Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
Patient Educ Couns. 2019 Jun;102(6):1140-1149. doi: 10.1016/j.pec.2019.01.015. Epub 2019 Jan 23.
Objective To investigate implementation of a tobacco dependence treatment guideline among five groups of healthcare professionals. Methods Data collected in The Netherlands (2016-2017) were compared among gynaecologists (N = 49), midwives (N = 68), respiratory nurses (N = 72), practice nurses (N = 84) and paediatricians (N = 38). Intentions to use the guideline, satisfaction with own implementation, and dosage delivered of quit-advice and assisting in quitting were predicted using linear regression analyses and regression tree analyses. Results Implementation of smoking cessation care (SCC) and barriers differed between the groups, with nurses reporting better implementation and fewer barriers. Main barriers were lacking training (gynecologists, pediatricians) and time (midwives). Regression tree analyses showed that self-efficacy and training interacted; participants with weaker self-efficacy provided more quit advice if they had participated in SCC training. Training was positively related to intentions to use the guideline, satisfaction, providing quit-advice, and assisting smokers in quitting. Conclusion Implementation of SCC is suboptimal, such that patients who smoke do not receive the highest quality of care. Profession and training in SCC are important determinants of implementation of SCC. Practice implications Efforts to improve implementation should be targeted at profession. Training is indicated, and may focus on skills for nurses, and knowledge for gynecologists, midwives and pediatricians.
调查 5 组医疗保健专业人员实施烟草依赖治疗指南的情况。
比较荷兰(2016-2017 年)收集的数据,比较妇科医生(N=49)、助产士(N=68)、呼吸护士(N=72)、执业护士(N=84)和儿科医生(N=38)之间的使用指南的意图、对自身实施情况的满意度,以及戒烟咨询和戒烟辅助的剂量。使用线性回归分析和回归树分析预测戒烟建议和协助戒烟。
戒烟护理(SCC)的实施和障碍在不同组之间存在差异,护士报告的实施情况更好,障碍更少。主要障碍是缺乏培训(妇科医生、儿科医生)和时间(助产士)。回归树分析显示,自我效能和培训相互作用;自我效能较弱的参与者如果参加了 SCC 培训,提供的戒烟建议就越多。培训与使用指南的意愿、满意度、提供戒烟建议和帮助吸烟者戒烟呈正相关。
SCC 的实施情况并不理想,因此吸烟患者未获得最佳护理质量。SCC 的专业和培训是 SCC 实施的重要决定因素。
应针对专业人士努力提高实施情况。培训是必要的,培训内容可能侧重于护士的技能,以及妇科医生、助产士和儿科医生的知识。