心脏康复患者戒烟意愿：态度、自我效能感和烟瘾的作用。

Intention to abstain from smoking among cardiac rehabilitation patients: the role of attitude, self-efficacy, and craving.

作者信息

Bakker Esther C, Nijkamp Marjan D, Sloot Caroline, Berndt Nadine C, Bolman Catherine A W

机构信息

Esther C. Bakker, PhD Assistant Professor in Health Psychology, Faculty of Psychology and Educational Sciences, Department of Health Psychology, Open University of the Netherlands, Heerlen, The Netherlands. Marjan D. Nijkamp, PhD Assistant Professor in Health Psychology, Faculty of Psychology and Educational Sciences, Department of Health Psychology, Open University of the Netherlands, Heerlen, The Netherlands. Caroline Sloot, MSc Researcher, Faculty of Psychology and Educational Sciences, Department of Health Psychology, Open University of the Netherlands, Heerlen, The Netherlands. Nadine C. Berndt, PhD Researcher, Faculty of Psychology and Educational Sciences, Department of Health Psychology, Open University of the Netherlands, Heerlen, The Netherlands, and Consultant in Public Health, Cellule d'Expertise Médicale, Inspection Générale de la Sécurité Sociale, Ministère de la Sécurité, Luxembourg, Luxembourg. Catherine A. W. Bolman, PhD Associate Professor in Health Psychology, Faculty of Psychology and Educational Sciences, Department of Health Psychology, Open University of the Netherlands, Heerlen, The Netherlands.

出版信息

J Cardiovasc Nurs. 2015 Mar-Apr;30(2):172-9. doi: 10.1097/JCN.0000000000000156.

DOI:10.1097/JCN.0000000000000156

PMID:24831728

Abstract

BACKGROUND

Smoking cessation after developing coronary heart disease improves disease prognosis more than any other treatment. However, many cardiac patients continue to smoke after hospital discharge.

OBJECTIVE

The aim of this study was to investigate factors associated with the intention to (permanently) abstain from smoking among cardiac rehabilitation patients 2 to 4 weeks after discharge from hospital.

METHODS

A cross-sectional survey was conducted among 149 cardiac rehabilitation patients recruited from 2 cardiac rehabilitation centers in The Netherlands 2 to 4 weeks after hospital discharge, at the start of the cardiac rehabilitation period. Psychosocial cognitions including attitude toward nonsmoking, social influence, and self-efficacy were measured with a standardized and validated Dutch questionnaire based on the Attitude-Social Influence-Self-efficacy model. Anxiety was measured using the shortened version of the State-Trait Anxiety Inventory. Craving for cigarettes was assessed with 6 items measuring the urge to smoke. Intention toward nonsmoking was assessed with 2 visual analog scales indicating the strength and probability of the intention to permanently refrain from smoking.

RESULTS

Of all patients, 31% still smoked after hospital discharge. The smokers had a lower self-efficacy and intention to abstain from smoking and reported higher craving. Logistic regression analyses revealed that attitudes that embraced the advantages of not smoking, self-efficacy, and craving were significantly related to the intention to (permanently) abstain from smoking, whereas social influence and anxiety were not. Actual smoking behavior moderated the relation between self-efficacy and intention: only the quitters showed a significant positive relation. Anxiety did not moderate the relationship between psychosocial cognitive factors and intention.

CONCLUSIONS

The intention to (permanently) abstain from smoking, measured 2 to 4 weeks after hospitalization for a cardiac event, predominantly depends on attitude, self-efficacy, and craving. Interventions aimed at smoking cessation among cardiac rehabilitation patients should focus on these factors.

摘要

背景

冠心病发病后戒烟比任何其他治疗方法都更能改善疾病预后。然而，许多心脏病患者出院后仍继续吸烟。

目的

本研究旨在调查出院2至4周后心脏康复患者（永久）戒烟意愿的相关因素。

方法

在荷兰2家心脏康复中心招募了149名出院2至4周后的心脏康复患者，在心脏康复期开始时进行横断面调查。基于态度-社会影响-自我效能模型，使用标准化且经过验证的荷兰语问卷测量包括对不吸烟的态度、社会影响和自我效能在内的社会心理认知。使用状态-特质焦虑量表的简化版测量焦虑。用6个测量吸烟冲动的项目评估对香烟的渴望。用2个视觉模拟量表评估不吸烟的意愿，这2个量表分别表明永久戒烟意愿的强度和可能性。

结果

所有患者中，31%出院后仍在吸烟。吸烟者的自我效能和戒烟意愿较低，且报告的烟瘾更大。逻辑回归分析显示，认可不吸烟益处的态度、自我效能和烟瘾与（永久）戒烟意愿显著相关，而社会影响和焦虑则不然。实际吸烟行为调节了自我效能与意愿之间的关系：只有戒烟者表现出显著的正相关。焦虑并未调节社会心理认知因素与意愿之间的关系。