Hsu Kuo-Yao, Tsai Yun-Fang, Huang Chu-Ching, Yeh Wen-Ling, Chang Kai-Ping, Lin Chen-Chun, Chen Ching-Yen, Lee Hsiu-Lan
Division of Orthopedic Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan.
College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
JMIR Mhealth Uhealth. 2018 Jun 11;6(6):e142. doi: 10.2196/mhealth.9783.
Smoking tobacco, drinking alcohol, and chewing betel quid are health-risk behaviors for several diseases, such as cancer, cardiovascular disease, and diabetes, with severe impacts on health. However, health care providers often have limited time to assess clients' behaviors regarding smoking tobacco, drinking alcohol, and chewing betel quid and intervene, if needed.
The objective of this study was to develop a Web-based survey system; determine the rates of tobacco-smoking, alcohol-drinking, and betel-quid-chewing behaviors; and estimate the efficiency of the system (time to complete the survey).
Patients and their family members or friends were recruited from gastrointestinal medical-surgical, otolaryngology, orthopedics, and rehabilitation clinics or wards at a medical center in northern Taiwan. Data for this descriptive, cross-sectional study were extracted from a large series of research studies. A Web-based survey system was developed using a Linux, Apache, MySQL, PHP stack solution. The Web survey was set up to include four questionnaires: the Chinese-version Fagerstrom Tolerance Questionnaire, the Chinese-version Alcohol Use Disorders Identification Test, the Betel Nut Dependency Scale, and a sociodemographic form with several chronic diseases. After the participants completed the survey, the system automatically calculated their score, categorized their risk level for each behavior, and immediately presented and explained their results. The system also recorded the time each participant took to complete the survey.
Of 782 patient participants, 29.6% were addicted to nicotine, 13.3% were hazardous, harmful, or dependent alcohol drinkers, and 1.5% were dependent on chewing betel quid. Of 425 family or friend participants, 19.8% were addicted to nicotine, 5.6% were hazardous, harmful, or dependent alcohol drinkers, and 0.9% were dependent on chewing betel quid. Regarding the mean time to complete the survey, patients took 7.9 minutes (SD 3.0; range 3-20) and family members or friends took 7.7 minutes (SD 2.8; range 3-18). Most of the participants completed the survey within 5-10 minutes.
The Web-based survey was easy to self-administer. Health care providers can use this Web-based survey system to save time in assessing these risk behaviors in clinical settings. All smokers had mild-to-severe nicotine addiction, and 5.6%-12.3% of patients and their family members or friends were at risk of alcohol dependence. Considering that these three behaviors, particularly in combination, dramatically increase the risk of esophageal cancer, appropriate and convenient interventions are necessary for preserving public health in Taiwan.
吸烟、饮酒和嚼槟榔是导致多种疾病的健康风险行为，如癌症、心血管疾病和糖尿病，对健康有严重影响。然而，医疗服务提供者通常时间有限，难以评估患者的吸烟、饮酒和嚼槟榔行为，也无法在需要时进行干预。
本研究的目的是开发一个基于网络的调查系统；确定吸烟、饮酒和嚼槟榔行为的发生率；并评估该系统的效率（完成调查所需的时间）。
从台湾北部一家医疗中心的胃肠外科、耳鼻喉科、骨科和康复科诊所或病房招募患者及其家庭成员或朋友。本描述性横断面研究的数据来自一系列大型研究。使用Linux、Apache、MySQL、PHP堆栈解决方案开发了一个基于网络的调查系统。网络调查设置了四份问卷：中文版的法格斯特罗姆耐受问卷、中文版酒精使用障碍识别测试、槟榔依赖量表以及一份包含几种慢性病的社会人口学表格。参与者完成调查后，系统会自动计算他们的得分，对每种行为的风险水平进行分类，并立即呈现并解释结果。系统还记录了每个参与者完成调查所需的时间。
在782名患者参与者中，29.6%对尼古丁上瘾，13.3%是危险、有害或依赖酒精的饮酒者，1.5%依赖嚼槟榔。在425名家庭成员或朋友参与者中，19.8%对尼古丁上瘾，5.6%是危险、有害或依赖酒精的饮酒者，0.9%依赖嚼槟榔。关于完成调查的平均时间，患者用时7.9分钟（标准差3.0；范围3 - 20），家庭成员或朋友用时7.7分钟（标准差2.8；范围3 - 18）。大多数参与者在5 - 10分钟内完成了调查。
基于网络的调查易于自行管理。医疗服务提供者可以使用这个基于网络的调查系统，在临床环境中节省评估这些风险行为的时间。所有吸烟者都有轻度至重度尼古丁成瘾，5.6% - 12.3%的患者及其家庭成员或朋友有酒精依赖风险。鉴于这三种行为，尤其是同时存在时，会显著增加患食管癌的风险，因此在台湾，采取适当且便捷的干预措施对于维护公众健康是必要的。
