哮喘联盟

   摘要
   背景：戒烟是预防和减缓一些呼吸系统疾病及其它疾病进程，并改善患者预后的最有效干预措施。罗马尼亚拥有与世界卫生组织烟草控制框架相符合的国家烟草控制项目，并已对相关内容进行立法。然而至少少数烟民得到了家庭医生的戒烟建议。
   目的：确定并探讨阻止罗马尼亚家庭医生和他的患者加入到戒烟活动中的认知障碍。
   方法：研究者展开了一项定性研究，共招募来自布加勒斯特以及城市600 公里内偏远地区的41名家庭医生。将10名医生纳入焦点组，31名医生纳入半结构式访谈组。根据认知障碍，进行描述性、归纳性及主题性的分析。
   结果：研究发现了五个主要障碍：家庭医生对自身角色认知不足、就诊时间不足、既往经历和现存约束、病人无法负担医疗费用、缺少戒烟技巧的训练。消除这些特定阻碍已成为各医疗及社会阶层中的关键难题，若不解决，会限制家庭医生的作用，使资源紧张并让健康护理受到制约。
   结论：许多罗马尼亚家庭医生所描述的阻碍反映了在提供戒烟建议过程中的普遍难题。相对阶层化的医疗卫生系统以及有限的时间和资源加重了这些问题，并且导致了新的阻碍。如果罗马尼亚希望达到其国家反烟草消费项目的目的，必须处理好这些问题。
 

（刘国梁 审校）
NPJ Prim Care Respir Med. 2014 Jul 10;24:14022. doi: 10.1038/npjpcrm.2014.22.

 

Barriers to the provision of smoking cessation assistance: a qualitative study among Romanian family physicians.
 

Panaitescu C1, Moffat MA2, Williams S3, Pinnock H4, Boros M5, Oana CS1, Alexiu S1, Tsiligianni I6.
 

ABSTRACT
BACKGROUND:Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for Tobacco Control. However, few smokers are advised to quit by their family physicians (FPs).
AIM:To identify and explore the perceived barriers that prevent Romanian FPs from engaging in smoking cessation with patients.
METHODS:A qualitative study was undertaken. A total of 41 FPs were recruited purposively from Bucharest and rural areas within 600 km of the city. Ten FPs took part in a focus group and 31 participated in semistructured interviews. Analysis was descriptive, inductive and themed, according to the barriers experienced.
RESULTS:Five main barriers were identified: limited perceived role for FPs; lack of time during consultations; past experience and presence of disincentives; patients' inability to afford medication; and lack of training in smoking cessation skills. Overarching these specific barriers were key themes of a medical and societal hierarchy, which undermined the FP role, stretched resources and constrained care.
CONCLUSIONS:Many of the barriers described by the Romanian FPs reflected universally recognised challenges to the provision of smoking cessation advice. The context of a relatively hierarchical health-care system and limitations of time and resources exacerbated many of the problems and created new barriers that will need to be addressed if Romania is to achieve the aims of its National Programme Against Tobacco Consumption.
 

NPJ Prim Care Respir Med. 2014 Jul 10;24:14022. doi: 10.1038/npjpcrm.2014.22.