组织改变理论在工厂戒烟干预中的应用研究

Application of theory of organizational change for smoking cessation in workplace

目的探索组织改变理论模型在中国工厂戒烟干预应用的可行性和效果。方法于2008～2009年对上海市两家工厂进行对照研究。对照组246人(男204,女42),平均年龄(34.7±13.2)岁,干预组233人(男203,女30),平均年龄(31.1±11.9)岁。将组织改变理论模型的4个阶段应用到干预组的戒烟干预中。分别在干预前和干预后,以问卷调查表的形式收集员工每日吸烟量、吸烟率、危害认知和戒烟意愿等方面的改变。在干预6个月后以戒烟者尿液中可的宁浓度的生物学检测判定是否成功戒烟。结果干预组的现在吸烟率由干预前的59.8%下降到干预后的39.1%(P<0.01),每日吸烟量由(15.0±8.6)支/天下降到(11.9±7.9)支/天(P<0.01)。对照组则无显著改变;干预组吸烟者中愿意接受同事戒烟帮助的比例由干预前的3.7%上升到干预后的15.6%(P<0.01),认为吸烟对健康有严重危害的比例也由干预前的36.5%上升到干预后的64.4%(P<0.05),对照组则均无显著改变(P>0.05);干预组吸烟者中打算在1个月内戒烟的比例由干预前的11.0%提高到干预后的41.5%(P<0.01),而对照组则无显著改变(8.5%vs9.5%);干预组和对照组6个月的戒烟成功率分别为24.6%和6.4%(P<0.01)。结论组织改变理论模型在中国工厂开展戒烟干预中的应用是可行的;该模型的应用对降低工人的吸烟率和每日吸烟量,提高吸烟者的戒烟意愿是显著的,6个月的戒烟成功率也显著提高。

Objective To explore the feasibility and effectiveness of tobacco control program in manufacture workplace with stage theory of organizational change.Methods Comunity intervention study was carried out among two manufacture plants of a multinational chemical company in Shanghai during 2008 to 2009.Totally 246 employees in control group and 233 in intervention group were involved.The average age was（34.7 ± 13.2） years old and（31.1 ± 11.9） years old,respectively.Four stages of the theory of organizational change were implemented in the intervention group.Self-administered questionnaire was employed prior to and after the interventions to collect the data on employees＇smoking behaviours such as smoking prevalence,daily cigarette consumption,perception on smoking＇s health impact,as well as their quitting intention.After six months,urine cotinine test was given to assess the successful cessation.Results The current smoking prevalence rate in intervention group was reduced from 59.8% before the study to 39.1% in follow-up（P 0.01）,while their daily cigarette smoked dropped from（15.0 ± 8.6） cigarettes per day to（11.9 ± 7.9） cigarettes per day（P 0.01）,while no significant changes in control group.In intervention group,the proportion of willing to accept cessation support from the work mates increased from 3.7% before the intervention to 15.6% afterwards,the perception of smoking having severe health impact increased from 36.5% to 64.4%（P 0.05）;No significant changes were found in control group.The quitting intention was also raised from 11.0% to 41.5%（P 0.01）.The successful cessation rate after six months were 24.6% in intervention group and 6.4% in control group（P 0.05）.Conclusion Stage theory of organizational change is feasible to be implemented within tobacco control program in manufacture workplace.Its application has effectiveness to decrease smoking prevalence and daily cigarette consumption with quitting intention raised.Successful cessation result was also indicated.