Vetter Mary, Thomas Katharine, Mohammed Alaa, Urrego Fernando
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA.
Ochsner J. 2018 Winter;18(4):326-331. doi: 10.31486/toj.18.0043.
Louisiana has one of the highest rates of smoking in the country, putting its children at high risk of secondhand and third-hand smoke exposure and subsequent morbidity. Pediatricians have an important role to play by including smoking cessation promotion (SCP) in their discussions with patient caregivers. The purpose of this study was to examine SCP trends at Ochsner Health System and to determine if pediatricians are less likely to express confidence in and performance of SCP activities than physicians in other specialties.
We distributed a survey to pediatricians and to physicians in the departments of obstetrics and gynecology, internal medicine, and psychiatry in the Ochsner Health System. The survey assessed physician confidence in and performance of several SCP behaviors. We analyzed pediatrician confidence in and performance of 3 behaviors (screening, counseling, and referring) and compared pediatrician responses to the responses of the physicians in the other specialties.
Twenty-eight pediatrician and 33 other physician responses were included in the analysis. No significant correlation 0.2785) was found between pediatrician confidence and performance in screening for smoking behavior. A significant correlation was found in counseling ( = 0.0159) and referring 0.0214). In the comparison of pediatrician responses to other physician responses, the physicians in the other specialties had higher medians and/or quartiles for both confidence and performance of all 3 behaviors, and the differences were significant.
The physicians in other specialties showed consistently higher rates of confidence and performance of SCP behaviors than the pediatricians. Intervention is necessary to encourage pediatricians at Ochsner Health System to promote smoking cessation in their practices.
路易斯安那州是美国吸烟率最高的地区之一,这使其儿童面临二手烟和三手烟暴露以及随后发病的高风险。儿科医生在与患者护理人员的讨论中纳入戒烟促进(SCP)方面可发挥重要作用。本研究的目的是调查奥施纳健康系统的SCP趋势,并确定与其他专科医生相比,儿科医生对SCP活动的信心和执行情况是否较低。
我们向奥施纳健康系统的儿科医生以及妇产科、内科和精神科的医生发放了一份调查问卷。该调查评估了医生对几种SCP行为的信心和执行情况。我们分析了儿科医生对三种行为(筛查、咨询和转诊)的信心和执行情况,并将儿科医生的回答与其他专科医生的回答进行了比较。
分析纳入了28名儿科医生和33名其他医生的回答。在吸烟行为筛查方面,儿科医生的信心和执行情况之间未发现显著相关性(=0.2785)。在咨询(=0.0159)和转诊(=0.0214)方面发现了显著相关性。在将儿科医生的回答与其他医生的回答进行比较时,其他专科医生在所有三种行为的信心和执行情况方面的中位数和/或四分位数更高,且差异显著。
其他专科医生在SCP行为方面的信心和执行率始终高于儿科医生。有必要进行干预,以鼓励奥施纳健康系统的儿科医生在其诊疗工作中促进戒烟。