Campbell Katarzyna Anna, Bowker Katharine Anna, Naughton Felix, Sloan Melanie, Cooper Sue, Coleman Tim
University of Nottingham, Division of Primary Care, Room 1406, Tower Building, University Park, Nottingham NG7 2RD, UK.
Behavioural Science Group, Institute of Public Health, University of Cambridge, Cambridge CB2 0SR, UK.
Int J Environ Res Public Health. 2016 Oct 12;13(10):1004. doi: 10.3390/ijerph13101004.
UK guidance recommends routine exhaled carbon monoxide (CO) screening for pregnant women and "opt-out" referrals to stop smoking services (SSS) of those with CO ≥ 4 ppm. We explored staff views on this referral pathway when implemented in one UK hospital Trust. Seventeen semi-structured interviews with staff involved in the implementation of the new referral pathway: six antenatal clinic staff (before and after implementation); five SSS staff (after). Data were analyzed using framework analysis. Two themes were identified: (1) views on implementation of the pathway and (2) impact of the pathway on the women. Generally, staff felt that following training, referrals were less arduous to implement and better received than expected. The majority believed this pathway helped engage women motivated to quit and offered a unique chance to impart smoking cessation knowledge to hard-to-reach women, who might not otherwise contact SSS. An unexpected issue arose during implementation-dealing with non-smokers with high CO readings. According to staff, the "opt-out" referral pathway is an acceptable addition to routine antenatal care. It can help engage hard-to-reach women and educate them about the dangers of smoking in pregnancy. Incorporating advice on dealing with non-smokers with high CO into routine staff training could help future implementations.
英国指南建议对孕妇进行常规呼出一氧化碳（CO）筛查，并对CO≥4 ppm的孕妇“默认”转介至戒烟服务机构（SSS）。我们探讨了在英国一家医院信托机构实施该转介途径时工作人员的看法。对参与新转介途径实施的工作人员进行了17次半结构化访谈：6名产前诊所工作人员（实施前后）；5名SSS工作人员（实施后）。采用框架分析法对数据进行分析。确定了两个主题：（1）对该途径实施的看法；（2）该途径对女性的影响。总体而言，工作人员认为经过培训后，转介实施起来不那么费力，且比预期更易被接受。大多数人认为这条途径有助于促使有戒烟意愿的女性参与进来，并为那些难以接触到的女性提供了一个独特的机会，向她们传授戒烟知识，否则这些女性可能不会联系SSS。在实施过程中出现了一个意想不到的问题——处理CO读数高的非吸烟者。据工作人员称，“默认”转介途径是常规产前护理中可接受的补充。它可以帮助接触那些难以接触到的女性，并让她们了解孕期吸烟的危害。将处理CO读数高的非吸烟者的建议纳入常规工作人员培训中，可能有助于未来的实施。
