Duffy Sonia A, Scheumann Angela L, Fowler Karen E, Darling-Fisher Cynthia, Terrell Jeffrey E
School of Nursing, Department of Otolaryngology, and Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
Oncol Nurs Forum. 2010 May;37(3):349-56. doi: 10.1188/10.ONF.349-356.
PURPOSE/OBJECTIVES: To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer.
This cross-sectional study is a substudy of a larger, randomized trial of patients with head and neck cancer that determined the predictors of smokers' participation in a cessation intervention.
Otolaryngology clinics at three Veterans Affairs medical centers (Ann Arbor, MI, Gainesville, FL, and Dallas, TX), and the University of Michigan Hospital in Ann Arbor.
286 patients who had smoked within six months of the screening survey were eligible for a smoking-cessation intervention.
Descriptive statistics and bivariate and multivariate logistic regression were used to determine the independent predictors of smokers' participation in an intervention study.
Perceived difficulty quitting (as a construct of self-efficacy), health behaviors (i.e., smoking and problem drinking), clinical characteristics (i.e., depression and cancer site and stage), and demographic variables.
Forty-eight percent of those eligible participated. High perceived difficulty quitting was the only statistically significant predictor of participation, whereas problem drinking, lower depressive symptoms, and laryngeal cancer site approached significance.
Special outreach may be needed to reach patients with head and neck cancer who are overly confident in quitting, problem drinkers, and patients with laryngeal cancer.
Oncology nurses are in an opportune position to assess patients' perceived difficulty quitting smoking and motivate them to enroll in cessation programs, ultimately improving quality of life, reducing risk of recurrence, and increasing survival for this population.
目的/目标:确定头颈癌患者参与戒烟项目的预测因素。
这项横断面研究是一项更大规模的头颈癌患者随机试验的子研究,该试验确定了吸烟者参与戒烟干预的预测因素。
三个退伍军人事务医疗中心(密歇根州安阿伯、佛罗里达州盖恩斯维尔和得克萨斯州达拉斯)的耳鼻喉科诊所,以及安阿伯的密歇根大学医院。
在筛查调查前六个月内吸烟的286名患者有资格参与戒烟干预。
采用描述性统计、双变量和多变量逻辑回归来确定吸烟者参与干预研究的独立预测因素。
感知到的戒烟困难(作为自我效能的一个构成要素)、健康行为(即吸烟和问题饮酒)、临床特征(即抑郁以及癌症部位和分期)和人口统计学变量。
48%的符合条件者参与了研究。感知到的高戒烟困难是参与的唯一具有统计学意义的预测因素,而问题饮酒、较低的抑郁症状和喉癌部位接近显著水平。
可能需要进行特别宣传,以覆盖那些对戒烟过于自信的头颈癌患者、有问题饮酒的患者以及喉癌患者。
肿瘤护士处于一个有利位置,可以评估患者感知到的戒烟困难,并激励他们参加戒烟项目,最终改善这一人群的生活质量、降低复发风险并提高生存率。