促进儿童健康:被动吸烟健康教育的实验研究

Promotion of Children’s Health: Experimental Study on Health Education about the Effects of Second Hand Smoke

目的 评价护士针对被动吸烟给儿童带来的不良影响而提供健康教育的有效性。方法 以 1997年 12月至 1998年 4月香港 4家医院的患儿母亲为研究对象 ,接受由护士提供的健康教育 ,其内容包括统一的健康指导 ,2本小册子 (发给母亲阅读的被动吸烟小册子及发给父亲的戒烟小册子 ) ,干预后 1周由护士进行电话跟踪调查。结果 共有 3 3 4名母亲接收了护士的电话跟踪调查。约2 0 %母亲阅读了小册子 ,2 3的母亲要求父亲阅读小册子。在所有获得小册子的父亲中 ,只有 5 5 %的父亲阅读过。2 0 %的患儿父亲在给予健康教育干预后停止在家吸烟 ,另外 3 8%的父亲减少了在家吸烟的次数。给予健康教育干预措施后 ,父亲在家中吸烟的比率减少 3 % ;阅读小册子的父亲在家中不吸烟或较少吸烟的比例较高 ,分别为 2 7∶13 ,48∶3 8。健康教育干预后 ,85 %～ 90 %的母亲能够采取一定的措施来保护她们的孩子免受被动吸烟的危害。结论 这种由护士提供的健康教育能有效地改变患儿父亲在家中的吸烟行为 ,并能促使母亲采取措施来保护患儿不受被动吸烟的危害。因此 ,为了增加患儿母亲对被动吸烟的认识 ,预防家中的危险因素 ,从而减轻患儿疾病程度 ,减少入院次数 。

Objective To assess the effectiveness of health education provided by nurses about the effects of second hand smoke (SHS) exposure on children.Methods The subjects were non smoking mothers of sick children admitted to the pediatric wards of four major hospitals in Hong Kong during December 1997 to April 1998, with a smoking husband, living together in the same household with the child.Eligible subjects received a health education intervention provided by nurses which included giving standardized health advice and two purpose designed and culturally relevant booklets after randomization, and a telephone reminder one week later.Results A total of 334 mothers received the telephone reminder given by nurses.About 20 percent of the mothers had read the booklet and two thirds had asked the father to read it as well.Among the fathers who had got the booklets, only 55 percent had read through it.The majority of the fathers had either stopped smoking at home (20 percent) or smoked less (38 percent) after the intervention. A comparison of smoking behaviour at baseline and 1 week indicated that less fathers still smoked at home after the intervention (83 percent vs 80 percent).More fathers who had read the booklet did not smoke at home (27 percent vs 13 percent) or smoked less (48 percent vs 38 percent) as compared with those who had not done so.There was a marked increase in the mothers (85 90 percent) taking action to protect the child from exposure to SHS by requesting the father to stop smoking,to smoke less,or not to smoke at home.Conclusion Health education is a legitimate activity of nurses and is useful in changing the father’s smoking behaviour at home and the mother’s actions in preventing SHS exposure in sick children.There is a critical need to provide health education to mothers in order to promote awareness of SHS exposure and to prevent the health risks in the family so as to reduce illness and hospital admission in children.