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Elshatarat RA, Yacoub MI, Khraim FM, Saleh ZT, Afaneh TR. Self-efficacy in treating tobacco use: A review article. PROCEEDINGS OF SINGAPORE HEALTHCARE 2016. [DOI: 10.1177/2010105816667137] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Globally, tobacco use continues to be a major health care concern. Despite strong recommendations to quit smoking, tobacco users are experiencing difficulties in quitting. The purpose of this integrative review is to discuss self-efficacy theory as an important behavioral therapy for treating tobacco use and nicotine dependence. Moreover, the paper proposes a literature-derived model that employs self-efficacy as a central component for treating tobacco use and nicotine dependence. Eleven relevant articles were included in this review. Self-efficacy has an important role in smoking cessation. Improving self-efficacy enhances the individual’s success in quitting tobacco use and preventing relapse. Moreover, incorporating self-efficacy as a cognitive behavioral intervention has shown various degrees of success for treating tobacco use and nicotine dependence. In order to offer guidance to health care providers assisting in quitting tobacco, a model that integrates self-efficacy as a central component of the quitting process is proposed.
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Affiliation(s)
- Rami Azmi Elshatarat
- Department of Medical and Surgical Nursing, Taibah University, Madinah, Kingdom of Saudi Arabia
| | - Mohammed Ibrahim Yacoub
- Department of Medical and Surgical Nursing, Taibah University, Madinah, Kingdom of Saudi Arabia
- Clinical Nursing Department, The University of Jordan, Amman, Jordan
| | - Fadi Marwan Khraim
- Department of Medical and Surgical Nursing, Taibah University, Madinah, Kingdom of Saudi Arabia
- School of Nursing, Memorial University of Newfoundland, Canada
| | - Zyad Taher Saleh
- Clinical Nursing Department, The University of Jordan, Amman, Jordan
| | - Tareq Rateb Afaneh
- Nursing Education Department, Security Forces Hospital, Makkah, Kingdom of Saudi Arabia
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Jaarsma T, Deaton C, Fitzsimmons D, Fridlund B, Hardig BM, Mahrer-Imhof R, Moons P, Noureddine S, O’Donnell S, Pedersen SS, Stewart S, Strömberg A, Thompson DR, Tokem Y, Kjellström B. Research in cardiovascular care: A position statement of the Council on Cardiovascular Nursing and Allied Professionals of the European Society of Cardiology. Eur J Cardiovasc Nurs 2013; 13:9-21. [DOI: 10.1177/1474515113509761] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Tiny Jaarsma
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Christi Deaton
- School of Nursing, Midwifery & Social Work, Central Manchester University Hospitals NHS Foundation Trust, UK
| | | | - Bengt Fridlund
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Bjarne M Hardig
- Physio-Control Sweden/Jolife AB, Sweden; Department of Cardiology, Lund University, Sweden
| | - Romy Mahrer-Imhof
- Institute of Nursing, Zurich University of Applied Sciences, Switzerland
| | - Philip Moons
- Department of Public Health and Primary Care, University of Leuven, Belgium; The Heart Centre, Copenhagen University Hospital, Denmark
| | - Samar Noureddine
- Hariri School of Nursing, American University of Beirut, Lebanon
| | | | - Susanne S Pedersen
- Department of Medical and Clinical Psychology, Tilburg University, The Netherlands; Thorax Center, Erasmus Medical Center, The Netherlands; Institute of Psychology, University of Southern Denmark, Denmark; Department of Cardiology, Odense University Hospital, Denmark
| | - Simon Stewart
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence to Reduce Inequality in Heart Disease & Preventative Health, Baker IDI Heart and Diabetes Institute, Australia
| | - Anna Strömberg
- Department of Medicine and Health Sciences, Linköping University, Sweden; Department of Cardiology, County Council of Östergötland, Sweden
| | - David R Thompson
- Cardiovascular Research Centre, Australian Catholic University, Australia
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Cosci F, Fava GA. Staging of mental disorders: systematic review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2013; 82:20-34. [PMID: 23147126 DOI: 10.1159/000342243] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 07/28/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND The staging method, whereby a disorder is characterized according to its seriousness, extension, development and features, is attracting increasing attention in clinical psychology and psychiatry. The aim of this systematic review was to critically summarize the tools that are available for reproducing and standardizing the clinical intuitions that are involved in a staging formulation. METHODS A comprehensive research was conducted on the MEDLINE, PsycINFO, EMBASE and Cochrane databases from inception to May 2012. The following search terms were used: 'stage/staging' AND 'psychiatric disorder/mental disorder/schizophrenia/mood disorder/anxiety disorder/substance use disorder/eating disorder'. RESULTS A total of 78 studies were identified for inclusion in the review. We discussed studies addressing or related to the issue of staging in a number of mental disorders (schizophrenia, unipolar depression, bipolar disorder, panic disorder, substance use disorders, anorexia and bulimia nervosa). The literature indicates that disorders have a longitudinal development or a treatment history that can be categorized according to stages. We proposed staging formulations for the above-mentioned psychiatric disorders. CONCLUSION Staging models offer innovative assessment tools for clinical psychologists and psychiatrists. Characterizing each stage of an illness demarcates major prognostic and therapeutic differences among patients who otherwise seem to be deceptively similar since they share the same psychiatric diagnosis. A stage 0 to denote an at-risk condition does not appear to be warranted at the current state of research.
