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Sohn M, Ahn Y, Park H, Lee M. Simulation-based smoking cessation intervention education for undergraduate nursing students. NURSE EDUCATION TODAY 2012; 32:868-872. [PMID: 22133485 DOI: 10.1016/j.nedt.2011.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 10/20/2011] [Accepted: 11/09/2011] [Indexed: 05/31/2023]
Abstract
Smoking is one of the most important preventable risk factors that contributes to premature death from many tobacco-related diseases. Clinicians should offer and provide effective smoking cessation interventions to their smoking patients. Yet, few clinicians receive training in smoking cessation intervention. This one-group, quasi-experimental study was conducted to describe a simulation-based training of smoking cessation intervention and to evaluate its effectiveness on nursing students' self-efficacy in performing smoking cessation intervention, based on 5-As recommended by the United States Department of Health and Human Services. In addition, nursing students' experience, attitude and perceived barriers of smoking cessation intervention were also described. Among the 21 students (mean age: 21.6 ± 2.0 years), 86% were female, 62% were in their third year and 1% were current smokers. Most of students believed the health benefits of smoking cessation (100.0-66.7%) and were well educated about health risks of smoking (81.0-61.9%). However, few were taught (33.3-14.4%) and practiced (28.6-0.0%) smoking cessation intervention. Students reported that they should be actively involved in smoking cessation for patients (100.0-95.2%), but lack of knowledge and skills were the main barriers (90.5-85.7%). The simulation-based training of smoking cessation intervention improved nursing students' self-efficacy in seven out of nine skills of smoking cessation intervention (mean scores of pre- vs. post-intervention: 30.86 ± 3.80 vs. 34.05 ± 5.10; paired t=2.298, p=.027). These findings indicate that simulation could be effectively used in teaching smoking cessation intervention education delivered to nursing students.
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Affiliation(s)
- Min Sohn
- Department of Nursing, Inha University, Incheon, South Korea.
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Patwardhan PD, Chewning BA. Effectiveness of intervention to implement tobacco cessation counseling in community chain pharmacies. J Am Pharm Assoc (2003) 2012; 52:507-14. [PMID: 22825231 PMCID: PMC4976687 DOI: 10.1331/japha.2012.10117] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To test the feasibility of implementing ask-advise-refer (AAR) tobacco cessation counseling approach in community chain pharmacies serving low socioeconomic areas and to assess the effectiveness of a multimodal intervention on short-term implementation of AAR. DESIGN Randomized controlled trial. SETTING South-central Wisconsin from July 2008 through March 2009. PARTICIPANTS Pharmacists and technicians from 16 community chain pharmacies. INTERVENTION Training to implement AAR, workflow integration recommendations, tobacco cessation poster to create awareness, and a support visit. MAIN OUTCOME MEASURES Number of pharmacy patrons asked about tobacco use, number of tobacco users advised to quit, number of tobacco users enrolled in the quit line, and number of quit line cards given. RESULTS As hypothesized, the multimodal intervention significantly predicted the number of patrons asked to quit (estimate 4.84, incidence rate ratio 127.2, P < 0.001), number of tobacco users advised to quit (2.12, 8.33, P < 0.01), number of tobacco users enrolled in the quit line (2.31, 10.13, P < 0.001), and number of quit line cards given (1.04, 2.82, P < 0.05). CONCLUSION This trial demonstrates the feasibility of implementing AAR in routine community pharmacy practice. This trial also supports the short-term effectiveness of the multimodal intervention in facilitating AAR in partnership with other public health systems. More research is needed to evaluate the generalizability, effectiveness, and sustainability of AAR, including factors influencing adoption and the impact on cessation.
