Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California 94143-0984, USA.
Clin Cardiol. 2011 Dec;34(12):738-43. doi: 10.1002/clc.20982. Epub 2011 Oct 10.
Heart disease is the leading cause of tobacco-related death in smokers and of deaths due to secondhand smoke (SHS) exposure in nonsmokers. This study centers on the development and evaluation of an evidence-based model curriculum for improving clinical attention to tobacco use and SHS exposure in cardiology.
We hypothesized that the curriculum would be associated with improvements in clinician tobacco-related knowledge, attitudes, confidence, and counseling behaviors from pre-to post-training and at the 3-month follow-up.
The 1-hour Cardiology Rx for Change curriculum was evaluated with 22 cardiology fellows and 77 medical residents with consistent training effects observed between the 2 groups.
Trainees' tobacco treatment knowledge increased significantly from pre- to post-training (t[81] = 6.51, P<0.001), and perceived barriers to providing cessation treatment decreased significantly (t[81] = -3.97, P<0.001). The changes, however, were not sustained at the 3-month follow-up, suggesting the need for booster training efforts. From pretraining to 3-month follow-up, the training was associated with significant sustained gains in clinician confidence for treating tobacco dependence (t[61] = 3.69, P = 0.001) and with improvements in clinicians assessing patients' readiness to quit smoking (from 61% to 79%, t[59] = 3.69,P<0.001) and providing assistance with quitting (from 47% to 59%, t[59] = 2.12, P = 0.038). Asking patients about tobacco use, advising cessation, and arranging follow-up also increased over time, but not significantly. All participants (100%) recommended the curriculum for dissemination to other training programs.
Available online via http://rxforchange.ucsf.edu, Cardiology Rx for Change offers a packaged training tool for improving treatment of tobacco use and SHS exposure in cardiology care.
心脏病是吸烟者因烟草使用导致死亡的主要原因，也是非吸烟者因接触二手烟导致死亡的主要原因。本研究的重点是开发和评估一个基于证据的模型课程，以改善心脏病学中对烟草使用和二手烟暴露的临床关注。
我们假设该课程将与培训前后以及 3 个月随访时临床医生与烟草相关的知识、态度、信心和咨询行为的改善相关。
使用 22 名心脏病学研究员和 77 名内科住院医师评估了 1 小时的“心脏病学改变处方”课程，这两组之间观察到一致的培训效果。
从培训前到培训后，受训者的烟草治疗知识显著增加（t[81] = 6.51，P<0.001），提供戒烟治疗的感知障碍显著减少（t[81] = -3.97，P<0.001）。然而，这些变化在 3 个月的随访中并没有持续，这表明需要加强培训工作。从培训前到 3 个月的随访，培训与治疗烟草依赖的临床医生信心的显著持续提高相关（t[61] = 3.69，P = 0.001），并改善了医生评估患者戒烟准备情况（从 61%到 79%，t[59] = 3.69，P<0.001）和提供戒烟帮助（从 47%到 59%，t[59] = 2.12，P = 0.038）。询问患者关于烟草使用、建议戒烟和安排随访的情况也随着时间的推移而增加，但没有显著增加。所有参与者（100%）都建议将该课程传播到其他培训项目中。
可通过 http://rxforchange.ucsf.edu 在线获取，“心脏病学改变处方”提供了一个包装好的培训工具，用于改善心脏病学中对烟草使用和二手烟暴露的治疗。