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Affiliation(s)
- Fiammetta Cosci
- Department of Psychology, University of Florence, Florence, Italy.
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Elshatarat RA, Stotts NA, Engler M, Froelicher ES. Knowledge and beliefs about smoking and goals for smoking cessation in hospitalized men with cardiovascular disease. Heart Lung 2013; 42:126-32. [PMID: 23290660 PMCID: PMC4748847 DOI: 10.1016/j.hrtlng.2012.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 11/26/2012] [Accepted: 11/27/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe perceptions of smoking in men hospitalized with cardiovascular disease (CVD). BACKGROUND Smoking is a major risk factor and associated with the high prevalence of CVD in Jordan. METHODS The study design was cross-sectional with a convenience sample. A structured interview was conducted in 112 men who were hospitalized with CVD. RESULTS The study showed that 91% of men hospitalized with CVD smoked daily. The majority (83%) had attempted to quit smoking in the past without help from others, and intended to quit in the future using the same previously unsuccessful method. They were unaware of the hazards of smoking such as stroke; or the long term health benefits of quitting smoking. Logistic regressions showed that men were more confident in quitting smoking if they had a high income (OR: 7.7; 95% CI: 2.7, 22.3), longer hospitalizations (OR: 2.6; 95% CI: 1.3, 5.3), or were hospitalized in acute cardiac settings (OR: 3.9; 95% CI: 1.2, 12.7), and admitted with a diagnosis of MI or angina (OR: 3.0; 95% CI: 1.1, 8.3). CONCLUSION Assessment of smoking status with smoking cessation counseling is paramount in hospitalized men with CVD who smoke.
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Affiliation(s)
- Rami Azmi Elshatarat
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA.
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Abstract
BACKGROUND The transtheoretical model is the most widely known of several stage-based theories of behaviour. It proposes that smokers move through a discrete series of motivational stages before they quit successfully. These are precontemplation (no thoughts of quitting), contemplation (thinking about quitting), preparation (planning to quit in the next 30 days), action (quitting successfully for up to six months), and maintenance (no smoking for more than six months). According to this influential model, interventions which help people to stop smoking should be tailored to their stage of readiness to quit, and are designed to move them forward through subsequent stages to eventual success. People in the preparation and action stages of quitting would require different types of support from those in precontemplation or contemplation. OBJECTIVES Our primary objective was to test the effectiveness of stage-based interventions in helping smokers to quit. SEARCH STRATEGY We searched the Cochrane Tobacco Addiction Group's specialised register for trials, using the terms ('stage* of change', 'transtheoretical model*', 'trans-theoretical model*, 'precaution adoption model*', 'health action model', 'processes of change questionnaire*', 'readiness to change', 'tailor*') and 'smoking' in the title or abstract, or as keywords. The latest search was in August 2010. SELECTION CRITERIA We included randomized controlled trials, which compared stage-based interventions with non-stage-based controls, with 'usual care' or with assessment only. We excluded trials which did not report a minimum follow-up period of six months from start of treatment, and those which measured stage of change but did not modify their intervention in the light of it. DATA COLLECTION AND ANALYSIS We extracted data in duplicate on the participants, the dose and duration of intervention, the outcome measures, the randomization procedure, concealment of allocation, and completeness of follow up.The main outcome was abstinence from smoking for at least six months. We used the most rigorous definition of abstinence, and preferred biochemically validated rates where reported. Where appropriate we