Faculty of Health Studies, Brandon University, Brandon, Manitoba R7A 6A9, Canada.
School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada.
Int J Environ Res Public Health. 2019 Oct 28;16(21):4158. doi: 10.3390/ijerph16214158.
The objective of this study was to perform a systematic review to examine the effectiveness of tobacco dependence education versus usual or no tobacco dependence education on entry-level health professional student practice and client smoking cessation. Sixteen published databases, seven grey literature databases/websites, publishers' websites, books, and pertinent reference lists were searched. Studies from 16 health professional programs yielded 28 RCTs with data on 4343 healthcare students and 3122 patients. Two researchers independently assessed articles and abstracted data about student knowledge, self-efficacy, performance of tobacco cessation interventions, and patient smoking cessation. All forms of tobacco were included. We did not find separate interventions for different kinds of tobacco such as pipes or flavoured tobacco. We computed effect sizes using a random-effects model and applied meta-analytic procedures to 13 RCTs that provided data for meta-analysis. Students' counseling skills increased significantly following the 5As model (SMD = 1.03; 95% CI 0.07, 1.98; < 0.00001, I 94%; = 0.04) or motivational interviewing approach (SMD = 0.90, 95% CI 0.59, 1.21; = 0.68, I 0%; < 0.00001). With tobacco dependence counseling, 78 more patients per 1000 (than control) reported quitting at 6 months (OR 2.02; 95% CI 1.49, 2.74, I² = 0%, = 0.76; < 0.00001), although the strength of evidence was moderate or low. Student tobacco cessation counseling improved guided by the above models, active learning strategies, and practice with standardized patients.
本研究旨在进行系统综述，考察烟草依赖教育与常规或无烟草依赖教育对入门级卫生专业学生实践和患者戒烟的效果。共检索了 16 个已发表的数据库、7 个灰色文献数据库/网站、出版商网站、书籍和相关参考文献。16 个卫生专业项目的研究共产生了 28 项 RCT，涉及 4343 名医学生和 3122 名患者的数据。两名研究人员独立评估了文章并提取了关于学生知识、自我效能、戒烟干预措施执行情况和患者戒烟情况的数据。纳入了所有形式的烟草。我们没有发现针对不同类型烟草（如烟斗或调味烟草）的单独干预措施。我们使用随机效应模型计算了效应量，并对提供了进行荟萃分析的数据的 13 项 RCT 应用了荟萃分析程序。学生的咨询技能在接受 5A 模型（SMD = 1.03；95%CI 0.07，1.98； < 0.00001，I 94%； = 0.04）或动机性访谈方法（SMD = 0.90，95%CI 0.59，1.21； = 0.68，I 0%； < 0.00001）后显著提高。与对照组相比，接受烟草依赖咨询的患者中，每 1000 人中有 78 人（6 个月时）报告戒烟（OR 2.02；95%CI 1.49，2.74，I² = 0%， = 0.76； < 0.00001），尽管证据强度为中等或低等。在上述模型、主动学习策略和使用标准化患者进行实践的指导下，学生的烟草戒断咨询效果得到改善。
