运动咨询干预在女性抑郁烟民中的可行性
2009/09/17
前言:抑郁对于戒烟可产生负面影响。然而,对于抑郁的吸烟者目前所能采取的干预措施较少。运动可改善心境,也许能使抑郁吸烟者有所获益。本试点研究旨在调查运动干预在抑郁的女性吸烟者(流行病研究中心抑郁量表[CES-D]评分≥16)中的可行性。
方法:受试者(平均年龄41岁,98%白人)被随机分成为期10周的个体运动咨询组(n=30)和健康教育对照组(n=30)。所有受试者均接受尼古丁贴剂治疗和戒烟行为咨询。
结果:鉴于吸烟者踊跃参与、运动咨询参与次数较多(平均7.6次[共10次])、运动频率增加以及基线状态至研究终点(EOT)(10周后)参数变化较大,说明该项干预措施具有一定的可行性。至第10周,受试者的流失率为35%,但两组间无显著性差异。意向处理分析结果显示,第10周运动咨询组的戒烟率为17%,健康咨询组为23%(p =0.75)。
讨论:运动咨询干预在抑郁的女性吸烟者中具有一定可行性。但仍需更为集中的干预措施来增加戒烟率,同时尚需优化研究方法,以减少受试者的负担和流失率。
(刘国梁 审校)
Vickers KS, Patten CA, Lewis BA, et al.
Nicotine Tob Res. 2009 Aug;11(8):985-995. Epub 2009 Jun 18.
Feasibility of an exercise counseling intervention for depressed women smokers.
Vickers KS, Patten CA, Lewis BA, Clark MM, Ussher M, Ebbert JO, Croghan IT, Decker PA, Hathaway J, Marcus BH, Hurt RD.
Department of Psychiatry and Psychology, Mayo Clinic Rochester, 200 First Street South West, Rochester, MN 55905, USA. vickersdouglas.kristin@mayo.edu
INTRODUCTION: Depressive symptoms negatively impact smoking abstinence. However, few interventions have been targeted to smokers with current depression. Exercise improves mood and may benefit depressed smokers. This pilot study investigated the feasibility of an exercise intervention for depressed female smokers (Center for Epidemiological Studies Depression Scale [CES-D] score > or =16).
METHODS: Participants (M = 41 years, 98% White) were randomized to 10 weeks of individually delivered exercise counseling (n = 30) or a health education contact control condition (n = 30). All participants received nicotine patch therapy and behavioral counseling for smoking cessation.
RESULTS: The intervention was feasible as indicated by ability to recruit participants, exercise counseling session attendance (M = 7.6 of 10 sessions attended), and significant increase in exercise frequency and stage of change from baseline to end of treatment (EOT) (Week 10). Participant attrition rate was 35% by Week 10 but did not differ significantly between groups. Smoking abstinence rates at Week 10, using intention-to-treat analysis, were 17% for exercise counseling participants and 23% for health education participants (p = .75).
DISCUSSION: An exercise counseling intervention was found to be feasible for depressed women smokers. More intensive intervention may be needed to increase smoking abstinence rates, and methods should be refined to reduce participant burden and attrition.
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