performed meta-analysis to estimate a pooled risk ratio, using the Mantel-Haenszel fixed-effect model. MAIN RESULTS We found 41 trials (>33,000 participants) which met our inclusion criteria. Four trials, which directly compared the same intervention in stage-based and standard versions, found no clear advantage for the staging component. Stage-based versus standard self-help materials (two trials) gave a relative risk (RR) of 0.93 (95% CI 0.62 to 1.39). Stage-based versus standard counselling (two trials) gave a relative risk of 1.00 (95% CI 0.82 to 1.22). Six trials of stage-based self-help systems versus any standard self-help support demonstrated a benefit for the staged groups, with an RR of 1.27 (95% CI 1.01 to 1.59). Twelve trials comparing stage-based self help with 'usual care' or assessment-only gave an RR of 1.32 (95% CI 1.17 to 1.48). Thirteen trials of stage-based individual counselling versus any control condition gave an RR of 1.24 (95% CI 1.08 to 1.42). These findings are consistent with the proven effectiveness of these interventions in their non-stage-based versions. The evidence was unclear for telephone counselling, interactive computer programmes or training of doctors or lay supporters. This uncertainty may be due in part to smaller numbers of trials. AUTHORS' CONCLUSIONS Based on four trials using direct comparisons, stage-based self-help interventions (expert systems and/or tailored materials) and individual counselling were neither more nor less effective than their non-stage-based equivalents. Thirty-one trials of stage-based self help or counselling interventions versus any control condition demonstrated levels of effectiveness which were comparable with their non-stage-based counterparts. Providing these forms of practical support to those trying to quit appears to be more productive than not intervening. However, the additional value of adapting the intervention to the smoker's stage of change is uncertain. The evidence is not clear for other types of staged intervention, including telephone counselling, interactive computer programmes and training of physicians or lay supporters. The evidence does not support the restriction of quitting advice and encouragement only to those smokers perceived to be in the preparation and action stages.
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Affiliation(s)
- Kate Cahill
- Department of Primary Health Care, University of Oxford, Rosemary Rue Building, Old Road Campus, Oxford, UK, OX3 7LF
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Li WW, Froelicher ES. Predictors of smoking relapse in women with cardiovascular disease in a 30-month study: extended analysis. Heart Lung 2008; 37:455-65. [PMID: 18992629 DOI: 10.1016/j.hrtlng.2008.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Revised: 07/18/2008] [Accepted: 07/22/2008] [Indexed: 11/18/2022]
Abstract
PURPOSE To identify predictors of long-term cessation after intervention for woman hospitalized with cardiovascular diseases (CVD). METHODS A randomized clinical trial (RCT) with a 30-month follow-up was conducted, recruiting 277 woman smokers with CVD from 10 hospitals. The intervention consisted of inpatient and outpatient counseling on smoking cessation and pharmacological protocol. Psychophysiological factors and time since quitting associated with relapse in the literature were assessed in our prediction model. RESULTS The nine independent variables for smoking relapse included time since quitting, group assignment, the interaction between time and group assignment, serious quit attempts and five and psychophysiological factors. Lower self-efficacy at baseline was a significant predictor of relapse (OR = 0.98, 95%CI = 0.97,0.99). Another predictor was the interaction between time and group assignment and the finding showed that for the usual care group, increase in time since quitting provided a significant protective factor (OR = 0.69, 95%CI = 0.60,0.79). CONCLUSIONS Cessation programs should include content on self-efficacy to help prevent relapse. The interaction between time and group warrants further investigation for its prediction for relapse.
