Hamzah M. Alghzawi, PhD, MSN, RN, Medstar Good Samaritan Hospital, Baltimore, MD, USA.
Carla L. Storr, ScD, MPH, University of Maryland School of Nursing, Baltimore, MD, USA.
J Am Psychiatr Nurses Assoc. 2023 Mar-Apr;29(2):146-160. doi: 10.1177/10783903211008248. Epub 2021 Apr 30.
Social support and stressful life events (SLEs) have been found to be influential factors for smoking cessation in the general population, but little is known about these factors among smokers with severe mental illnesses (SMIs) and whether their associations with smoking cessation differ by gender.
To examine the association between social support and smoking cessation as mediated by SLEs in people with SMI and to examine whether the interrelations among social support, SLEs, and smoking cessation differ by gender.
A population sample of 4,610 American lifetime adult smokers with schizophrenia, bipolar disorder, or major depressive disorder were identified in a limited public use data set of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Four mediation and moderated mediation models were used to examine gender differences in the interrelations among social support (total and three subscales of the Interpersonal Support Evaluation List-12), SLEs (summative score of positive responses to 16 types experienced in past year and related to health, job, death, or legal situations), and smoking status in prior year.
Total, appraisal, and tangible support among females exerted indirect effects on smoking cessation via decreasing SLE scores. Among males, only belonging support exerted an indirect effect on smoking cessation via an increased SLE score.
Findings suggest that interventions focusing on improving social support should be a priority for those working with smokers with SMI.
社会支持和压力性生活事件(SLEs)已被发现是普通人群戒烟的影响因素,但在患有严重精神疾病(SMI)的吸烟者中,这些因素的知之甚少,以及它们与戒烟的关联是否因性别而异。
在患有 SMI 的人群中,检验社会支持与戒烟的关系,以及 SLEs 是否通过 SLEs 来介导,并检验社会支持、SLEs 和戒烟之间的相互关系是否因性别而异。
在一个有限的公共使用数据集中,确定了来自 2012-2013 年国家酒精和相关条件流行病学调查的人群样本,该样本包括 4610 名美国终身成年吸烟者,他们患有精神分裂症、双相情感障碍或重度抑郁症。采用四种中介和调节中介模型,检验社会支持(人际支持评估清单-12 的总分和三个子量表)、SLEs(过去一年中经历的 16 种积极反应的综合得分,与健康、工作、死亡或法律情况有关)和吸烟状况之间相互关系的性别差异。
女性的总支持、评价支持和有形支持通过降低 SLE 分数对戒烟产生间接影响。而在男性中,只有归属感支持通过增加 SLE 得分对戒烟产生间接影响。
研究结果表明,关注改善社会支持的干预措施应成为与患有 SMI 的吸烟者合作的重点。