解决儿科住院期间的环境烟草烟雾暴露问题：儿科护士与呼吸治疗师的态度与实践。
Addressing Environmental Smoke Exposure During Pediatric Hospitalization: Attitudes and Practices of Pediatric Nurses Versus Respiratory Therapists.
机构信息
Department of Pediatrics and Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
出版信息
Respir Care. 2021 Feb;66(2):275-280. doi: 10.4187/respcare.08038. Epub 2020 Sep 22.
BACKGROUND
Tobacco smoke exposure leads to numerous adverse health effects in children. Providing cessation interventions to caregivers who smoke during pediatric hospitalizations can help protect children from such exposure. Both pediatric registered nurses (RNs) and pediatric respiratory therapists (RTs) are well positioned to provide these interventions. Little is known about their rates of participation in cessation efforts. Our objective was to compare the attitudes and practice of pediatric RNs versus pediatric RTs to evaluate their relative cessation-intervention practices in the in-patient pediatric setting.
METHODS
An online survey was sent to pediatric RNs and RTs at 4 tertiary pediatric hospitals in California. The survey assessed individual demographics, work environment, experience, beliefs, and practices related to smoking cessation activities. Questions used 3-point and 5-point Likert scales and were compared with the chi-square test. Institutions with a response rate < 20% were excluded.
RESULTS
A total of 401 respondents were included in the final analysis (292 RNs, 109 RTs). RTs versus RNs were older (42.0 y vs 35.4 y, respectively, < .001) and more likely to be former smokers (29.9% vs 13.3%, respectively, < .001). RNs reported lower levels of confidence in discussing smoking cessation with parents, with 11.7% saying they felt "very confident" compared to 29.0% of RTs ( < .001). RNs also reported screening for smoke exposure less frequently than RTs, with 18.8% responding "often" or "always" compared to 28.9% of RTs ( = .033). RNs had lower rates of advising parents "to make a smoke-free home policy" compared to RTs (ie, 13.4% vs 26.9%, respectively, = .002).
CONCLUSIONS
Compared to in-patient pediatric RNs, RTs reported higher rates of confidence in providing cessation interventions, screening for smoke exposure, and counseling on reducing smoke exposure, suggesting that they may be better positioned for intervening. These results can inform the design of an in-patient cessation intervention for caregivers of hospitalized children.
背景
烟草烟雾暴露会导致儿童出现许多健康不良影响。为住院期间吸烟的照护者提供戒烟干预措施，有助于保护儿童免受此类暴露。儿科注册护士（RN）和儿科呼吸治疗师（RT）都非常适合提供这些干预措施。但他们参与戒烟工作的比例知之甚少。我们的目的是比较儿科 RN 和 RT 的态度和实践，以评估他们在住院儿科环境中相对的戒烟干预实践。
方法
我们向加利福尼亚州 4 家三级儿科医院的儿科 RN 和 RT 发送了在线调查。该调查评估了个人人口统计学、工作环境、经验、信念和与戒烟活动相关的实践。使用 3 分和 5 分李克特量表的问题，并与卡方检验进行比较。如果机构的回复率<20%，则将其排除在外。
结果
共有 401 名受访者被纳入最终分析（292 名 RN，109 名 RT）。RT 与 RN 相比年龄更大（分别为 42.0 岁和 35.4 岁， <.001），且更有可能是前吸烟者（分别为 29.9%和 13.3%， <.001）。RN 报告说，他们在与父母讨论戒烟方面的信心较低，有 11.7%的人表示他们感到“非常有信心”，而 RT 则有 29.0%（ <.001）。与 RT 相比，RN 报告说筛查暴露于吸烟的频率也较低，分别有 18.8%的人回答“经常”或“总是”，而 RT 则有 28.9%（ =.033）。与 RT 相比，RN 向父母建议“制定无烟家庭政策”的比例也较低（分别为 13.4%和 26.9%， =.002）。
结论
与住院儿科 RN 相比，RT 报告说他们在提供戒烟干预、筛查吸烟暴露和就减少吸烟暴露进行咨询方面的信心更高，这表明他们可能更适合进行干预。这些结果可以为住院儿童的照护者的住院戒烟干预措施的设计提供信息。
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