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Affiliation(s)
- Wen-Wen Li
- School of Nursing, San Francisco State University, San Francisco, California 94132, USA
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Sohn M, Benowitz N, Stotts N, Christopherson D, Kim KS, Jang YS, Ahn MS, Froelicher ES. Smoking behavior in men hospitalized with cardiovascular disease in Korea: A cross-sectional descriptive study. Heart Lung 2008; 37:366-79. [DOI: 10.1016/j.hrtlng.2007.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 10/13/2007] [Accepted: 11/05/2007] [Indexed: 10/21/2022]
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Wilson JS, Fitzsimons D, Bradbury I, Stuart Elborn J. Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease? A randomised controlled trial. Int J Nurs Stud 2008; 45:508-17. [PMID: 17184783 DOI: 10.1016/j.ijnurstu.2006.10.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Revised: 10/02/2006] [Accepted: 10/03/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Smoking cessation is the primary disease modifying intervention for chronic obstructive pulmonary disease (COPD). SETTING A Regional Respiratory Centre (RRC) out-patient department in Northern Ireland. METHODS A randomised controlled trial (RCT) evaluated the effectiveness of brief advice alone or accompanied by individual nurse support or group support facilitated by nurses. Smoking status was biochemically validated and stage of change, nicotine addiction and dyspnoea were recorded at 2, 3, 6, 9 and 12 months. PARTICIPANTS Ninety-one cigarette smokers with COPD were enrolled in the study (mean age 61 years, 47 female). RESULTS After 12 months cessation rates were not significantly different between groups (p=0.7), but all groups had a significant reduction in their nicotine addiction (p=0.03-0.006). No changes in subjects' motivation or dyspnoea were detected over the 12 months. CONCLUSION Patients with COPD were unable to stop smoking regardless of the type of support they received. Harm reduction may be a more appropriate goal than complete cessation for intractable smokers and nurses must evaluate their role in this arena.
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Affiliation(s)
- Julie S Wilson
- Regional Respiratory Centre, Belfast City Hospital Trust, Belfast BT9 7AB, N. Ireland, UK.
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Zheng P, Guo F, Chen Y, Fu Y, Ye T, Fu H. A randomized controlled trial of group intervention based on social cognitive theory for smoking cessation in China. J Epidemiol 2007; 17:147-55. [PMID: 17827861 PMCID: PMC7058478 DOI: 10.2188/jea.17.147] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND New training programs need to be developed to help Chinese smokers achieve quitting. The objective of this study was to assess the effectiveness of a group smoking cessation intervention based on social cognitive theory among Chinese smokers. METHOD A total of 225 smokers were eligible for the study and were randomly assigned to an intervention group (n=118) and a control group (n=107). The intervention group received the course soon after a baseline survey, whereas the control group received routine training in the first 6 months, and then took the same course. Effectiveness was evaluated at 6-month and 1-year follow-up from baseline. RESULTS After 6 months, 40.5% (47/116) in the intervention group and 5.0% (5/101) in the control group quit smoking (absolute risk reduction: 35.5% [95% confidence interval (CI): 24.2-46.8%]). The 6-month continuous abstinence rate was 28.4% (33/116) in the intervention group and 3.0% (3/101) in the control group (absolute risk reduction 25.4% [95% CI: 15.6-35.2%]). At 1-year follow-up, the proportion of quitting and the 6-month abstinence rate in the intervention group were 35.8% and 22.0%, respectively. The factors associated with smoking cessation during the 6 month period were intervention (adjusted odds ratio [OR]=6.42 [95% CI: 2.46-13.28]), as well as anticipation of quitting (adjusted OR=1.46 [95% CI: 1.12-1.91]) and skill self-efficacy score in the baseline (adjusted OR=1.04 [95% CI: 1.01-1.07]). The same intervention was conducted in the control group after the 6-month study, in which a similar intervention effect was observed. CONCLUSION A smoking cessation intervention based on social cognitive theory among Chinese smokers is highly effective.