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Zao Li H, Zhang Y, MacDonell K, Ping Li X, Chen X. Counseling Chinese patients about cigarette smoking: the role of nurses. HEALTH EDUCATION 2012. [DOI: 10.1108/09654281211237171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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The role of physical therapists in smoking cessation: opportunities for improving treatment outcomes. Phys Ther 2012; 92:757-66. [PMID: 22228603 DOI: 10.2522/ptj.20110304] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Katz DA, Vander Weg MW, Holman J, Nugent A, Baker L, Johnson S, Hillis SL, Titler M. The Emergency Department Action in Smoking Cessation (EDASC) trial: impact on delivery of smoking cessation counseling. Acad Emerg Med 2012; 19:409-20. [PMID: 22506945 DOI: 10.1111/j.1553-2712.2012.01331.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The focus on acute care, time pressure, and lack of resources hamper the delivery of smoking cessation interventions in the emergency department (ED). The aim of this study was to 1) determine the effect of an emergency nurse-initiated intervention on delivery of smoking cessation counseling based on the 5As framework (ask-advise-assess-assist-arrange) and 2) assess ED nurses' and physicians' perceptions of smoking cessation counseling. METHODS The authors conducted a pre-post trial in 789 adult smokers (five or more cigarettes/day) who presented to two EDs. The intervention focused on improving delivery of the 5As by ED nurses and physicians and included face-to-face training and an online tutorial, use of a charting/reminder tool, fax referral of motivated smokers to the state tobacco quitline for proactive telephone counseling, and group feedback to ED staff. To assess ED performance of cessation counseling, a telephone interview of subjects was conducted shortly after the ED visit. Nurses' and physicians' self-efficacy, role satisfaction, and attitudes toward smoking cessation counseling were assessed by survey. Multivariable logistic regression was used to assess the effect of the intervention on performance of the 5As, while adjusting for key covariates. RESULTS Of 650 smokers who completed the post-ED interview, a greater proportion had been asked about smoking by an ED nurse (68% vs. 53%, adjusted odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.3 to 2.9), assessed for willingness to quit (31% vs. 9%, adjusted OR= 4.9, 95% CI = 2.9 to 7.9), and assisted in quitting (23% vs. 6%, adjusted OR = 5.1, 95% CI = 2.7 to 9.5) and had arrangements for follow-up cessation counseling (7% vs. 1%, adjusted OR = 7.1, 95% CI = 2.3 to 21) during the intervention compared to the baseline period. A similar increase was observed for emergency physicians (EPs). ED nurses' self-efficacy and role satisfaction in cessation counseling significantly improved following the intervention; however, there was no change in "pros" and "cons" attitudes toward smoking cessation in either ED nurses or physicians. CONCLUSIONS Emergency department nurses and physicians can effectively deliver smoking cessation counseling to smokers in a time-efficient manner. This trial also provides empirical support for expert recommendations that call for nursing staff to play a larger role in delivering public health interventions in the ED.
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Affiliation(s)
- David A Katz
- Department of Medicine, University of Iowa, Iowa City, USA.
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Duffy SA, Kilbourne AM, Austin KL, Dalack GW, Woltmann EM, Waxmonsky JA, Noonan D. Risk of smoking and receipt of cessation services among veterans with mental disorders. Psychiatr Serv 2012; 63:325-32. [PMID: 22337005 PMCID: PMC3323716 DOI: 10.1176/appi.ps.201100097] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to determine rates of smoking and receipt of provider recommendations to quit smoking among patients with mental disorders treated in U.S. Department of Veterans Affairs (VA) treatment settings. METHODS The authors conducted a secondary analysis of the yearly, cross-sectional 2007 Veterans Health Administration Outpatient Survey of Healthcare Experiences of Patients (N=224,193). Logistic regression was used to determine the independent association of mental health diagnosis and the dependent variables of smoking and receipt of provider recommendations to quit smoking. RESULTS Patients with mental disorders had greater odds of smoking, compared with those without mental disorders (p<.05). Those with various mental disorders reported similar rates of receiving services (more than 60% to 80% reported receiving selected services), compared with those without these disorders, except that those with schizophrenia had more than 30% lower odds of receiving advice to quit smoking from their physicians (p<.05). Moreover, those who had co-occurring posttraumatic stress disorder or substance use disorders had significantly greater odds of reporting that they received advice to quit, recommendations for medications, and physician discussions of quitting methods, compared with those without these disorders (p<.05). Older patients, male patients, members of ethnic minority groups, those who were unmarried, those who were disabled or unemployed, and those living in rural areas had lower odds of receiving selected services (p<.05). CONCLUSIONS The majority of patients with mental disorders served by the VA reported receiving cessation services, yet their smoking rates remained high, and selected groups were at risk for receiving fewer cessation services, suggesting the continued need to disseminate cessation services.
