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两种用于全科医疗的戒烟方案的有效性:一项随机临床试验。

The effectiveness of two smoking cessation programmes for use in general practice: a randomised clinical trial.

作者信息

Slama K, Redman S, Perkins J, Reid A L, Sanson-Fisher R W

机构信息

Faculty of Medicine, University of Newcastle, New South Wales, Australia.

出版信息

BMJ. 1990 Jun 30;300(6741):1707-9. doi: 10.1136/bmj.300.6741.1707.

Abstract

OBJECTIVE

To evaluate a structured, behavioural change, smoking cessation intervention designed for use within general practice.

DESIGN

Randomised controlled clinical trial.

SETTING

General practices in Newcastle, Australia.

PATIENTS

311 Patients identified as smokers by a screening question were enrolled in the study. Of these, 101 were assigned to a structured behavioural change programme, 104 to a simple advice programme adapted from previous research, and 106 to a control group. No significant differences were found between groups for demographic and smoking related variables before the study.

INTERVENTIONS

Patients in the simple advice group received a brief statement of advice from the general practitioner as well as three pamphlets; those in the structured intervention group were given strategies which included attitude and behavioural change programmes as well as techniques to aid compliance. The amount of smoking in all groups was assessed by self reports with validation by measurement of salivary cotinine concentrations.

MAIN OUTCOME MEASURE

Significant increase in cessation rates.

CONCLUSIONS

Significant differences between controls and the structured behavioural change group were found at the one month follow up, but only for self reported abstinence. The simple advice programme did not produce any significant differences over the control group. General practitioner evaluation of the structured programme highlighted difficulties in relation to the duration of the intervention. Overall the structured programme in its present form did not appear to be an effective programme for use within general practice.

摘要

目的

评估一项为在全科医疗中使用而设计的结构化行为改变戒烟干预措施。

设计

随机对照临床试验。

地点

澳大利亚纽卡斯尔的全科医疗诊所。

患者

通过筛查问题被确定为吸烟者的311名患者纳入研究。其中,101名被分配到结构化行为改变项目组,104名被分配到根据先前研究改编的简单建议项目组,106名被分配到对照组。研究前,各组在人口统计学和吸烟相关变量方面未发现显著差异。

干预措施

简单建议组的患者从全科医生那里得到一份简短的建议声明以及三本小册子;结构化干预组的患者则获得包括态度和行为改变项目以及有助于依从性的技巧等策略。所有组的吸烟量通过自我报告评估,并通过测量唾液可替宁浓度进行验证。

主要结局指标

戒烟率显著提高。

结论

在1个月的随访中,对照组与结构化行为改变组之间存在显著差异,但仅在自我报告的戒烟方面。简单建议项目组与对照组相比未产生任何显著差异。全科医生对结构化项目的评估突出了干预持续时间方面的困难。总体而言,目前形式的结构化项目似乎不是在全科医疗中使用的有效项目。

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本文引用的文献

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General practitioners' detection of patients' smoking status.全科医生对患者吸烟状况的检测。
Med J Aust. 1989 Apr 17;150(8):420-2, 425-6. doi: 10.5694/j.1326-5377.1989.tb136560.x.

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