Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
J Surg Res. 2021 Feb;258:422-429. doi: 10.1016/j.jss.2020.08.058. Epub 2020 Oct 12.
Tobacco use is the greatest preventable cause of death and disease in the United States. Despite recommendations from the Centers for Disease Control and Prevention, United States Preventive Task Force, and major professional societies that all health-care providers provide smoking-cessation counseling, smoking-cessation interventions are not consistently delivered in clinical practice. We sought to identify important barriers and facilitators to the utilization of smoking-cessation interventions in a thoracic oncology program.
We conducted 14 semistructured interviews with providers including thoracic surgeons (n = 3), interventional pulmonologists (n = 1), medical oncologists (n = 3), radiation oncologists (n = 2), and nurses (n = 5). Interviewees were asked about prior and current smoking-cessation efforts, their perspectives on barriers to successful smoking cessation, and opportunities for improvement. Responses were analyzed inductively to identify common themes.
All interviewees report discussing smoking cessation with their patients and realize the importance of a smoking-cessation counseling; however, smoking-cessation interventions are inconsistent and often lacking. Providers emphasized five domains that impact their delivery of smoking-cessation interventions: patient willingness and motivation to quit, clinical engagement and follow-up, documentation of smoking history, provider education in smoking cessation, and the availability of additional smoking-cessation resources.
Providers recognize the need for more efficient and consistent smoking-cessation interventions. Therefore, the development of interventions that address this need would not only be easily taught to providers and delivered to patients but also be welcomed into clinics.
在美国,吸烟是导致死亡和疾病的最大可预防因素。尽管疾病控制与预防中心、美国预防服务工作组和主要专业协会都建议所有医疗保健提供者提供戒烟咨询,但在临床实践中,戒烟干预措施并没有得到一致实施。我们试图确定在胸肿瘤科计划中利用戒烟干预措施的重要障碍和促进因素。
我们对包括胸外科医生(n=3)、介入肺科医生(n=1)、肿瘤内科医生(n=3)、放射肿瘤学家(n=2)和护士(n=5)在内的 14 名提供者进行了 14 次半结构化访谈。受访者被问及之前和当前的戒烟努力、他们对成功戒烟的障碍的看法,以及改进的机会。通过归纳分析来识别常见的主题。
所有受访者都表示与患者讨论了戒烟问题,并认识到戒烟咨询的重要性;然而,戒烟干预措施不一致,而且往往缺乏。提供者强调了五个影响他们提供戒烟干预措施的领域:患者戒烟的意愿和动机、临床参与和随访、吸烟史的记录、戒烟方面的提供者教育,以及额外的戒烟资源的可用性。
提供者认识到需要更有效和一致的戒烟干预措施。因此,开发满足这一需求的干预措施不仅可以轻松教授给提供者并提供给患者,而且还会受到诊所的欢迎。