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一种定性方法,探索 1 型糖尿病患者的吸烟和戒烟尝试经历。

A qualitative approach exploring the experiences of smoking and quitting attempts in type 1 diabetes.

机构信息

Florence Nightingale Faculty of Nursing and Midwifery, London, UK.

出版信息

J Clin Nurs. 2018 Aug;27(15-16):3091-3103. doi: 10.1111/jocn.14499.

Abstract

AIMS AND OBJECTIVES

To explore the experiences of smoking and quitting attempts in people with type 1 diabetes, including their perceptions of existing services for smoking cessation.

BACKGROUND

In the UK, approximately a fifth of the population with type 1 diabetes smoke and despite the adverse effects of smoking, these individuals continue with their smoking habits. There is limited information on the barriers and facilitators to quitting smoking in people with type 1 diabetes.

METHODS

This study adopted a qualitative study design using semi-structured individual interviews guided by PRIME theory. Participants (n = 12) were purposively sampled and recruited from two diabetes outpatient clinics in London (UK). Audio-recorded interviews were transcribed verbatim and analysed using the Framework method.

RESULTS

Most smokers with type 1 diabetes reported lack of motivation to stop smoking due to the addictive nature of cigarettes. Further barriers to quitting included self-image and habits associated with smoking, such as social activities. Generally, most reported limited awareness about the risks associated with smoking and diabetes. Moreover, the perceived negative attitude towards nicotine replacement therapy and pharmacotherapy impeded their willingness to alter their smoking habits. Nonetheless, these patients suggested that informative guidance from medical professionals and strategies to tackle cravings related to nicotine as helpful approaches to improve quitting attempts.

CONCLUSION

Internal and external factors influence quitting attempts among smokers with type 1 diabetes, with particular emphasis on self-image and societal norms. It is evident that existing strategies for smoking cessation recommended by the National Institute for Health and Care Excellence have either not been implemented or not well received by people with type 1 diabetes.

RELEVANCE TO CLINICAL PRACTICE

Strategies and resources, such as staff training, to increase delivery of smoking cessation support to patients with diabetes are needed.

摘要

目的和目标

探索 1 型糖尿病患者的吸烟和戒烟尝试经历,包括他们对现有戒烟服务的看法。

背景

在英国,大约五分之一的 1 型糖尿病患者吸烟,尽管吸烟有不良影响,但这些人仍继续吸烟。关于 1 型糖尿病患者戒烟的障碍和促进因素的信息有限。

方法

本研究采用定性研究设计,使用 PRIME 理论指导的半结构化个体访谈。参与者(n=12)是从伦敦(英国)的两个糖尿病门诊诊所中通过目的性抽样和招募而来的。对录音的访谈进行逐字转录,并使用框架方法进行分析。

结果

大多数 1 型糖尿病吸烟者由于香烟的成瘾性而缺乏戒烟的动机。戒烟的进一步障碍包括与吸烟相关的自我形象和习惯,如社交活动。总的来说,大多数人报告说对吸烟和糖尿病相关风险的认识有限。此外,对尼古丁替代疗法和药物治疗的负面看法阻碍了他们改变吸烟习惯的意愿。尽管如此,这些患者认为,来自医疗专业人员的信息指导和解决与尼古丁相关的渴望的策略是改善戒烟尝试的有用方法。

结论

内部和外部因素影响 1 型糖尿病吸烟者的戒烟尝试,特别强调自我形象和社会规范。显然,国家卫生与保健卓越研究所推荐的现有的戒烟策略要么没有实施,要么没有得到 1 型糖尿病患者的欢迎。

临床相关性

需要制定策略和资源,例如培训工作人员,以增加向糖尿病患者提供戒烟支持的服务。

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