本文關(guān)鍵詞：應(yīng)用5A和5R策略對肺結(jié)核門診病人進行戒煙干預(yù)的實施效果分析　出處：《安徽醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 結(jié)核/預(yù)防和控制 5A干預(yù)法 戒煙

【摘要】：目的： 通過在縣級結(jié)核病門診項目針對吸煙的肺結(jié)核患者進行戒煙勸導(dǎo)，了解吸煙的肺結(jié)核患者對戒煙的態(tài)度、信心，評價戒煙干預(yù)效果，為建立有效的、可實施的結(jié)核病戒煙勸導(dǎo)模式提供依據(jù)。 方法： 在肺結(jié)核項目門診，對于前來就診的肺結(jié)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(yīng)用5A和5R戒煙干預(yù)法對吸煙患者實施戒煙宣傳干預(yù)；在發(fā)放肺結(jié)核治療卡同時發(fā)放戒煙干預(yù)卡；記錄戒煙信心、動機分值，在第2、5、6個月復(fù)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(jié)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(dǎo)戒煙的效果。 結(jié)果： 項目實施一年，共計登記肺結(jié)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(fù)吸率為37.5%；治療后6個月期間復(fù)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(jié)論： 由醫(yī)生用5A和5R策略對吸煙者進行戒煙勸導(dǎo)，在國內(nèi)的戒煙門診干預(yù)研究中取得了一定成效，但應(yīng)用在結(jié)核病門診，針對結(jié)核病人進行在國內(nèi)還沒有研究結(jié)果，通過本次項目的實施，結(jié)果表示：在結(jié)核病人接受督導(dǎo)治療的同時，給予戒煙宣傳、勸導(dǎo)的措施是可行的，在進一步的推廣研究中，在調(diào)動患者戒煙的主動性和積極性、增加干預(yù)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(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R521;R163

【參考文獻】

相關(guān)期刊論文 前10條

1 李嵐,劉海濱,顏晉輝;吸煙對部隊肺結(jié)核患者痰菌的影響[J];解放軍預(yù)防醫(yī)學(xué)雜志;2001年04期

2 胡大林,譚紅專,全俊,荊春霞;結(jié)核病患者化療轉(zhuǎn)歸的多因素分析[J];中國熱帶醫(yī)學(xué);2004年05期

3 楊焱,姜垣,楊小麗,鄧亞中,黎江,郭則宇,林德南,王俊堂,陳啟超,于飛;影響戒煙成功因素的分析——中國2002年戒煙競賽一年隨訪研究[J];衛(wèi)生研究;2004年04期

4 姜垣,魏小帥,陶金,宋貴德,王健,許宏杰,吳先萍,夏江,徐浩鋒,王紅美,楊焱;中國六城市醫(yī)生吸煙狀況[J];中國健康教育;2005年06期

5 徐小生,凌建軍,趙峗,廖一民;長沙市望月湖社區(qū)控?zé)熜Ч难芯縖J];中國健康教育;2005年06期

6 黃愛群,孫業(yè)桓,馬金香,劉蘋;安徽省某農(nóng)村社區(qū)居民吸煙狀況調(diào)查[J];中國行為醫(yī)學(xué)科學(xué);1999年03期

7 譚吉賓;劉劍君;王海東;李明虎;袁燕莉;許國璋;谷鑫;;結(jié)核病人吸煙狀況調(diào)查研究[J];中國預(yù)防醫(yī)學(xué)雜志;2010年11期

8 王曦,郝天玲,吳人亮,郝春榮,熊密;香煙煙霧提取物對動物氣道上皮細胞E鈣粘著蛋白表達的影響[J];中華結(jié)核和呼吸雜志;1999年07期

9 楊功煥;1996年全國吸煙行為的流行病學(xué)調(diào)查[J];中國腫瘤;1998年02期

10 高殿舉;曲桂香;胡學(xué)偉;李桂芬;;吸煙對肺結(jié)核治療效果影響觀察[J];吉林醫(yī)學(xué)院學(xué)報(自然科學(xué)版);1994年01期

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