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Affiliation(s)
- Sonia A. Duffy
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Amy M. Kilbourne
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Karen L. Austin
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Gregory W. Dalack
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Emily M. Woltmann
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Jeanette A. Waxmonsky
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Devon Noonan
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
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Simmons VN, Litvin EB, Unrod M, Brandon TH. Oncology healthcare providers' implementation of the 5A's model of brief intervention for smoking cessation: patients' perceptions. PATIENT EDUCATION AND COUNSELING 2012; 86:414-9. [PMID: 21784598 PMCID: PMC3222746 DOI: 10.1016/j.pec.2011.06.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 05/20/2011] [Accepted: 06/23/2011] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Health care providers (HCPs) can play an important role in promoting smoking cessation and preventing relapse. Public Health Service guidelines recommend the "5A's" model of brief intervention. The goal of the current study was to examine cancer patients' perceptions of 5A's model implementation by their oncology HCPs. METHODS This study included 81 thoracic and 87 head and neck cancer patients at a large NCI-designated comprehensive cancer center. Patients completed questionnaires assessing perceptions of their oncology HCPs' implementation of the 5A's model of brief intervention. RESULTS Results indicate partial implementation of the 5A's model. The majority of patients reported that their providers had asked about smoking and advised them to quit, however; only half reported that their interest in quitting had been assessed, and few reported assistance in quitting or follow-up. Delivery of the 5A's was greater among patients who requested cessation advice from their HCPs. CONCLUSION The current findings suggest a need to increase adherence to the 5A's in the oncology setting. PRACTICAL IMPLICATIONS Efforts to increase smoking cessation treatment provision by HCPs may improve the rate of cessation among cancer patients, and ultimately translate into better long-term cancer treatment outcomes.
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Affiliation(s)
- Vani Nath Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33647, USA.
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Disparities in health behaviors and chronic conditions in health care providers in the Veterans Health Administration. J Occup Environ Med 2012; 53:1134-45. [PMID: 21926920 DOI: 10.1097/jom.0b013e31822b8379] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine baseline prevalence of health behaviors and chronic health conditions in Veterans Health Administration (VHA) employees and highlight disparities by occupation group. METHODS There were 29,834 responses to the survey. Age-standardized prevalence estimates for VHA employees were compared to national estimates from BRFSS surveys. The VHA estimates were analyzed for physicians and dentists; physician assistants and nurse practitioners; registered nurses; licensed practical nurses and nursing assistants; other clinical; nonclinical; and wage grade staff. Multilevel regression explored the effect of worksite. RESULTS The VHA employees have higher rates of unhealthy behaviors and chronic health conditions than US adults, except for smoking. Results illustrated significant disparities between occupation groups by demographics and variability by worksite. CONCLUSIONS Veterans Health Administration's population appears less healthy than the US general population. Disparities between occupation groups support the establishment of targeted health promotion programs, with attention paid to differences in local culture.
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Nonnemaker J, Hersey J, Homsi G, Busey A, Hyland A, Juster H, Farrelly M. Self-reported exposure to policy and environmental influences on smoking cessation and relapse: a 2-year longitudinal population-based study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:3591-608. [PMID: 22016705 PMCID: PMC3194106 DOI: 10.3390/ijerph8093591] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 08/25/2011] [Indexed: 11/16/2022]
Abstract
Although most smokers want to quit, the long-term success rate of quit attempts remains low; research is needed to understand the policy and environmental influences that can increase the success of cessation efforts. This paper uses regression methods to investigate self-reported exposure to policy and environmental influences on quit attempts, maintenance of a quit attempt for at least 6 months, and relapse in a longitudinal population-based sample, the New York Adult Cohort Survey, followed for 12 months (N = 3,261) and 24 months (N = 1,142). When policy or environmental influence variables were assessed independently of other policy or environmental influence variables, many were significant for at least some of the cessation outcomes. In the full models that included a full set of policy or environmental influence variables, many significant associations became nonsignificant. A number of policies may have an influence on multiple cessation outcomes. However, the effect varies by cessation outcome, and statistical significance is influenced by model specification.
