1 Denver Health Medical Center, Denver, Colorado, USA.
2 Ball State University, Muncie, Indiana, USA.
Qual Health Res. 2019 Jul;29(8):1145-1160. doi: 10.1177/1049732318817047. Epub 2018 Dec 14.
Tobacco cessation is an important intervention to reduce mortality from ischemic heart disease, the leading cause of death in India. In this study, we explored facilitators, barriers, and cultural context to tobacco cessation among acute coronary syndrome (ACS, or heart attack) patients and providers in a tertiary care institution in the south Indian state of Kerala, with a focus on patient trajectories. Patients who quit tobacco after ACS expressed greater understanding about the link between tobacco and ACS, exerted more willpower at the time of discharge, and held less fatalistic beliefs about their health compared to those who continued tobacco use. The former were motivated by the fear of recurrent ACS, strong advice to quit from providers, and determination to survive and financially provide for their families. Systemic barriers included inadequate training, infrequent prescription of cessation pharmacotherapy, lack of ancillary staff to deliver counseling, and stigma against mental health services.
戒烟是减少印度缺血性心脏病（该国主要死因）死亡率的重要干预措施。在这项研究中，我们在印度喀拉拉邦一家三级护理机构中探索了急性冠脉综合征（ACS，或心脏病发作）患者和提供者戒烟的促进因素、障碍和文化背景，重点关注患者的轨迹。与继续使用烟草的患者相比，戒烟的 ACS 患者对烟草与 ACS 之间的联系有了更深入的了解，在出院时表现出更强的意志力，对自己的健康持较少的宿命论信念。前者是出于对复发性 ACS 的恐惧、来自提供者的强烈戒烟建议以及生存和为家人提供经济支持的决心所驱动的。系统障碍包括培训不足、停止吸烟药物治疗的处方不频繁、缺乏提供咨询的辅助人员以及对心理健康服务的污名化。
