中国儿科医生正在错过帮助父母戒烟的机会？
2016/10/09
摘要
背景：因父母吸烟而孩子暴露于二手烟（SHS）是一种特别普遍的健康问题，将导致不良的健康结果。根据美国临床实践指南，在美国的儿科医生将对吸烟父母提供5A咨询服务（询问、建议、评估、协助和安排）已被证实是有效的。我们研究中国的儿科医生根据临床实践指南（即5A的咨询实践）帮助吸烟的父母戒烟的情况，并确定与这些做法相关的一些因素。
方法：儿科医生的横断面问卷调查在中国南方随机选择的12家医院里进行。与5A戒烟咨询实践任何相关因素均用逻辑回归分析确定。
结果：受访者（504 / 550）中，只有26%的儿科医生给经常吸烟的父母提供5A的戒烟咨询。超过80%的儿科医生没有接受正规的戒烟咨询训练，没有读中国戒烟指南；24%表示“非常有信心”与父母讨论吸烟或减少二手烟。那些从来没有吸过烟（OR：2.29，CI：1.02-5.12）、接受过戒烟培训（OR：2.50，CI：1.40-4.48）、读过中国戒烟指南（OR：2.17，CI：1.10-4.26）、感觉非常（OR：7.12，CI：2.45-20.70）或有些（OR：3.05，CI：1.11-8.37）自信给吸烟父母提供戒烟咨询的儿科医生更容易实践5A咨询。那些“很难找到时间与父母谈话（OR：0.32，CI：0.11-0.92）或“缺乏一个需要儿科医生提供戒烟或减少二手烟暴露的干预标准”（OR：0.45, CI：0.21-0.98）的儿科医生不大可能按照5A的指南提供戒烟咨询。
结论：为吸烟的父母提供戒烟咨询在中国的儿科医生中是罕见的。有必要开发和测试干预策略来提高向父母吸烟提供5A戒烟咨询。
（苏欣 审校）
BMC Pediatr. 2016 Aug 20;16:135. doi: 10.1186/s12887-016-0672-0.
Are Chinese pediatricians missing the opportunity to help parents quit smoking?
Liao J1, Winickoff JP2, Nong G1, Huang K3, Yang L3, Zhang Z3, Abdullah AS4,5,6.
Author information
Abstract
BACKGROUND:Secondhand smoke (SHS) exposure of children due to parental tobacco use is a particularly prevalent health issue and is associated with adverse health outcomes. Following the US Clinical Practice guidelines, pediatricians in the United States deliver 5A's (ask, advise, assess, assist, and arrange) counseling to smoking parents which has proven to be effective. We examined Chinese pediatricians' adherence to the clinical practice guidelines for smoking cessation (i.e. 5A's counseling practices) with smoking parents, and identified factors associated with these practices.
METHODS:A cross-sectional paper-and-pencil survey of pediatricians was conducted in twelve conveniently selected southern Chinese hospitals. Factors associated with any of the 5A's smoking cessation counseling practices were identified by logistic regression.
RESULTS:Of respondents (504/550), only 26 % routinely provided 5A's smoking cessation counseling to smoking parents. More than 80 % of pediatricians didn't receive formal training in smoking cessation and had not read China smoking cessation guidelines; 24 % reported being "very confident" in discussing smoking or SHS reduction with parents. Pediatricians who had never smoked (OR: 2.29, CI:1.02-5.12), received training insmoking cessation (OR: 2.50, CI:1.40-4.48), had read China smoking cessation guidelines (OR: 2.17, CI:1.10-4.26), and felt very (OR: 7.12, CI:2.45-20.70) or somewhat (OR: 3.05, CI:1.11-8.37) confident in delivering cessation counseling were more likely to practice 5A's. Pediatricians who reported "it is hard to find a time to talk with parents" (OR: 0.32, CI: 0.11-0.92) or "lack of a standard of care requiring pediatricians to providesmoking cessation or SHS exposure reduction intervention" (OR: 0.45, CI: 0.21-0.98) as a barrier were less likely to follow the 5A's guidelines.
CONCLUSIONS:Smoking cessation counseling to address parental smoking is infrequent among Chinese pediatricians. There is a need to develop and test intervention strategies to improve the delivery of 5A's smoking cessation counseling to parental smokers.
KEYWORDS:5A’s; Chinese; Counseling; Pediatrician; Smoking cessation
BMC Pediatr. 2016 Aug 20;16:135. doi: 10.1186/s12887-016-0672-0.
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呼吸道和支气管炎症状在已患有慢性阻塞性肺疾病或有患病风险的当前吸烟者中预测戒烟意愿
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在中国，手机短信干预戒烟的疗效研究（“快乐戒烟”）