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Affiliation(s)
- James Nonnemaker
- RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA; E-Mails: (J.H.); (G.H.); (A.B.); (M.F.)
| | - James Hersey
- RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA; E-Mails: (J.H.); (G.H.); (A.B.); (M.F.)
| | - Ghada Homsi
- RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA; E-Mails: (J.H.); (G.H.); (A.B.); (M.F.)
| | - Andrew Busey
- RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA; E-Mails: (J.H.); (G.H.); (A.B.); (M.F.)
| | - Andrew Hyland
- Roswell Park Cancer Institute, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA; E-Mail:
| | - Harlan Juster
- Corning Tower, Room 710, New York State Department of Health, Empire State Plaza, Albany, NY 12237, USA; E-Mail:
| | - Matthew Farrelly
- RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA; E-Mails: (J.H.); (G.H.); (A.B.); (M.F.)
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Abstract
BACKGROUND Physical therapists are uniquely positioned in health care to initiate or support smoking cessation (SC). Little is known, however, about their knowledge and views of SC as part of their practices. Objective The purpose of this study was to assess Canadian physical therapists' knowledge about the health effects of smoking, their views about addressing SC in practice, and their self-efficacy in enabling patients to quit smoking. Design This study was a cross-sectional survey. METHODS Licensed physical therapists in Canada were surveyed with postal methods. RESULTS A total of 738 survey questionnaires were returned. The mean age and years of clinical experience of the respondents were 41.9 (SD=10.8) years and 17.4 (SD=11.0), respectively. Most respondents (78.6%) were women. Canadian physical therapists are largely informed about the negative effects of smoking on health. Although 76.9% of the physical therapists agreed or strongly agreed that the profession should be more involved in helping people who smoke quit, only 56.8% of the physical therapists agreed or strongly agreed that they should receive training on SC. More than 70% of the physical therapists reported that they were not prepared to provide counseling and, overall, the level of self-efficacy regarding counseling about SC was low. Lack of resources and time were reported to be key barriers to counseling patients to quit smoking. Limitations The findings of this study are limited to Canadian physical therapists. Response bias and social desirability bias also are potential limiters in this study. CONCLUSIONS Overall, the majority of physical therapists expressed the view that advising people who smoke to quit is a clinical responsibility and endorsed greater involvement of the profession in helping people who smoke quit. Discordance existed, however, between these views and the physical therapists' interest in receiving training on counseling about SC. This is a benchmark study that has practical implications for targeting training consistent with the profession's mission to improve health by increasing physical therapists' preparedness and self-efficacy regarding counseling about SC.
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Teo SHJ, Sew S, Backman C, Forwell S, Lee WK, Chan PL, Dean E. Health of people with spinal cord injury in Singapore: implications for rehabilitation planning and implementation. Disabil Rehabil 2010; 33:1460-74. [PMID: 21091048 DOI: 10.3109/09638288.2010.533812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study aimed to provide a broad overview of the health of people with spinal cord injury (SCI) in Singapore, so as to highlight areas of potential need. These areas could then guide future research and rehabilitation programme development. METHODS Demographic data, injury information and information about SCI-related secondary impairments, chronic conditions and their associated risk factors, medical and hospital utilisation, participation (Craig Handicap Assessment and Reporting Technique) and life satisfaction (Satisfaction with Life Scale) were collected via interviews from people living with traumatic SCI. RESULTS On average, participants (50 men and 5 women) were aged 48.3 ± 16.54 years and had had their SCIs for 5 years. -75% with tetraplegia. The most prevalent SCI-related secondary impairments were pain, spasms, bladder problems, bowel problems and oedema. Chronic conditions and their associated risk factors were prevalent. Participation and life satisfaction scores were lower than those reported for similar populations cross-culturally. CONCLUSION The study revealed several health areas that may be affecting the overall health of people with SCI in Singapore. By focusing on community reintegration and health promotion, physiotherapists and other rehabilitation professionals may augment health outcomes and improve the quality of life of this population in Singapore.
