Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany.
Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany.
Ger Med Sci. 2020 Jul 3;18:Doc06. doi: 10.3205/000282. eCollection 2020.
The objective was to evaluate the effect of a short physician training in smoking cessation on the physicians' performance of smoking cessation interventions. The effects on patients' cessation rates were analyzed as well. A further aim was to identify barriers for providing cessation interventions. The study was conducted in an acute care pulmonology department of a German university hospital. 24 physicians of the pulmonology department of a German university hospital received a two-hour training in smoking cessation. 109 pre- and 89 post-training group patients were compared with regard to the frequencies of received smoking cessation interventions (Ask, Advise, Assist) and three- and six-month abstinence rates. Physicians estimated their intervention frequencies and gave reasons for not providing cessation interventions. In a multivariable analysis (p<0.05), the physicians' application of "Ask" (OR 3.28, 95% CI 1.13-9.53) and the six-month abstinence rates (OR 2.70, 95% CI 1.24-5.84) were significantly higher in the post-training group. The univariate analysis also showed a significant effect on "Assist" (OR 2.05, 95% CI 1.09-3.87). No significant effect was seen on "Advise to quit". Physicians overestimated their intervention frequencies and reported the patients' low motivation to stop, an oncological disease and palliative care situation as barriers to performing smoking cessation. A short physician training in a hospital department of pulmonology increases the use of guideline-based cessation strategies and may improve cessation rates. The findings show that hospital-based strategies such as physician trainings could be useful in the improvement of smoking cessation. Strategies for overcoming barriers for providing smoking cessation interventions are needed.
目的是评估对医生进行简短的戒烟培训对其实施戒烟干预的效果。同时分析了对患者戒烟率的影响。此外，还旨在确定提供戒烟干预的障碍因素。该研究在德国一所大学医院的急性呼吸科肺病病房进行。德国一所大学医院肺病科的 24 名医生接受了两小时的戒烟培训。比较了 109 名培训前组和 89 名培训后组患者接受的戒烟干预（询问、建议、协助）频率，以及 3 个月和 6 个月的戒烟率。医生评估了他们的干预频率，并给出了未提供戒烟干预的原因。在多变量分析（p<0.05）中，培训后组医生“询问”（OR 3.28，95%CI 1.13-9.53）和 6 个月戒烟率（OR 2.70，95%CI 1.24-5.84）的应用显著更高。单变量分析也显示对“协助”（OR 2.05，95%CI 1.09-3.87）有显著影响。对“建议戒烟”没有显著影响。医生高估了他们的干预频率，并报告患者戒烟动机低、患有癌症疾病和姑息治疗情况是实施戒烟的障碍因素。在肺病科医院部门进行的简短医生培训增加了基于指南的戒烟策略的使用，并可能提高戒烟率。研究结果表明，基于医院的策略，如医生培训，可能有助于提高戒烟率。需要制定克服提供戒烟干预障碍的策略。
