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针对吸烟的创伤后应激障碍退伍军人的家庭远程医疗护理管理项目的观点

Perspectives on a Home Telehealth Care Management Program for Veterans With Posttraumatic Stress Disorder Who Smoke.

作者信息

Peterson Jamie, Battaglia Catherine, Fehling Kelty B, Williams Katherine M, Lambert-Kerzner Anne

机构信息

Jamie Peterson, MPH, RN, Department of Veterans Affairs, Eastern Colorado Health Care System, Denver. Catherine Battaglia, PhD, RN, Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, and University of Colorado, Anschutz Medical Campus, Aurora. Kelty B. Fehling, MPH, Department of Veterans Affairs, Eastern Colorado Health Care System, Denver. Katherine M. Williams, MPH, Department of Veterans Affairs, Eastern Colorado Health Care System, Denver. Anne Lambert-Kerzner, PhD, MSPH, Department of Veterans Affairs, Eastern Colorado Health Care System, Denver.

出版信息

J Addict Nurs. 2017 Jul/Sep;28(3):117-123. doi: 10.1097/JAN.0000000000000174.

Abstract

BACKGROUND

Individuals with posttraumatic stress disorder (PTSD) have high rates of smoking and low quit rates. We conducted a qualitative evaluation of an integrated smoking cessation randomized controlled trial (RCT) that used home telehealth and motivational interviewing (MI) to change smoking behaviors among individuals with PTSD.

METHOD

Using a convenience sample sourced from the original RCT, intervention and control group participants were invited to participate in a qualitative evaluation. Semistructured interview guides were used to assess the effectiveness of study components, make recommendations for future interventions, and identify facilitators/barriers to smoking cessation. We analyzed these data using an inductive and deductive, team-based content analysis approach.

RESULTS

We interviewed 32 study participants (intervention: n = 15, control: n = 17) who completed the original RCT within the previous 6 months. Respondents were highly satisfied with home telehealth and MI counseling. The intervention group respondents found MI counseling to be supportive, nonjudgmental, and informative. Control group respondents felt that they had received smoking cessation assistance. Respondents from both groups desired more information about PTSD and smoking, relied on smoking as a coping mechanism for PTSD, and believed that quitting was an individual choice.

CONCLUSION

Respondents reported that home telehealth and MI were acceptable ways to provide smoking cessation assistance to individuals with PTSD. The support and increased awareness of smoking behaviors were perceived as helpful. Future investigations should focus on increasing support and information about stress management, smoking, PTSD, and the relationship between them for individuals with PTSD who smoke.

摘要

背景

创伤后应激障碍(PTSD)患者的吸烟率很高,戒烟率很低。我们对一项综合戒烟随机对照试验(RCT)进行了定性评估,该试验采用家庭远程医疗和动机性访谈(MI)来改变PTSD患者的吸烟行为。

方法

利用从原始RCT中选取的便利样本,邀请干预组和对照组参与者参与定性评估。采用半结构化访谈指南来评估研究组成部分的有效性,为未来干预提出建议,并确定戒烟的促进因素/障碍。我们使用基于团队的归纳和演绎内容分析方法对这些数据进行了分析。

结果

我们采访了32名研究参与者(干预组:n = 15,对照组:n = 17),他们在过去6个月内完成了原始RCT。受访者对家庭远程医疗和MI咨询高度满意。干预组受访者认为MI咨询具有支持性、非评判性且信息丰富。对照组受访者觉得他们得到了戒烟帮助。两组受访者都希望获得更多关于PTSD和吸烟的信息,将吸烟作为应对PTSD的一种机制,并认为戒烟是个人选择。

结论

受访者报告称,家庭远程医疗和MI是为PTSD患者提供戒烟帮助的可接受方式。对吸烟行为的支持和更多了解被认为是有帮助的。未来的调查应侧重于为吸烟的PTSD患者增加关于压力管理、吸烟、PTSD及其相互关系的支持和信息。

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