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Affiliation(s)
- Sock Hui Joy Teo
- Tan Tock Seng Hospital Rehabilitation Centre, Singapore, Singapore.
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Kurko T, Linden K, Pietilä K, Sandström P, Airaksinen M. Community pharmacists' involvement in smoking cessation: familiarity and implementation of the National smoking cessation guideline in Finland. BMC Public Health 2010; 10:444. [PMID: 20670409 PMCID: PMC2922110 DOI: 10.1186/1471-2458-10-444] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 07/29/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Guidelines on smoking cessation (SC) emphasize healthcare cooperation and community pharmacists' involvement. This study explored the familiarity and implementation of the National SC Guideline in Finnish community pharmacies, factors relating to Guideline familiarity, implementation and provision of SC services. METHODS A nationwide mail survey was sent to a systematic, sample of community pharmacy owners and staff pharmacists (total n = 2291). Response rate was 54% (n = 1190). Factors related to the SC Guideline familiarity were assessed by bivariate and multivariate analysis. RESULTS Almost half (47%) of the respondents (n = 1190) were familiar with the SC Guideline and familiarity enhanced Guideline implementation. The familiarity was associated with the respondents' perceptions of their personal SC skills and knowledge (OR 3.8); of customers' value of counseling on nicotine replacement therapy (NRT) (OR 3.3); and regular use of a pocket card supporting SC counseling (OR 3.0). Pharmacists' workplaces' characteristics, such as size and geographical location were not associated with familiarity. In addition to recommending NRT, the pharmacists familiar with the Guideline used more frequently other Guideline-based SC methods, such as recommended non-pharmacological SC aids, compared to unfamiliar respondents. CONCLUSIONS SC Guideline familiarity and implementation is crucial for community pharmacists' involvement in SC actions in addition to selling NRT products. Pharmacists can constitute a potential public health resource in SC easily accessible throughout the country.
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Affiliation(s)
- Terhi Kurko
- University of Helsinki, Faculty of Pharmacy, Division of Social Pharmacy, Viikinkaari 9C, P.O Box 56, 00014 University of Helsinki, Finland
| | | | | | | | - Marja Airaksinen
- University of Helsinki, Faculty of Pharmacy, Division of Social Pharmacy, Viikinkaari 9C, P.O Box 56, 00014 University of Helsinki, Finland
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George J, Taylor S, Hong T, Leung S, Nguyen J. A pilot study to investigate the scope for an inpatient smoking cessation programme. Intern Med J 2010; 42:e80-3. [DOI: 10.1111/j.1445-5994.2010.02287.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tong EK, Strouse R, Hall J, Kovac M, Schroeder SA. National survey of U.S. health professionals' smoking prevalence, cessation practices, and beliefs. Nicotine Tob Res 2010; 12:724-33. [PMID: 20507899 DOI: 10.1093/ntr/ntq071] [Citation(s) in RCA: 188] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tobacco dependence treatment efforts have focused on primary care physicians (PCPs), but evidence suggests that they are insufficient to help most smokers quit. Other health professionals also frequently encounter smokers, but their smoking prevalence, cessation practices, and beliefs are less well known. METHODS The study included 2,804 subjects from seven health professional groups: PCPs, emergency medicine physicians, psychiatrists, registered nurses, dentists, dental hygienists, and pharmacists. Outcomes included self-reported smoking status, smoking cessation practices, and beliefs. Multivariate regression was used to examine factors associated with health professionals (except pharmacists) self-reportedly performing the "5 A's": asking, advising, assessing, assisting, or arranging follow-up about tobacco. RESULTS Health professionals have a low smoking prevalence (<6%), except nurses (13%). Many health professionals report asking (87.3%-99.5%) and advising (65.6%-94.9%) about smoking but much less assessing smokers' interest (38.7%-84.8%), assisting (16.4%-63.7%), and arranging follow-up (1.3%-23.1%). Controlling for health professional and practice demographics, factors positively associated in the multivariate analyses with self-reportedly performing multiple components of the 5 A's include awareness of the Public Health Service guidelines, having had cessation training, and believing that treatment was an important professional responsibility. Negative associations include the health professional being a current smoker, not being a PCP, being uncomfortable asking patients if they smoke, believing counseling was not an appropriate service, and reporting competing priorities. CONCLUSION U.S. health professionals report not fully performing the 5 A's. The common barriers and facilitators identified may help inform strategies for increasing the involvement of all health professionals in conducting tobacco dependence treatments.
