北京市临床护士实施5A’s戒烟干预的现状调查

Nurses＇ practice of 5A＇s smoking cessation intervention in clinical settings of Beijing

目的了解护士在临床工作中实施5A’S戒烟干预的现状，为促进其实施戒烟干预行为提供依据。方法采用方便取样，在北京市城区6家三级医院对230名护士进行问卷调查。问卷主要内容包括：护士实施5A’s戒烟干预的频度及影响因素，护士对自身戒烟干预能力的评价，护士在校期间学习烟草相关知识的情况。结果护士实施5A’s戒烟干预方案中的“建议”和“评估患者的吸烟史及现状”比较频繁，实施其余干预内容的现状均不理想（如评估对尼古丁的依赖程度、提供尼古丁替代疗法的帮助、协助制定戒烟计划等）。“戒烟能改善患者的健康”的信念能促进护士实施戒烟干预，“患者没有戒烟的动机”、“繁重的工作量”、不认为“帮助患者戒烟是护理工作中优先考虑的”，会阻碍护士实施戒烟干预。临床护士对自身进行吸烟危害的健康教育、沟通能力等评价较为理想，但对给予尼古丁替代疗法（NRT）建议和使用一氧化碳检测仪等方面的能力认同较差。护士在校期间学习过的相关内容主要是烟草的危害，且学时有限（1～2h），很少涉及戒烟技巧、药物疗法等内容，毕业工作后参加过戒烟培训的护士比例也极低（12．8％）。结论临床护士对5A’s戒烟干预的实施、所接受的戒烟相关教育以及实际戒烟干预能力和临床戒烟干预需要之间存在差距。

Objective To identify nurses＇ practice of 5A＇s smoking cessation intervention in clini cal settings of Beijing. Methods A cross sectional survey was conducted among 248 nurses by conve nient sampling. The questionnaire included the frequency of nurses＇ practice of 5A＇s intervention and its influencing factors, nurses＇ self evaluation of competency, and tobacco related curricula in school of nurs ing. Results Most nurses implemented ＂advice＂ and ＂evaluated the patients＇ smoking history and cur rent status＂ more frequently, but nurses＇ practice of other interventions was dissatisfactory. The belief that smokers could benefit from quitting was facilitating, however the barriers included no motivations to quit smoking, heavy work, and the belief that helping smokers to quit is not the priority in nursing routine. The nurses got insufficient knowledge about smoking cessation through school education and in service training （12.8%）. Conclusions There＇s a big gap between the implementation of nurses＇ smoking cessation in tervention, accepted smoking cessation education, smoking cessation intervention competency and the ur gent demands to help patients quit smoking.