University Centre for Rural Health-North Coast, School of Public Health, University of Sydney, Lismore NSW, Australia.
BMC Public Health. 2012 Mar 7;12:165. doi: 10.1186/1471-2458-12-165.
As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice.
This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women.
The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025); cessation knowledge score (p = 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011).
Addressing knowledge of smoking risks and cessation counselling is a priority and should improve both confidence and ability, and increase the frequency and effectiveness of counselling. The health system must provide supports to providers through appropriate policy and resourcing, to enable them to address this issue.
与许多原住民一样，澳大利亚原住民的吸烟率明显高于非原住民。大约 50%的土著妇女在怀孕期间吸烟，而此时女性更有戒烟的动力。产前护理提供者是减少与吸烟相关危害的潜在重要变革者，但他们的知识、态度或技能，以及与提供戒烟建议相关的因素知之甚少。
本文旨在探讨为澳大利亚土著妇女提供产前护理的卫生保健提供者对吸烟风险和戒烟的知识和态度；并确定与自我报告的吸烟评估相关的因素。在澳大利亚两个司法管辖区（北领地和新南威尔士州）对 127 名为土著妇女提供产前护理的工作人员进行了横断面调查。措施包括受访者对孕妇吸烟流行率的估计；最佳和实际的吸烟状况评估；与产前吸烟相关风险的知识；戒烟知识；为孕妇提供戒烟建议的态度；以及为孕妇戒烟的感知障碍和动机。
提供者对吸烟流行率的中位数估计为 69%（95%CI：60,70）。大多数受访者认为评估吸烟状况是产前护理的组成部分，也是专业责任。大多数人（79%）表示，他们会在 100%的客户中评估吸烟状况。风险知识普遍良好，但戒烟知识较差。在所有女性中，与评估吸烟状况相关的独立因素包括：雇主服务类型（p = 0.025）；戒烟知识得分（p = 0.011）；以及不同意“鉴于成功率低，提供建议不值得”的说法（p = 0.011）。
解决吸烟风险和戒烟咨询知识是当务之急，这应能提高信心和能力，并增加咨询的频率和有效性。卫生系统必须通过适当的政策和资源为提供者提供支持，使他们能够解决这个问题。
