Prochazka A, Koziol-McLain J, Tomlinson D, Lowenstein S R
Veterans Affairs Medical Center, Denver, CO, USA.
Acad Emerg Med. 1995 Mar;2(3):211-6. doi: 10.1111/j.1553-2712.1995.tb03201.x.
To determine: 1) the extent of emergency physicians' (EPs') training in smoking cessation counseling; 2) their understanding of counseling and pharmacologic treatment techniques; 3) their current practices in screening, counseling, and referring patients who smoke; and 4) perceived barriers to routine smoking cessation counseling in emergency medical practice.
A 26-item questionnaire addressing the above issues was mailed to all 256 members of the Colorado Chapter of the American College of Emergency Physicians.
Completed questionnaires were returned by 196 physicians (77% response rate). The majority of respondents were men (80%), practiced in urban settings (87%), and were board-certified in emergency medicine (82%). Most EPs lacked formal smoking cessation training (55%) and felt poorly prepared to counsel patients about smoking cessation (65%). A minority (27%) of the physicians reported routinely asking patients to quit smoking. The physicians with formal smoking cessation training were more likely to counsel and refer patients routinely (34% vs 20%, p = 0.03). The physicians cited the following barriers to routine smoking cessation counseling: a lack of time; a perception that patients are not interested; a belief that the ED setting is inappropriate for counseling; and a sense that counseling is ineffective. Lack of reimbursement was cited by only 13% of the respondents. The physicians who had formal smoking cessation training perceived fewer barriers to ED-based counseling.
Emergency physicians have received little training in smoking cessation and perceive many barriers to ED-based smoking cessation interventions. Not surprisingly, they infrequently take action to encourage or assist their patients to quit smoking.
确定：1）急诊医生（EPs）在戒烟咨询方面的培训程度；2）他们对咨询和药物治疗技术的理解；3）他们目前在筛查、咨询和转诊吸烟患者方面的做法；4）在急诊医疗实践中常规戒烟咨询的感知障碍。
一份针对上述问题的26项问卷被邮寄给美国急诊医师学会科罗拉多分会的所有256名成员。
196名医生返回了完整的问卷（回复率77%）。大多数受访者为男性（80%），在城市环境中执业（87%），并拥有急诊医学专业认证（82%）。大多数急诊医生缺乏正式的戒烟培训（55%），并觉得在为患者提供戒烟咨询方面准备不足（65%）。少数医生（27%）报告说会常规询问患者戒烟情况。接受过正式戒烟培训的医生更有可能常规为患者提供咨询和转诊（34%对20%，p = 0.03）。医生们列举了常规戒烟咨询的以下障碍：缺乏时间；认为患者不感兴趣；认为急诊环境不适合咨询；以及觉得咨询无效。只有13%的受访者提到了报销问题。接受过正式戒烟培训的医生认为基于急诊的咨询障碍较少。
急诊医生在戒烟方面接受的培训很少，并且认为基于急诊的戒烟干预存在许多障碍。不出所料，他们很少采取行动鼓励或协助患者戒烟。