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Affiliation(s)
- Elisa K Tong
- Division of General Internal Medicine, University of California, Davis Medical Center, 4150 V Street, Suite 2400, Sacramento, CA 95817, USA.
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Alzoubi KH, Azab M, Khabour OF, Al‐shamaila AW, Ayoub NM, Al‐Omiri MK, Al‐Nasser AD, Mhaidat NM, Al‐Azzam SI. Smoking‐cessation practice guidelines: awareness and implementation among medical teams. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2010. [DOI: 10.1211/ijpp.18.02.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Karem H. Alzoubi
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Azab
- School of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F. Khabour
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Adan W. Al‐shamaila
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Nehad M. Ayoub
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mahmoud K. Al‐Omiri
- Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Nizar M. Mhaidat
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer I. Al‐Azzam
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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66
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Patwardhan PD, Chewning BA. Ask, advise and refer: Hypothesis generation to promote a brief tobacco-cessation intervention in community pharmacies. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2010. [DOI: 10.1211/ijpp.17.04.0005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Objectives
A preliminary qualitative study was conducted to identify key facilitators and barriers for pharmacists' adoption of a brief tobacco-cessation protocol, Ask-Advise-Refer (AAR).
Methods
Ten community pharmacists were interviewed using semi-structured, face-to-face interviews with open-ended questions. Purposive and saturation sampling techniques were applied to identify participants and determine sample size respectively. Interviews were audio-recorded and transcribed. Using thematic analysis, two reviewers independently coded all transcripts to identify prominent themes. Appropriate measures were taken to ensure study rigor and validity.
Key findings
All facilitators and barriers identified were grouped into nine distinct themes. Pharmacists' fear of negative patient reaction was the most prominent barrier to initiating tobacco-cessation discussions with patients. Other themes identified in decreasing order of prevalence were pharmacists perceiving a rationale for initiating tobacco cessation, pharmacy environment, pharmacists' perception of/prior knowledge of patients' willingness to discuss tobacco cessation/to quit, patient initiation of tobacco-cessation or worsening-health discussion, pharmacists' perceptions of AAR characteristics, length of pharmacist-patient relationship/rapport with patients, low expectations of pharmacy patrons and pharmacists' communication ability.
Conclusions
This study highlights the potential fear among pharmacists about negative reactions from patients in response to initiating tobacco cessation discussions. Based on the results of this study it is hypothesized that the following strategies would facilitate adoption of AAR: (1) train pharmacists to initiate cessation discussions; (2) initially target discussions with patients who have a disease or medication adversely affected by tobacco use; (3) encourage patient enquiry about pharmacy cessation services through visual cues; and (4) help pharmacists set up a workflow system compatible with the AAR protocol.
