本文關鍵詞：應用5A和5R策略對肺結核門診病人進行戒煙干預的實施效果分析　出處：《安徽醫(yī)科大學》2013年碩士論文　論文類型：學位論文

  更多相關文章： 結核/預防和控制 5A干預法 戒煙

【摘要】：目的： 通過在縣級結核病門診項目針對吸煙的肺結核患者進行戒煙勸導，了解吸煙的肺結核患者對戒煙的態(tài)度、信心，評價戒煙干預效果，為建立有效的、可實施的結核病戒煙勸導模式提供依據(jù)。 方法： 在肺結核項目門診，對于前來就診的肺結核患者進行登記，了解煙草使用情況，對于戒煙的態(tài)度，意愿。由醫(yī)生應用5A和5R戒煙干預法對吸煙患者實施戒煙宣傳干預；在發(fā)放肺結核治療卡同時發(fā)放戒煙干預卡；記錄戒煙信心、動機分值，在第2、5、6個月復診時，再次對患者進行戒煙宣傳并記錄煙草使用狀況，對戒煙的信心、動機進行評分。治療結束后在12個月時進行電話隨訪；了解患者煙草使用狀況，對戒煙的信心、動機進行評分，收集5次隨訪信息建立Epidata數(shù)據(jù)庫，利用SPSS軟件對數(shù)據(jù)進行分析，評價項目門診醫(yī)生勸導戒煙的效果。 結果： 項目實施一年，共計登記肺結核患者491名，其中有302名吸煙患者，首次登記表示愿意戒煙者292人，四次隨訪失訪人數(shù)為0、8、5、7，失訪率分別為0.0%、2.6%、1.7%和2.3%�？呻S訪到的患者第2個月、第5個月、半年后以及一年后的戒煙率分別為32.1%、30.6%、27.9%和18.0%；第5個月、半年、一年的連續(xù)3個月戒煙成功率分別為4.1%、5.0%和3.7%，治療的6個月期間復吸率為37.5%；治療后6個月期間復吸率為77.1%采用非參數(shù)檢驗中的Friedman法對五次戒煙動機和信心進行比較，得出五次動機得分不全相等，x2=405.524，P=0.000；五次信心得分也不全相等，，x2=390.893，P=0.000。進一步兩兩比較用編秩后的LSD法，得出：戒煙動機的比較中，第6個月和第12個月比較的P值為0.019，其余P值均為0.000，說明五次動機得分都各不相等，動機分值呈下降趨勢；信心的比較中，P均為0.000，說明每次信心得分都各不相等，信心分值呈下降趨勢。 結論： 由醫(yī)生用5A和5R策略對吸煙者進行戒煙勸導，在國內的戒煙門診干預研究中取得了一定成效，但應用在結核病門診，針對結核病人進行在國內還沒有研究結果，通過本次項目的實施，結果表示：在結核病人接受督導治療的同時，給予戒煙宣傳、勸導的措施是可行的，在進一步的推廣研究中，在調動患者戒煙的主動性和積極性、增加干預的次數(shù)以及爭取患者家庭的支持等方面來加強，從而提高戒煙成功率并維持長期效果。
[Abstract]:Objective: Through the county-level tuberculosis outpatient program for smoking tuberculosis patients smoking cessation persuasion, to understand the smoking pulmonary tuberculosis patients' attitude, confidence, evaluation of smoking cessation intervention effect, in order to establish an effective. The feasible smoking cessation and persuasion model of tuberculosis can provide the basis. Methods: In the tuberculosis project outpatient clinic, to come to visit the tuberculosis patient to carry on the registration, understands the tobacco use situation, regarding the smoking cessation attitude. Willingness. The doctors applied 5A and 5R smoking cessation intervention method to smoking cessation patients to give up smoking propaganda intervention; Issuing tuberculosis treatment cards at the same time as smoking cessation intervention cards; Record smoking cessation confidence, motivation score, at the 2nd month, 6 months, the patients again to quit smoking publicity and record the status of tobacco use, confidence in smoking cessation. Motivation score. Telephone follow-up at 12 months after treatment. To understand the status of tobacco use in patients, to score the confidence and motivation of quitting smoking, to collect 5 follow-up information to set up the Epidata database, and to analyze the data by SPSS software. To evaluate the effect of exhortation of outpatient doctor on smoking cessation. Results: A total of 491 pulmonary tuberculosis patients were registered in one year, of which 302 were smokers, 292 were first registered to quit smoking, and the number of missing visits at four follow-up visits was 0 / 8 / 5 / 7. The rates of missing visit were 0.02.6and 2.30.The smoking cessation rate was 32.6% in the second month, the fifth month, the half year and one year after the follow-up. 27.9% and 18.0; The success rate of quitting smoking for the fifth month, half a year and one year for 3 consecutive months was 4.1% and 3.7%, respectively, and the relapse rate was 37.5% during the 6 months of treatment. The relapse rate of 77.1% months after treatment was compared with the five smoking cessation motivation and confidence by Friedman method in non-parametric test. The results showed that the scores of the five motivations were not equal. X2 + 405.524 Pu 0.000; The confidence score of five times was not equal to that of x2n390.893P0.000.A further comparison was made by using the rank LSD method to obtain the following conclusions: the comparison of smoking cessation motivation. At the 6th and 12th months, the P value was 0.019, and the other P values were 0.000, which indicated that the scores of five times of motivation were not equal, and the scores of motivation showed a downward trend. The confidence scores were 0.000, indicating that each confidence score was not equal, and the confidence score showed a downward trend. Conclusion: Doctors used 5A and 5R strategies to persuade smokers to give up smoking, and some results were achieved in the study of smoking cessation outpatient intervention in China, but it was used in tuberculosis outpatient clinic. There are no research results in China for TB patients, through the implementation of this project, the results show that: while TB patients receive supervision treatment, give smoking cessation publicity, persuasive measures is feasible. In the further popularizing research, we should arouse the initiative and enthusiasm of patients to quit smoking, increase the times of intervention and win the support of patients' families, so as to improve the success rate of smoking cessation and maintain the long-term effect.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R521;R163

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