Klinik Primer PPUKM Cheras, Kuala Lumpur, Malaysia.
Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Family Medicine, Kuala Lumpur, Malaysia.
Med J Malaysia. 2020 Jan;75(1):1-6.
Primary care doctors are responsible to provide smoking cessation intervention (SCI) to smokers in a community. This study aimed to assess the SCI practice among primary care doctors themselves and its associated factors.
This cross-sectional study was conducted from July to October 2016. All the 140 doctors in 12 public primary care clinics in Kuala Lumpur were invited to participate in this study. However, only 122 doctors (females, 82.8%) completed the self-administered questionnaire that assessed their demography, clinical experience, SCI practice and its barriers, self-efficacy in delivering and knowledge on smoking and SCI.
Only 42.6% of the doctors had good SCI practice. Almost all doctors assessed the smoking status of their patients (98.4%) and advised them to quit (98.4%). However, lesser proportions of the doctors followed up the practice of patients (50.0%), taught smokers on various methods of quit smoking (46.70%) and discussed about the barriers and resources to quit prior to the quit date (27.9%). Less than one-fourth of the doctors were confident in providing SCI. Although 69.7% had previous training in SCI, many felt they had inadequate knowledge (56.6%) and skills (47.5%). Only 11.5% of doctors thought their previous training was enough. Having higher level of knowledge on smoking and SCI was significantly associated with good SCI practice [adjusted Odds Ratio (95% Confidence Intervals): 1.21 (1.02, 1.43), p=0.026].
The SCI practiced by the primary care doctors in this study was sub-standard, particularly in assisting smokers to quit and arranging follow up. Low self-efficacy in providing SCI was also common. These inadequacies may be due to poor knowledge and skills, which needs to be improved through effective clinical training.
初级保健医生有责任为社区内的吸烟者提供戒烟干预（SCI）。本研究旨在评估初级保健医生自身的 SCI 实践及其相关因素。
本横断面研究于 2016 年 7 月至 10 月进行。邀请吉隆坡 12 家公立初级保健诊所的 140 名医生参加，但只有 122 名医生（女性，82.8%）完成了自我管理问卷，评估了他们的人口统计学、临床经验、SCI 实践及其障碍、戒烟的自我效能和吸烟与 SCI 的知识。
只有 42.6%的医生有良好的 SCI 实践。几乎所有的医生都会评估患者的吸烟状况（98.4%）并建议他们戒烟（98.4%）。然而，只有较少比例的医生会跟踪患者的戒烟实践（50.0%），教授吸烟者各种戒烟方法（46.7%），并在戒烟日期前讨论戒烟的障碍和资源（27.9%）。不到四分之一的医生对提供 SCI 有信心。尽管 69.7%的医生接受过 SCI 培训，但许多人认为他们的知识（56.6%）和技能（47.5%）不足。只有 11.5%的医生认为他们之前的培训已经足够。对吸烟和 SCI 的知识水平较高与良好的 SCI 实践显著相关[调整后的优势比（95%置信区间）：1.21（1.02，1.43），p=0.026]。
本研究中初级保健医生的 SCI 实践水平不高，尤其是在帮助吸烟者戒烟和安排随访方面。提供 SCI 的自我效能感也普遍较低。这些不足之处可能是由于知识和技能不足，需要通过有效的临床培训来提高。