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Affiliation(s)
| | - Fengxia Guo
- Xuhui District Center for Disease Prevention and Control
| | - Yue Chen
- Department of Epidemiology and Community Medicine, University of Ottawa
| | - Yingying Fu
- Xuhui District Center for Disease Prevention and Control
| | | | - Hua Fu
- School of Public Health, Fudan University
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Sohn M, Stotts NA, Benowitz N, Christopherson D, Kim KS, Jang YS, Ahn MS, Froelicher ES. Beliefs about health, smoking, and future smoking cessation among South Korean men hospitalized for cardiovascular disease. Heart Lung 2007; 36:339-47. [PMID: 17845880 DOI: 10.1016/j.hrtlng.2006.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2005] [Accepted: 11/13/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND A particularly high rate of smoking among South Korean men corresponds to high rates of cardiovascular disease. OBJECTIVES This study evaluated South Korean men hospitalized with cardiovascular disease to explore beliefs about the health benefits of smoking cessation, to determine smoking cessation intentions, and to identify factors associated with confidence in quitting smoking. METHODS This was a cross-sectional, descriptive study. RESULTS Of the study's 97 participants, only 78% believed that smoking cessation avoids or decreases the chance of developing heart disease; 93% reported their intention to quit; 74% had moderate to high confidence about quitting within the month after hospital discharge; and 88% preferred to quit by themselves without help. Significant predictors of low confidence in quitting were being married (odds ratio: 5.54, 95% confidence interval: 1.33-23.08); being alcohol dependent (odds ratio: 3.25, confidence interval: 1.20-8.80); and starting to smoke at or before 20 years of age (odds ratio: 2.96, confidence interval: 1.14-7.68). CONCLUSION The study's participants were motivated to quit smoking for their health, but they must be educated to understand that smoking is addictive and that special intervention is needed.
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Affiliation(s)
- Min Sohn
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA
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Cahill K, Green N. Stage-based interventions for smoking cessation. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2007. [DOI: 10.1002/14651858.cd004492.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Oka RK, Katapodi MC, Lim JW, Bacchetti P, Froelicher ES. Quantifying smoking cessation outcomes: from The Women's Initiative for Nonsmoking Study (X): methodological implications. Nurs Res 2006; 55:292-7. [PMID: 16849982 DOI: 10.1097/00006199-200607000-00010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Classification of smoking status has a major impact on the conclusions drawn from smoking cessation intervention research, yet few studies have addressed this critical issue. OBJECTIVES The aim of this study was to compare three classifications (naïve, optimistic, and pessimistic) of smoking cessation outcomes or smoking status from the Women's Initiative for Nonsmoking Study (WINS). METHODS This is a longitudinal prospective study nested within a randomized clinical trial (RCT) design of WINS, an RCT of 277 women over the age of 18 years who reported smoking cigarettes continuously for 1 month prior to a cardiovascular event requiring hospital admission. Women were randomized to either the usual care group (UC) or the intervention group (IG). Recruitment for WINS occurred between October 1996 and December 1998 in 10 hospitals in the San Francisco Bay area. Follow-up data on smoking status was obtained from the UC and the IG using a structured telephone interview at 6 and 12 months from baseline and was confirmed by family members and salivary cotinine levels. RESULTS Seven-day point prevalence(self-report of not smoking in the past 7 days; "not even a puff") using the naïve (the most liberal) classification yields a greater number of nonsmokers than the pessimistic or most conservative classification (cotinine level verification of smoking status). The classification of smoking status also affects time to continuous smoking. The pessimistic classification results in the shortest time to continuous smoking, whereas the opposite is observed with the naïve classification. DISCUSSION It is important to critically evaluate the underlying assumptions made by study investigators when measuring and reporting smoking status. The classification of smoking status and the selection of analysis, meaning point prevalence versus survival analysis, affect study results and contribute to the variability observed in the research findings of smoking cessation intervention trials and the challenges faced in making appropriate comparisons across studies.
