Bleckwenn Markus, Kaluç Asya, Zipfel Mathias, Schnakenberg Rieke, Brossart Peter, Weckbecker Klaus
Institut für Hausarztmedizin der Medizinischen Fakultät der Universität Bonn.
Medizinische Klinik und Poliklinik III Abteilung für Onkologie, Hämatologie, Immunonkologie und Rheumatologie, Universitätsklinikum Bonn.
Dtsch Med Wochenschr. 2018 Aug;143(16):132-138. doi: 10.1055/a-0601-6191. Epub 2018 Aug 7.
About 40 % of the patients are active smokers when diagnosed lung cancer. Half of these patients is the nicotine consumption continues despite the existence of cancer. The overall mortality in these patients is a factor of 3 higher. In addition, the quality of life increases and symptoms such as cough and dyspnoea are reduced.
How do the treating physicians deal with the tobacco consumption of their patients with lung carcinoma?
A total of 14 physicians from the Bonn University Hospital were interviewed from the departments of pneumology, oncology and thoracic surgery involved in the treatment of the lung carcinoma. The interviews were transcribed and analysed according to the qualitative content analysis Mayring with MAXQDA 12.
The doctors handled the nicotine consumption of their patients very individually. In doing so, the doctors were primarily oriented on the possible life expectancy of the patients. In a curative treatment approach, the doctors presumed a smoking stop in their patients for successful treatment. In the context of a palliative treatment, many doctors no longer wanted the burden of smoking cessation to their patients. Came the desire for a cessation therapy in patients were referred generally to colleagues who were trained in smoking cessation. Obstacles to the independent execution of a smoking cessation were in particular lack of knowledge and short treatment times or high number of patients, especially during the consultation hours.
The doctors were quite convinced of the benefit of a smoking stop in the treatment of the lung carcinoma. Lung cancer patients would benefit if smoking cessation would be even more integrated into the overall therapy. For that one could rely on already established cessation programs and concepts for clinics.
约40%的肺癌患者在确诊时为现吸烟者。其中一半患者即便患癌仍继续吸食尼古丁。这些患者的总体死亡率高出3倍。此外，生活质量会提高，咳嗽和呼吸困难等症状会减轻。
治疗医生如何应对肺癌患者的吸烟问题？
对波恩大学医院参与肺癌治疗的呼吸科、肿瘤科和胸外科的14名医生进行了访谈。访谈内容根据Mayring的定性内容分析法转录并使用MAXQDA 12进行分析。
医生对患者吸烟问题的处理方式非常个体化。在此过程中，医生主要依据患者可能的预期寿命。在根治性治疗方法中，医生认为患者戒烟是成功治疗的前提。在姑息治疗的情况下，许多医生不再希望让患者承受戒烟的负担。患者若有戒烟意愿，通常会被转介给接受过戒烟培训的同事。独立实施戒烟的障碍尤其包括知识欠缺、治疗时间短或患者数量多，尤其是在门诊时间。
医生坚信戒烟对肺癌治疗有益。如果将戒烟更全面地纳入整体治疗，肺癌患者将从中受益。为此，可以依靠已有的针对诊所的戒烟项目和理念。
