Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27759, USA.
Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27759, USA.
Int J Environ Res Public Health. 2020 Mar 19;17(6):2050. doi: 10.3390/ijerph17062050.
Tobacco use treatment is an essential component of cancer care. Family members play a significant role in smoking behavior, but more research is needed regarding the development, implementation, and impact of family-based interventions in cancer care. The UNC Tobacco Treatment Program conducted an 18-month pilot study to examine the feasibility of implementing a family systems approach to treat tobacco use among patients at the North Carolina Cancer Hospital and to measure the impact of such an approach on patient abstinence. Implementation included four phases: (1) modifying the electronic health record and monthly report generated from the electronic health record; (2) training Tobacco Treatment Specialists to provide family counseling; (3) integrating family members into patients' treatment; and (4) conducting six-month follow-up calls. During the course of the study, 42% (N = 221/532) of patients had family members integrated into their tobacco use treatment. Only 21 patients (4%) had family members present but not integrated into the treatment plan. At the six-month follow up time point, the seven-day point-prevalence quit rate for patients with family integration was 28% (N = 56/200), compared to 23% (N = 67/291) ( = 0.105) for patients without family integration. Integration of family members is clearly possible in an academic medical center's oncology tobacco treatment program. Although pilot results were not statistically significant at 6 months, a potentially higher quit rate suggests a need for expanded research on methods to integrate family members in oncology settings for patients with tobacco-related cancers.
烟草使用治疗是癌症护理的重要组成部分。家庭成员在吸烟行为中起着重要作用，但需要更多的研究来探讨癌症护理中基于家庭的干预措施的发展、实施和影响。UNC 烟草治疗计划进行了为期 18 个月的试点研究，以检验在北卡罗来纳癌症医院采用家庭系统方法治疗烟草使用的可行性，并衡量这种方法对患者戒烟的影响。实施包括四个阶段：（1）修改电子病历和电子病历生成的每月报告；（2）培训烟草治疗专家提供家庭咨询；（3）将家庭成员纳入患者的治疗中；（4）进行六个月的随访电话。在研究过程中，42%（N = 221/532）的患者有家庭成员参与他们的烟草使用治疗。只有 21 名患者（4%）有家庭成员在场，但未纳入治疗计划。在六个月的随访时间点，有家庭成员参与治疗的患者的七天点前戒烟率为 28%（N = 56/200），而没有家庭成员参与治疗的患者的七天点前戒烟率为 23%（N = 67/291）（ = 0.105）。在学术医疗中心的肿瘤烟草治疗计划中，将家庭成员纳入治疗显然是可行的。尽管 6 个月时的试点结果没有统计学意义，但更高的戒烟率表明需要进一步研究在肿瘤环境中整合有烟草相关癌症患者的家庭成员的方法。
