呼吸科患者戒烟教育与管理存在问题的调查研究

Education and management on smoking cessation of patients with pulmonary diseases

目的调查呼吸科患者戒烟教育与管理存在的问题,探讨提升呼吸科患者戒烟教育效果的措施和对策。方法选取2015年2月至2017年1月杭州市余杭区第二人民医院收治的吸烟患者468例,了解患者戒烟过程中的戒断症状、复吸率、干预方式等。采用呼吸系统疾病与戒烟相关知识认知调查表对患者进行调查,了解患者对戒烟干预的认知状况,采用戒烟教育与管理过程中患者依从性调查表对实施戒烟教育与管理的医护人员实施调查,了解患者对戒烟教育与管理的依从性。结果 468例吸烟患者中,心理行为干预88例,药物治疗82例,电话干预125例,针灸干预52例,联合干预121例。在戒烟过程中226例出现戒断症状,完成既定戒烟方案后,314例患者戒烟成功,154例戒烟失败。6个月内314例成功戒烟患者中128例复吸,复吸率40.76%。患者对吸烟危害、吸烟认识误区、戒烟方式认知合格率为45.30%、40.38%、28.21%。参加戒烟教育患者的依从性合格率57.48%。结论呼吸科吸烟患者戒烟教育和管理难度大,应提升施教环境、严格管理制度,实施个性化戒烟教育,提升戒烟成功率。

Objective To understand the existing problems in education and management on smoking cessation of patients with pulmonary diseases, and to explore better ways to improve the effect of smoking cessation education. Methods 468 patients with smoking admitted to Respiratory Division in the Second People′s Hospital of Yuhang District from February 2015 to January 2017 were enrolled.The symptoms of smoking cessation, smoking relapse rate and intervention methods were discussed.Patients were surveyed to collect information about their cognition on smoking intervention using respiratory diseases and smoking cessation related knowledge scale.Meanwhile, medical staff in charge of education and management for smoking cessation were also surveyed to understand the compliance of patients on smoking cessation management. Results Among 468 patients with smoking, 82 were treated with medicine, others received interventions including psychological and behavioral intervention(88), call intervention(125), acupuncture intervention(52) and combined intervention(121).During the course of smoking cessation, 226 cases had symptoms.After completing the program, 314 cases succeeded in quitting smoking while 154 cases failed.In 6 months after the program, 128 patients smoked again with the smoking relapse rate of 40.76%(128/314).Less than half patients(45.30%) fully understood the hazards of smoking, 40.38% of patients misunderstood the cigarette smoking and 28.21% of patients knew how to quit smoking.Only 57.48% of patients who participated in the smoking cessation education complied with the course. Conclusions It is not easy to educate and manage patients for smoking cessation in Respiratory Division.It is suggested to improve the teaching environment, strengthen management system,implement personalized smoking cessation education,and to increase the success rate of smoking cessation.