Tang Ming Wei, Oakley Richard, Dale Catherine, Purushotham Arnie, Møller Henrik, Gallagher Jennifer Elizabeth
Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, Denmark Hill Campus, London, SE5 9RS, UK.
Guy's and St Thomas' NHS Foundation Trust, London, UK.
BMC Health Serv Res. 2014 Dec 20;14:636. doi: 10.1186/s12913-014-0636-8.
The government has recognised the role of healthcare professionals in smoking cessation interventions with integrated care pathways for identification and referral of at-risk patients who smoke. Referral for suspected cancers has been suggested as a 'teachable moment', whereby individuals are motivated and more likely to adopt risk-reducing behaviours. A head and neck cancer referral clinic could therefore provide opportunities for smoking cessation intervention. This study aims to pilot a brief smoking cessation intervention during a consultation visit for patients referred with suspected head and neck cancer and evaluate its acceptability and impact.
A brief script for smoking cessation intervention which included a smoking cessation referral was designed to be delivered to patients attending a rapid access clinic. Patient outcome data was collected by the stop smoking team for patients who accepted the referral. A subset of these patients was also interviewed by telephone; these findings were combined with data provided by the stop smoking services to assess the acceptability and impact of pilot smoking cessation intervention on patients.
In total, 473 new patients attended the clinic during the study period, of whom 102 (22%) were smokers. Of these, 80 (78%) accepted a referral to stop smoking services. A total of 75 (74%) patients were approached subsequently in a telephone survey. Of the 80 newly referred patients, 29 (36%) quit smoking at least temporarily. Another eight patients reduced their smoking or set a quit date (10%), so the experience of attending the clinic and the intervention impacted favourably on almost half of the patients (46%). The patient survey found the intervention to be acceptable for 94% (n = 50) of patients. Qualitative analysis of patient responses revealed five elements which support the acceptability of the intervention.
The findings of this pilot study suggest that discussion of smoking cessation with patients referred for suspected head and neck cancer may have an impact and facilitate the process towards quitting. A possible diagnosis of cancer appears to present a 'teachable moment' to encourage positive health behaviour change.
政府已认识到医疗保健专业人员在戒烟干预措施中的作用，这些措施通过综合护理途径来识别和转诊吸烟的高危患者。有人建议将疑似癌症的转诊作为一个“可教育时机”，在此期间，个人会受到激励，更有可能采取降低风险的行为。因此，头颈癌转诊诊所可以提供戒烟干预的机会。本研究旨在对疑似头颈癌患者的会诊期间进行简短的戒烟干预进行试点，并评估其可接受性和影响。
设计了一个包含戒烟转诊的简短戒烟干预脚本，用于向快速就诊诊所的患者提供。戒烟团队收集接受转诊患者的患者结局数据。还对这些患者中的一部分进行了电话访谈；这些结果与戒烟服务提供的数据相结合，以评估试点戒烟干预对患者的可接受性和影响。
在研究期间，共有473名新患者到该诊所就诊，其中102名（22%）为吸烟者。其中，80名（78%）接受了戒烟服务转诊。随后，共有75名（74%）患者接受了电话调查。在80名新转诊的患者中，29名（36%）至少暂时戒烟。另外8名患者减少了吸烟量或设定了戒烟日期（10%），因此就诊诊所和干预措施对近一半的患者（46%）产生了积极影响。患者调查发现，94%（n = 50）的患者认为该干预措施是可接受的。对患者回答的定性分析揭示了支持该干预措施可接受性的五个要素。
这项试点研究的结果表明，与疑似头颈癌患者讨论戒烟可能会产生影响，并促进戒烟进程。癌症的可能诊断似乎提供了一个“可教育时机”，以鼓励积极的健康行为改变。
