School of Nursing, University of Hong Kong, Pokfulam, Hong Kong SAR.
J Adv Nurs. 2021 Aug;77(8):3331-3342. doi: 10.1111/jan.14869. Epub 2021 Apr 24.
To systematically summarize seminal studies on the design and effectiveness of smoking cessation interventions targeted at patients with chronic diseases through a critical appraisal of the literature.
A systematic review.
This review included literature identified through a search of six databases up to June 2020.
This review was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. The literature search was limited to English-language articles on the effectiveness of smoking cessation interventions for smokers who were aged ≥18 years and diagnosed with chronic diseases. Data were extracted using the Cochrane Data collection form for intervention reviews of randomized controlled trials and non-randomized controlled trials. The articles were subjected to a quality assessment.
Ten relevant articles were identified. The designs of the interventions were highly heterogeneous, and only six articles reported a significant increase in smoking abstinence among patients with chronic diseases. In the target population, an intervention delivered by healthcare professionals on an intensive schedule was shown to more effectively induce smoking cessation, compared with minimal counselling. However, methodological flaws were identified in most of the included studies.
The findings of this review suggest that additional efforts are needed to design smoking cessation interventions for patients with chronic diseases and that further examination of the effectiveness and feasibility of these interventions is warranted.
What problem did the study address? This review evaluated the effectiveness of smoking cessation interventions targeted at patients with chronic diseases. What were the main findings? An intervention with an intensive schedule that was delivered by healthcare professionals was shown to more effectively induce smoking cessation in patients with chronic diseases, compared with minimal counselling. More attention and resources should be directed towards smokers with no intention to quit, especially those with chronic diseases. There is an urgent need for generic smoking cessation interventions that use novel approaches to address the unique needs of this population and to integrate such evidence-based interventions into routine care. Where and on whom will the research have impact? The findings of this review may guide nurses, who play a prominent role in raising the issue of smoking cessation with patients, to design appropriate smoking cessation interventions for patients with chronic diseases. The resulting improvements in patients' health would not only benefit patients themselves but also reduce the burden of chronic diseases on healthcare systems.
通过对文献的批判性评价,系统总结针对慢性病患者的戒烟干预措施的设计和效果的重要研究。
系统评价。
本综述包括截至 2020 年 6 月通过搜索六个数据库获得的文献。
本综述根据 Cochrane 干预措施系统评价手册进行。文献检索仅限于关于针对年龄≥18 岁且诊断为慢性病的吸烟者的戒烟干预措施的有效性的英文文章。使用 Cochrane 数据收集表从随机对照试验和非随机对照试验中提取数据。对文章进行质量评估。
确定了 10 篇相关文章。干预措施的设计高度异质,只有 6 篇文章报告了慢性病患者的戒烟率显著提高。在目标人群中,与最低限度的咨询相比,由医疗保健专业人员密集安排的干预措施更有效地诱导戒烟。然而,纳入的大多数研究都存在方法学缺陷。
本综述的结果表明,需要进一步努力为慢性病患者设计戒烟干预措施,并进一步研究这些干预措施的有效性和可行性。
该研究解决了什么问题?本综述评估了针对慢性病患者的戒烟干预措施的效果。主要发现是什么?与最低限度的咨询相比,由医疗保健专业人员密集安排的干预措施更有效地诱导慢性病患者戒烟。应该更加关注和资源投入到没有戒烟意愿的吸烟者,特别是那些患有慢性病的吸烟者。迫切需要使用新方法满足这一人群独特需求的通用戒烟干预措施,并将这些基于证据的干预措施纳入常规护理。该研究将对谁和哪些人群产生影响?本综述的结果可能会指导护士,他们在与患者讨论戒烟问题方面发挥着重要作用,为慢性病患者设计适当的戒烟干预措施。这将不仅使患者受益,还将减轻慢性病对医疗系统的负担。