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印度南部一家三级护理医院中医生的烟草干预咨询服务

Physicians' tobacco intervention counseling in a tertiary care hospital of South India.

作者信息

Akshaya K M, Majra J P

机构信息

Department of Community Medicine, Yenepoya Medical College, Yenepoya University, Deralakatte, Mangalore, 575018, Karnataka, India,

出版信息

J Community Health. 2014 Oct;39(5):908-13. doi: 10.1007/s10900-014-9896-9.

Abstract

The tobacco epidemic is one of the biggest public health threats in the present world with a substantial contribution to mortality and morbidity. Patients' visits to their doctors for illnesses and health check-ups offer a great opportunity to screen them for tobacco use and also counsel them to quit tobacco use. This cross sectional study was carried out in out-patient departments of General Medicine and Pulmonary Medicine of a tertiary care medical college teaching hospital in Dakshina Kannada district of Karnataka state of India between April 2012 and July 2012 among the patients aged 18 years or above who were diagnosed as suffering from tobacco related diseases. Exit interview was conducted on the patients after obtaining a written informed consent using a pre designed semi-structured questionnaire. Data was entered, analyzed using SPSS v17 and Descriptive statistics, Fisher Exact test, Bivariate and multivariable logistic regression analyses were used. The present study reveals that 305 (87.1 %), 281 (80.3 %) and 257 (73.1 %) of the 350 participants were asked, assessed and advised respectively by the treating physicians to quit tobacco use where as only 18 (15.1 %) were assisted in their efforts to quit tobacco. Physician's counseling inventions were significantly associated with patient's age, sex, education, marital status and socio economic status of the patients as well as the treating physician's experience of more than 3 years. There is a need to incorporate tobacco history taking as a vital sign during medical history taking and this should be made as a routine in medical schools.

摘要

烟草流行是当今世界最大的公共卫生威胁之一,对死亡率和发病率有重大影响。患者因疾病和健康检查前往看医生,为筛查他们的烟草使用情况并劝导他们戒烟提供了绝佳机会。这项横断面研究于2012年4月至2012年7月在印度卡纳塔克邦达欣纳卡纳达区一所三级医疗学院教学医院的普通内科和肺病科门诊进行,研究对象为18岁及以上被诊断患有烟草相关疾病的患者。在获得书面知情同意后,使用预先设计的半结构化问卷对患者进行出院访谈。数据录入后,使用SPSS v17进行分析,并采用描述性统计、Fisher精确检验、双变量和多变量逻辑回归分析。本研究显示,350名参与者中,分别有305名(87.1%)、281名(80.3%)和257名(73.1%)被主治医生询问、评估并建议戒烟,而只有18名(15.1%)在戒烟努力中得到了帮助。医生的咨询干预与患者的年龄、性别、教育程度、婚姻状况和社会经济状况以及主治医生超过3年的经验显著相关。有必要在病史采集过程中将烟草使用史作为一项生命体征纳入,并且这应该在医学院校成为常规做法。

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