动机性访谈对促进慢性阻塞性肺病老年男性患者戒烟及生活质量改善的影响

Effects of motivational interviewing on smoking cessation and quality of life among old male patients with chronic obstructive pulmonary disease

目的 探究动机性访谈对老年男性慢性阻塞性肺病（COPD）患者戒烟情况和生活质量的影响。方法 选择2013年1~10月中国人民解放军总医院呼吸科门诊就诊的吸烟史且未戒烟的老年（年龄〉60岁）COPD男性患者60例为研究对象,将其随机分为访谈组和对照组,每组30例。采用社会人口特征表、患者认知评估问卷、Fagerstrom尼古丁依赖量表（FTND）、St George＇s呼吸问卷（SGRQ）收集相关数据。在对访谈组患者进行为期1个月和3个月的动机性访谈后,分别评估各组患者生活质量、每日吸烟数量和尼古丁依赖度。结果 访谈1个月后,访谈组患者尼古丁依赖度和每日吸烟数量均下降（χ^2=10.5、36.9,P〈0.05或P〈0.01）;访谈3个月尼古丁依赖度和每日吸烟数量进一步下降（χ^2=2.9、2.2,均P〈0.05）,而对照组访谈1个月后尼古丁依赖度和每日吸烟数量,以及访谈3个月后尼古丁依赖度差异均无统计学意义（P〉0.05）,但访谈3个月后每日吸烟数量有所下降（P〈0.05）。同时访谈组在访谈3个月后生活质量也有所改善（χ^2=6.8,P〈0.05）。结论 动机性访谈可以显著促进COPD患者戒烟,并改善患者的生活质量,适合在COPD患者的健康指导中推广应用。

Objective To evaluate the effects of motivational interviewing on smoking cessation and quality of life of old male patients with COPD. Methods 60 old male（age60 years） patients with COPD and who were smoker and not to give up smoking from January to October 2013 in the Department of Respiratory, the General Hospital of PLA were selected, and they were divided into intervention group and control group, with 30 cases in each group. Four tools were used for data collection at the beginning included： Socio-demographic characteristics sheet, patient＇s knowledge assessment questionnaire, Fagerstrom test for nicotine dependence and St. George＇s respiratory questionnaire. Then, motivational interviewing was conducted for the intervention group followed by reassessment of quality of life, number of cigarettes smoked per day and level of dependence on nicotine one month after intervention and 3 months later for the two groups. Results After 1 month intervention, level of dependence on nicotine and their number of cigarettes smoked per day were significantly reduced in the intervention group（χ^2=10.5, 36.9, P〈0.05 or P〈0.01）, the differences were more obvious after 3 months intervention（χ^2=2.9, 2.2, all P〈0.05）. But there were no differences in the control group regarding their number of cigarettes smoked per day, level of dependence on nicotine and quality of life after 1 month,smoked per day, level of dependence on nicotine and quality of life also showed no difference after 3 month（P〈0.05）,while number of cigarettes of the control group decreased after 3 month（P〈0.05）. Motivational interviewing improved quality of life in intervention group（χ^2=6.8, P〈0.05）. Conclusion There are positive effects of the motivational interviewing on the smoking cessation and quality of life of patients with COPD.