Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC 29203, USA.
J Am Board Fam Med. 2013 Mar-Apr;26(2):116-25. doi: 10.3122/jabfm.2013.02.110078.
Primary care practices are an ideal setting for reducing national smoking rates because >70% of smokers visit their physician annually, yet smoking cessation counseling is inconsistently delivered to patients. We designed and created a novel software program for handheld computers and hypothesized that it would improve clinicians' ability to provide patient-tailored smoking cessation counseling at the point of care.
A handheld computer software program was created based on smoking cessation guidelines and an adaptation of widely accepted behavioral change theories. The tool was evaluated using a validated before/after survey to measure physician smoking cessation counseling behaviors, knowledge, and comfort/self-efficacy.
Participants included 17 physicians (mean age, 41 years; 71% male; 5 resident physicians) from a practice-based research network. After 4 months of use in direct patient care, physicians were more likely to advise patients to stop smoking (P = .049) and reported an increase in use of the "5 As" (P = .03). Improved self-efficacy in counseling patients regarding smoking cessation (P = .006) was seen, as was increased comfort in providing follow-up to patients (P = .04).
Use of a handheld computer software tool improved smoking cessation counseling among physicians and shows promise for translating evidence about smoking cessation counseling into practice and educational settings.
初级保健实践是降低全国吸烟率的理想场所，因为超过 70%的吸烟者每年都会去看医生，但向患者提供戒烟咨询的服务并不一致。我们设计并创建了一款适用于掌上电脑的新型软件程序，并假设它将提高临床医生在护理点为患者提供个性化戒烟咨询的能力。
根据戒烟指南和广泛接受的行为改变理论的改编，创建了一个手持式计算机软件程序。该工具使用经过验证的前后调查进行评估，以衡量医生的戒烟咨询行为、知识和舒适度/自我效能感。
参与者包括来自实践为基础的研究网络的 17 名医生（平均年龄 41 岁；71%为男性；5 名住院医师）。在直接为患者提供 4 个月的服务后，医生更有可能建议患者戒烟（P =.049），并报告使用“5A”的频率增加（P =.03）。咨询患者关于戒烟的自我效能感提高（P =.006），为患者提供后续服务的舒适度提高（P =.04）。
使用手持式计算机软件工具提高了医生的戒烟咨询能力，并为将戒烟咨询的证据转化为实践和教育环境提供了希望。