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Affiliation(s)
- Roberta K Oka
- Department of Community Health Systems, University of California, San Francisco, CA 94143-0608, USA
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Doolan DM, Froelicher ES. Efficacy of smoking cessation intervention among special populations: review of the literature from 2000 to 2005. Nurs Res 2006; 55:S29-37. [PMID: 16829774 DOI: 10.1097/00006199-200607001-00005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The United States Public Health Service acknowledges in the 2000 Clinical Practice Guideline for Treating Tobacco Use and Dependence that certain special populations have unique needs and considerations in regard to smoking cessation interventions. In a review of the current smoking cessation literature, the following special populations were identified: women; older adults; gay, lesbian, bisexual, and transgender smokers; smokers with psychiatric diagnoses; smokers addicted to illicit drugs, alcohol, or both; American Indians and Alaska Natives; African Americans; Hispanics; and Asian Americans. Existing smoking cessation research pertaining to these special populations was assessed, and an agenda for future research is proposed in this presentation. The available smoking cessation randomized clinical trials for efficacy and other research relevant to these groups is insufficient. Recent progress has been made in research in the areas of smoking cessation and women; smokers with psychiatric diagnoses; smokers addicted to illicit drugs, alcohol, or both; and African Americans. There is, however, a paucity of research evaluating smoking cessation interventions and older adults; gay, lesbian, bisexual, and transgender smokers; American Indians and Alaska Natives; Hispanics; and Asian Americans. Further research relevant to the smoking cessation needs of these special populations can enable nurses and other healthcare providers to administer culturally adequate and efficacious smoking cessation interventions to these groups.
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Affiliation(s)
- Daniel M Doolan
- Department of Physiological Nursing, University of California, San Francisco 94143-0610, USA
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Gerrard M, Gibbons FX, Lane DJ, Stock ML. Smoking cessation: Social comparison level predicts success for adult smokers. Health Psychol 2005; 24:623-9. [PMID: 16287409 DOI: 10.1037/0278-6133.24.6.623] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The affiliation preferences of 151 adult heavy smokers who joined smoking cessation groups were assessed at the 1st group session and were then used to predict their smoking status 6 and 12 months later. Those who preferred to be in groups with other smokers who were having relatively little trouble quitting were more likely to be successful than were those who preferred others who were having more difficulty quitting. This prospective effect was mediated by psychological distancing from the image of the typical smoker: Preference for others who were doing well was associated with a decrease in perceived similarity to the typical smoker, which, in turn, was associated with successful cessation. Implications of these findings for cessation groups and social comparison theory are discussed.
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Affiliation(s)
- Meg Gerrard
- Department of Psychology, Iowa State University, Ames, IA 50011-3180, USA.
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Liddle J, Carlson G, McKenna K. Using a matrix in life transition research. QUALITATIVE HEALTH RESEARCH 2004; 14:1396-1417. [PMID: 15538007 DOI: 10.1177/1049732304268793] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Life transitions can be planned or can occur unexpectedly. They can cause a major change to a person's life patterns and well-being. Older adulthood is a time for many life transitions as a result of changes in life roles and health status. In this exploratory study, the authors investigate the transition involved in driving cessation for older people. In analyzing and organizing the data, they develop a matrix that incorporated descriptive and temporal factors associated with the transition. This matrix is useful in organizing and communicating the findings as a whole and could be used in describing individual experiences. It might be of use for the organization of qualitative data about other life transitions such as illness, retirement, and the development and adoption of new behaviors.
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Affiliation(s)
- Jacki Liddle
- Division of Occupational Therapy at the University of Queensland, Brisbane, Australia
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Froelicher ES, Sohn M, Max W, Bacchetti P. Women's Initiative for Nonsmoking-VII: evaluation of health service utilization and costs among women smokers with cardiovascular disease. ACTA ACUST UNITED AC 2004; 24:218-28. [PMID: 15286526 DOI: 10.1097/00008483-200407000-00003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The Women's Initiative for Nonsmoking (WINS), a randomized clinical trial of a smoking cessation intervention for women with cardiovascular disease, permitted an assessment of the types and costs of health services women used during the 30 months after their hospitalization with cardiovascular disease. METHODS A prospective design nested within WINS was used for this study. A structured telephone interview guide included questions about medical services and 15 categories of prevention services, including cardiac rehabilitation at 6, 12, 24, and 30 months. Costs were estimated from state and national databases. RESULTS The 277 women studied had a mean age of 60.7 +/- 10 years. They had smoked approximately 40 +/- 11.4 years. More than 50% of the women had one or more risk factors for cardiovascular disease. During the first 6 months after the index hospitalization, 94% had a physician visit, 39% had an emergency-room visit, and 36% had a hospital admission. Prevention services used were home healthcare by nurse or home health aide (26%), a cardiac rehabilitation program, including Multifit and Heart Smart (19%), and physical therapy (14%). Usage decreased over the 30 months. For the women who used any service, the mean total monthly cost per woman was 913 dollars +/- 1204 dollars. CONCLUSIONS This is the first report on health service use by women smokers with cardiovascular disease. Data collection using a telephone interview guide proved feasible for evaluating health service use. The greatest costs resulted from hospital admissions and physician and emergency-room visits. Considering the high prevalence of risk factors in this cohort, secondary prevention services were severely underutilized. By increasing referrals to such services, physicians and nurses might influence women to reduce their risk for subsequent cardiovascular disease.
