Okoli Chizimuzo T C, Greaves Lorraine, Bottorff Joan L, Marcellus Lenora M
Tobacco Research Program at the British Columbia Centre of Excellence for Women's Health, Vancouver, British Columbia, Canada..
Health System Strategy Division of the Ministry of Health and Long Term Care in the Province of Ontario and an investigator at the British Columbia Centre of Excellence for Women's Health, Vancouver, British Columbia, Canada.
J Obstet Gynecol Neonatal Nurs. 2010 Jan-Feb;39(1):64-77. doi: 10.1111/j.1552-6909.2009.01084.x.
To review how health care providers' (HCPs) engage in smoking cessation (SC) with pregnant smokers, and to examine the effect of system-level approaches and training initiatives to promote SC provision by HCPs.
A comprehensive search of the CINAHL, COCHRANE Library, EMBASE, ERIC, MEDLINE, PsycINFO, and SIGLE databases was conducted.
Selected studies assessed the behaviors of HCPs working among pregnant/postpartum girls and women, employed a quantitative approach, and had clearly defined behavioral outcomes of HCPs' delivery of SC to pregnant smokers.
A total of 988 studies were obtained from the literature search, of which 28 publications met the inclusion criteria. The data extracted from the articles are presented under the following areas: how HCPs are engaging pregnant smokers and approaches to enhancing SC by HCP with pregnant smokers.
Although more than 50% of HCPs are likely to ask women about their smoking status and advise pregnant smokers to quit, fewer than 50% either assess readiness to change, assist in smoking cessation, or arrange for follow-up appointments/referrals. Important provider-specific, patient-specific, and system/organizational barriers were found to hinder the provision of SC by HCP. Several system-level and training approaches to enhancing HCP's engagement in SC with pregnant smokers show merit.
Few HCPs working with pregnant women use all the components of the Agency for Healthcare Research and Quality clinical guidelines. However, system-level and training approaches are effective ways to enhance HCP's engagement in SC; although, the effects of such initiatives may not be sustained. Factors such as the gender of the provider, geographical location, and the use of women-centered treatment approaches could be further examined in relation to provision of SC by HCPs among pregnant smokers.
回顾医疗保健提供者（HCPs）如何与怀孕吸烟者进行戒烟（SC）工作，并研究系统层面的方法和培训举措对促进HCPs提供戒烟服务的效果。
对CINAHL、COCHRANE图书馆、EMBASE、ERIC、MEDLINE、PsycINFO和SIGLE数据库进行了全面检索。
所选研究评估了在怀孕/产后女孩和妇女中工作的HCPs的行为，采用定量方法，并明确界定了HCPs向怀孕吸烟者提供戒烟服务的行为结果。
通过文献检索共获得988项研究，其中28篇出版物符合纳入标准。从文章中提取的数据在以下方面呈现：HCPs如何与怀孕吸烟者接触以及HCPs帮助怀孕吸烟者戒烟的方法。
尽管超过50%的HCPs可能会询问女性的吸烟状况并建议怀孕吸烟者戒烟，但不到50%的HCPs会评估其改变的意愿、协助戒烟或安排随访预约/转诊。发现重要的提供者特定、患者特定以及系统/组织障碍阻碍了HCPs提供戒烟服务。几种系统层面和培训方法在增强HCPs与怀孕吸烟者的戒烟工作参与度方面显示出价值。
很少有与孕妇打交道的HCPs使用医疗保健研究与质量机构临床指南的所有组成部分。然而，系统层面和培训方法是增强HCPs参与戒烟工作的有效途径；尽管如此，这些举措的效果可能无法持续。与HCPs在怀孕吸烟者中提供戒烟服务相关的因素，如提供者的性别、地理位置以及以女性为中心的治疗方法的使用等，可进一步研究。
