Keto Jaana, Jokelainen Jari, Timonen Markku, Linden Kari, Ylisaukko-oja Tero
Department of General Medicine, Faculty of Medicine, University of Oulu, P.O. Box 5000, FIN-90014, Oulu, Finland.
Unit of General Practice, Oulu University Hospital, FIN-90014, Oulu, Finland.
Subst Abuse Treat Prev Policy. 2015 Nov 2;10:43. doi: 10.1186/s13011-015-0039-9.
Our aim was to study the smoking cessation-related 1) attitudes & experiences and 2) consultation practices of Finnish physicians and to determine if there is a relationship between the two.
An online survey on smoking cessation was sent to 39 % of all Finnish physicians, with emphasis on physicians working in fields relevant to smoking cessation. A total of 1141 physicians (response rate 15 %) responded to the online survey, 53 % of whom were employed in primary health care. A total of 1066 respondents were eligible for the analysis. The questionnaire included questions on the physician's own smoking status, their attitudes and experiences on smoking cessation, and the implementation of smoking cessation in clinical practice. Two sub-scales concerning smoking-related consultation activities were constructed: one for conversation, and another for practical actions.
The most common consultation activities (respondents who reported doing the following actions "nearly always") were asking how much the patient smokes (65 %), marking smoking status in patient records (58 %) and recommending quitting to the patient (55 %). The least common activity was prescribing withdrawal medication (4 %). Primary care physicians were more active than those working in secondary health care in nearly all activities mapped. A positive attitude and experiences on smoking cessation were associated with actively offering withdrawal support. Those who were familiar with the local treatment guidelines for tobacco addiction were 30 % more active in offering practical cessation help to their patient. The respondents were more active in discussing smoking with their patients than in offering practical cessation help.
Physicians offer their patients practical cessation support relatively infrequently. Practical cessation calls for continuous education of physicians about the nature of tobacco and nicotine addiction, the role of smoking as a risk factor for various diseases, and the practical measures needed for smoking cessation. Secondary care physicians should acknowledge the authority they pose toward smoking patients.
我们的目的是研究芬兰医生与戒烟相关的1）态度和经历，以及2）咨询实践，并确定两者之间是否存在关联。
向39%的芬兰医生发送了一份关于戒烟的在线调查问卷，重点是从事与戒烟相关领域工作的医生。共有1141名医生（回复率为15%）回复了在线调查，其中53%受雇于初级卫生保健机构。共有1066名受访者符合分析条件。问卷包括医生自身的吸烟状况、他们对戒烟的态度和经历，以及临床实践中戒烟的实施情况等问题。构建了两个与吸烟相关咨询活动的子量表：一个用于对话，另一个用于实际行动。
最常见的咨询活动（报告“几乎总是”进行以下行动的受访者）是询问患者吸烟量（65%）、在患者记录中标记吸烟状况（58%）以及向患者推荐戒烟（55%）。最不常见的活动是开具戒烟药物（4%）。在几乎所有列出的活动中，初级保健医生比二级卫生保健机构的医生更积极。对戒烟持积极态度和有相关经历与积极提供戒烟支持相关。熟悉当地烟草成瘾治疗指南的人在为患者提供实际戒烟帮助方面的积极性要高30%。受访者与患者讨论吸烟比提供实际戒烟帮助更积极。
医生相对较少地为患者提供实际的戒烟支持。实际的戒烟需要对医生持续开展关于烟草和尼古丁成瘾的本质、吸烟作为各种疾病风险因素的作用以及戒烟所需实际措施的教育。二级保健医生应认识到他们对吸烟患者所具有的权威性。
