人群的有效戒烟策略。即使在强化干预之后，仍需要进一步努力来维持长期的戒烟率。
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