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Affiliation(s)
- Erika Sivarajan Froelicher
- Department of Physiological, Nursing, School of Nursing, University of California San Francisco, 94143-0610, USA.
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Price JAD. Management and prevention of cardiovascular disease in women. Nurs Clin North Am 2004; 39:873-84, xi. [PMID: 15561167 DOI: 10.1016/j.cnur.2004.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cardiovascular disease, including coronary artery disease, hypertension, and stroke, is the number one killer of men and women in the United States and Canada. In the United States, cardiovascular disease accounts for more deaths in women, compared with men, every year since 1984. Unfortunately, many women are unaware of their risk for developing cardiovascular disease. This article reviews the statistics of this disease, identifies the risk factors, and reviews the evidence-based guidelines for prevention of cardiovascular disease in women.
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Affiliation(s)
- Jennifer A D Price
- Sunnybrook and Women's College Health Sciences Centre, 76 Grenville Street, Room 749, Toronto, Ontario M4E 3L5, Canada.
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Froelicher ES, Li WW, Mahrer-Imhof R, Christopherson D, Stewart AL. Women's Initiative for Non-Smoking (WINS) VI: reliability and validity of health and psychosocial measures in women smokers with cardiovascular disease. Heart Lung 2004; 33:162-75. [PMID: 15136776 DOI: 10.1016/j.hrtlng.2004.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE We present psychometric properties of 9 health and psychosocial measures in a sample of hospitalized women with cardiovascular disease. This information will be useful to others needing to make choices about selection of health and psychosocial measurements in women smokers. METHODS Psychometric properties were examined using baseline measures from a cross-sectional study, nested within a randomized clinic trial, Women's Initiative for Non-Smoking. Women smokers hospitalized with cardiovascular disease were recruited from 10 hospitals in the San Francisco Bay Area. Measures included the perceived stress scale, a depression screener, self-efficacy, the sense of mastery scale, and measures of health-related quality of life from the Medical Outcomes Study. RESULTS The sample of 277 women smokers ranged in age from 34 to 86 years (mean = 61 +/- 10.1). Studies of variability, including floor/ceiling effects, skewness, range, mean, and SD, indicated that most measures had sufficient variability to be predictive and detect both positive and negative changes over time. Internal-consistency reliabilities ranged from 0.63 to 0.86. Preliminary evidence of construct validity was found, with most hypotheses being confirmed. CONCLUSIONS The battery of tests included in the Women's Initiative for Non-Smoking trial may be useful in identifying women at high risk of relapse and in detecting short-term quality-of-life outcomes. The measures generally performed well and show promise for advancing our understanding of the process of successful smoking cessation in this population. SUMMARY Psychometric properties of the perceived stress scale, a depression screener, self-efficacy for quitting smoking, the sense of mastery scale, and measures of health-related quality of life from the Medical Outcomes Study in 277 women smokers hospitalized with cardiovascular disease were examined. The measures generally performed well and show promise for advancing our understanding of smokers in this population.