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Affiliation(s)
- Pallavi D Patwardhan
- Department of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin, Madison, Wisconsin, USA
| | - Betty A Chewning
- Department of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin, Madison, Wisconsin, USA
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Chang FC, Hu TW, Lo SY, Yu PT, Chao KY, Hsiao ML. Quit smoking advice from health professionals in Taiwan: the role of funding policy and smoker socioeconomic status. Tob Control 2009; 19:44-9. [PMID: 19965797 PMCID: PMC2921261 DOI: 10.1136/tc.2009.031435] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives In 2002, Taiwan launched a program to encourage doctors to provide brief cessation counselling to their patients during routine outpatient visits. This study is to compare and analyse the annual prevalence rate of receiving advice to quit smoking from health professionals before (2004) and after (2005, 2006) the increase in funding and the withdrawal of additional funding (2007). Methods We analysed pooled data from 2004 to 2007 Taiwan Adult Tobacco Survey, an annual random digit dialling telephone survey, to estimate the prevalence of receiving quit advice among ever smokers across these years. Smoking characteristics and the socioeconomic factors of smokers associated with receipt of advice to quit smoking were also examined. Results The prevalence rate of receiving quit advice increased from 21.1% in 2004 to 28.2% in 2006, and then decreased slightly to 27.6% in 2007 after the funds were cut. Multivariate analyses results indicated that increasing financing for smoking cessation services in 2005, being male, older, a daily cigarette user, having previously attempted to quit, perceiving oneself as having poor health and being aware of the benefits of smoking cessation services were significantly positively associated with receiving quit advice from health professionals. In contrast, smokers who were younger, female and occasional cigarette users were less likely to receive quit advice. Also, smokers with socioeconomic disadvantages were not less likely to receive quit advice. Conclusions During the period of increased funding for smoking cessation services, the rates of receiving quit advice increased among all smokers and across different socioeconomic groups.
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Laws RA, Kemp LA, Harris MF, Davies GP, Williams AM, Eames-Brown R. An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study. Implement Sci 2009; 4:66. [PMID: 19825189 PMCID: PMC2770564 DOI: 10.1186/1748-5908-4-66] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 10/13/2009] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Despite the effectiveness of brief lifestyle intervention delivered in primary healthcare (PHC), implementation in routine practice remains suboptimal. Beliefs and attitudes have been shown to be associated with risk factor management practices, but little is known about the process by which clinicians' perceptions shape implementation. This study aims to describe a theoretical model to understand how clinicians' perceptions shape the implementation of lifestyle risk factor management in routine practice. The implications of the model for enhancing practices will also be discussed. METHODS The study analysed data collected as part of a larger feasibility project of risk factor management in three community health teams in New South Wales (NSW), Australia. This included journal notes kept through the implementation of the project, and interviews with 48 participants comprising 23 clinicians (including community nurses, allied health practitioners and an Aboriginal health worker), five managers, and two project officers. Data were analysed using grounded theory principles of open, focused, and theoretical coding and constant comparative techniques to construct a model grounded in the data. RESULTS The model suggests that implementation reflects both clinician beliefs about whether they should (commitment) and can (capacity) address lifestyle issues. Commitment represents the priority placed on risk factor management and reflects beliefs about role responsibility congruence, client receptiveness, and the likely impact of intervening. Clinician beliefs about their capacity for risk factor management reflect their views about self-efficacy, role support, and the fit between risk factor management ways of working. The model suggests that clinicians formulate different expectations and intentions about how they will intervene based on these beliefs about commitment and capacity and their philosophical views about appropriate ways to intervene. These expectations then provide a cognitive framework guiding their risk factor management practices. Finally, clinicians' appraisal of the overall benefits versus costs of addressing lifestyle issues acts to positively or negatively reinforce their commitment to implementing these practices. CONCLUSION The model extends previous research by outlining a process by which clinicians' perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices.
