关于将戒烟治疗整合到常见精神疾病患者心理服务中的观点：一项多视角定性研究。
Views about integrating smoking cessation treatment within psychological services for patients with common mental illness: A multi-perspective qualitative study.
机构信息
Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.
Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK.
出版信息
Health Expect. 2021 Apr;24(2):411-420. doi: 10.1111/hex.13182. Epub 2020 Dec 23.
BACKGROUND
Tobacco smoking rates are significantly higher in people with common mental illness compared to those without. Smoking cessation treatment could be offered as part of usual outpatient psychological care, but currently is not.
OBJECTIVE
To understand patient and health care professionals' views about integrating smoking cessation treatment into outpatient psychological services for common mental illness.
DESIGN
Qualitative in-depth interviews, with thematic analysis.
PARTICIPANTS
Eleven Improving Access to Psychological Therapies (IAPT) psychological wellbeing practitioners (PWPs), six IAPT patients, and six stop smoking advisors were recruited from English smoking cessation, and IAPT services.
RESULTS
Patients reported psychological benefits from smoking, and also described smoking as a form of self-harm. Stop smoking advisors displayed therapeutic pessimism and stigmatizing attitudes towards helping people with mental illness to quit smoking. PWPs have positive attitudes towards smoking cessation treatment for people with common mental illness. PWPs and patients accept evidence that smoking tobacco may harm mental health, and quitting might benefit mental health. PWPs report expertise in helping people with common mental illness to make behavioural changes in the face of mood disturbances and low motivation. PWPs felt confident in offering smoking cessation treatments to patients, but suggested a caseload reduction may be required to deliver smoking cessation support in IAPT.
CONCLUSIONS
IAPT appears to be a natural environment for smoking cessation treatment. PWPs may need additional training, and a caseload reduction. Integration of smoking cessation treatment into IAPT services should be tested in a pilot and feasibility study.
PATIENT OR PUBLIC CONTRIBUTION
Service users and members of the public were involved in study design and interpretation of data.
背景
与没有常见精神疾病的人相比，患有常见精神疾病的人群的吸烟率要高得多。戒烟治疗可以作为常规门诊心理护理的一部分，但目前并未提供。
目的
了解患者和医疗保健专业人员对将戒烟治疗纳入常见精神疾病门诊心理服务的看法。
设计
定性深入访谈，采用主题分析。
参与者
从英国戒烟和 IAPT 服务中招募了 11 名改善心理治疗机会（IAPT）心理健康从业者（PWPs）、6 名 IAPT 患者和 6 名戒烟顾问。
结果
患者报告说吸烟对他们的心理健康有好处，同时也将吸烟描述为一种自我伤害的形式。戒烟顾问对帮助有精神疾病的人戒烟表现出治疗性悲观和污名化的态度。PWPs 对为常见精神疾病患者提供戒烟治疗持积极态度。PWPs 和患者接受了吸烟可能损害精神健康的证据，并且戒烟可能有益于精神健康。PWPs 报告说，他们在面对情绪障碍和低动力时，具有帮助患有常见精神疾病的人改变行为的专业知识。PWPs 有信心为患者提供戒烟治疗，但建议可能需要减少工作量，以在 IAPT 中提供戒烟支持。
结论
IAPT 似乎是戒烟治疗的自然环境。PWPs 可能需要额外的培训和减少工作量。应在试点和可行性研究中测试将戒烟治疗纳入 IAPT 服务的方案。
患者或公众的贡献
服务使用者和公众参与了研究设计和数据解释。
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