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Affiliation(s)
- Rachel A Laws
- Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052, Australia
| | - Lynn A Kemp
- Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052, Australia
| | - Mark F Harris
- Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052, Australia
| | - Gawaine Powell Davies
- Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052, Australia
| | - Anna M Williams
- Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052, Australia
| | - Rosslyn Eames-Brown
- Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052, Australia
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69
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Akpanudo SM, Price JH, Jordan T, Khuder S, Price JA. Clinical psychologists and smoking cessation: treatment practices and perceptions. J Community Health 2009; 34:461-71. [PMID: 19701699 DOI: 10.1007/s10900-009-9178-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A random sample of clinical psychologists was surveyed regarding their smoking cessation practices and perceptions. A total of 352 psychologists responded (57%) to the valid and reliable questionnaire. The majority (59.1%) of psychologists did not always identify and document the smoking status of patients. The majority reported high efficacy expectations (66.4%) and low outcome expectations (55.1%) for using the 5A's smoking cessation counseling technique. Counselors that had never smoked were almost two times more likely to have higher efficacy expectations than those that were current smokers or ex-smokers (OR = 1.94, 95% CI 1.18-3.12). The factors that predicted regular use of the 5A's included the number of identified barriers, psychologists' level of self efficacy, and the urbanicity of one's practice location.
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Affiliation(s)
- Sutoidem M Akpanudo
- Department of Health & Rehabilitative Services, College of Health Science and Human Service, The University of Toledo, Toledo, OH 43606, USA
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Bodner ME, Dean E. Advice as a smoking cessation strategy: A systematic review and implications for physical therapists. Physiother Theory Pract 2009; 25:369-407. [DOI: 10.1080/09593980903011887] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Patwardhan PD, Chewning BA. Ask, advise and refer: hypothesis generation to promote a brief tobacco-cessation intervention in community pharmacies. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2009; 17:221-9. [PMID: 20161528 PMCID: PMC2801921 DOI: 10.1211/ijpp/17.04.0005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES A preliminary qualitative study was conducted to identify key facilitators and barriers for pharmacists' adoption of a brief tobacco-cessation protocol, Ask-Advise-Refer (AAR). METHODS Ten community pharmacists were interviewed using semi-structured, face-to-face interviews with open-ended questions. Purposive and saturation sampling techniques were applied to identify participants and determine sample size respectively. Interviews were audio-recorded and transcribed. Using thematic analysis, two reviewers independently coded all transcripts to identify prominent themes. Appropriate measures were taken to ensure study rigor and validity. KEY FINDINGS All facilitators and barriers identified were grouped into nine distinct themes. Pharmacists' fear of negative patient reaction was the most prominent barrier to initiating tobacco-cessation discussions with patients. Other themes identified in decreasing order of prevalence were pharmacists perceiving a rationale for initiating tobacco cessation, pharmacy environment, pharmacists' perception of/prior knowledge of patients' willingness to discuss tobacco cessation/to quit, patient initiation of tobacco-cessation or worsening-health discussion, pharmacists' perceptions of AAR characteristics, length of pharmacist-patient relationship/rapport with patients, low expectations of pharmacy patrons and pharmacists' communication ability. CONCLUSIONS This study highlights the potential fear among pharmacists about negative reactions from patients in response to initiating tobacco cessation discussions. Based on the results of this study it is hypothesized that the following strategies would facilitate adoption of AAR: (1) train pharmacists to initiate cessation discussions; (2) initially target discussions with patients who have a disease or medication adversely affected by tobacco use; (3) encourage patient enquiry about pharmacy cessation services through visual cues; and (4) help pharmacists set up a workflow system compatible with the AAR protocol.
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Affiliation(s)
- Pallavi D Patwardhan
- Department of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin, Madison, Wisconsin 53705, USA.
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Padmawati RS, Ng N, Prabandari YS, Nichter M. Smoking among diabetes patients in Yogyakarta, Indonesia: cessation efforts are urgently needed. Trop Med Int Health 2009; 14:412-9. [DOI: 10.1111/j.1365-3156.2009.02241.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Martinelli E, Palmer RM, Wilson RF, Newton JT. Smoking behaviour and attitudes to periodontal health and quit smoking in patients with periodontal disease. J Clin Periodontol 2008; 35:944-54. [DOI: 10.1111/j.1600-051x.2008.01324.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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