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Affiliation(s)
- Erika Sivarajan Froelicher
- Department of Physiological Nursing at the School of Nursing, University of California San Francisco, 94143-0610, USA
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Sivarajan Froelicher ES, Miller NH, Christopherson DJ, Martin K, Parker KM, Amonetti M, Lin Z, Sohn M, Benowitz N, Taylor CB, Bacchetti P. High Rates of Sustained Smoking Cessation in Women Hospitalized With Cardiovascular Disease. Circulation 2004; 109:587-93. [PMID: 14769679 DOI: 10.1161/01.cir.0000115310.36419.9e] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although men hospitalized with cardiovascular disease (CVD) show high smoking-cessation rates, similar data for women are lacking. We tested the efficacy of smoking-cessation intervention in women hospitalized for CVD. METHODS AND RESULTS In this randomized controlled trial conducted from 1996 to 2001, 277 women diagnosed with CVD (mean age 61+/-10 years) were randomly assigned within 1 of 12 San Francisco Bay Area hospitals to a usual-care group (UG; n=135) or intervention group (IG; n=142). Baseline histories were obtained, and interviews to ascertain self-reported smoking status occurred at 6, 12, 24, and 30 months after hospitalization. The UG received strong physician's advice, a self-help pamphlet, and a list of community resources. The IG received strong physician's advice and a nurse-managed cognitive behavioral relapse-prevention intervention at bedside, with telephone contact at intervals after discharge. The groups were similar demographically and had smoked cigarettes for a median of 38 (IG) or 40 (UG) years. Time to resumption of continuous smoking was assessed by Kaplan-Meier analysis, and risk differences between groups were determined. Time smoke-free was significantly greater for the IG than the UG (P=0.038). Point prevalence for nonsmoking at the interviews was somewhat greater for the IG than the UG (P>0.15 at all times). CONCLUSIONS Cognitive behavioral intervention resulted in longer average times to resumption of smoking, but in these 2 groups of older women with limited social and financial resources, long-term success rates were similar. Systematic identification of smokers and even the brief intervention afforded the UG yielded a high smoking-cessation rate over time.
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Affiliation(s)
- Erika S Sivarajan Froelicher
- University of California at San Francisco, Department of Physiological Nursing, School of Nursing, San Francisco, CA 94143-0610, USA.
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Mahrer-Imhof R, Froelicher ES, Li WW, Parker KM, Benowitz N. Women's Initiative for Nonsmoking (WINS V): under-use of nicotine replacement therapy. Heart Lung 2002; 31:368-73. [PMID: 12487015 DOI: 10.1067/mhl.2002.126539] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the use of nicotine replacement therapy (NRT) in a nurse-managed smoking cessation program. DESIGN A cohort design nested within the WINS randomized clinical trial was used with follow-up at 2, 7, 21, 28, and 90 days. SETTING The study took place in 10 hospitals in the San Francisco Bay Area. SUBJECTS Participants included 142 women hospitalized with cardiovascular disease (CVD). OUTCOME MEASURE The outcome measure was the use of NRT after having been assessed as eligible for its use. INTERVENTION NRT was used as an adjunct in the behavioral intervention protocol. NRT was recommended during the hospital intervention and during the 90-day outpatient phase. RESULTS Of 142 women in the intervention group, 127 met the criteria for NRT use. During the 5 follow-up assessments, the reported NRT use ranged from 9% to 22%. CONCLUSION A low NRT use rate among women with CVD is evident. The results suggest that future research about NRT myths pertaining to women is needed. Nurses can help patients dispel these myths and prevent smoking relapse in women with CVD.
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Affiliation(s)
- Romy Mahrer-Imhof
- Department of Physiological Nursing, School of Nursing, University of California-San Francisco, San Francisco, CA, USA
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Froelicher ES, Christopherson DJ, Miller NH, Martin K. Women's initiative for nonsmoking (WINS) IV: description of 277 women smokers hospitalized with cardiovascular disease. Heart Lung 2002; 31:3-14. [PMID: 11805744 DOI: 10.1067/mhl.2002.121247] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This article describes the demographic, psychosocial, and medical characteristics and smoking patterns of women hospitalized with cardiovascular disease (CVD) enrolled in the Women's Initiative for Nonsmoking (WINS) trial. DESIGN Study design is a randomized clinical trial with cross-sectional baseline data. SETTING Women enrolled during a 27-month period from 10 hospitals in the San Francisco Bay Area. PARTICIPANTS Subjects included 277 women. RESULTS The women's ages ranged from 33 to 86 years, with a mean age of 60.7 (+/-10) years. Most (51%) were college graduates, had attended some college or had postgraduate degrees; 40% were married; 76% were white. Median income was between 30,000 dollars and 35,000, but 27% of the women had incomes less than 15,000 dollars per year. The women smoked a median of 20 cigarettes per day (range, 1-90). Median age when women began smoking was 18.6 years; average number of years smoked was 40; and 78% had made more than 2 previous attempts to quit. On a 10-point scale, 71% of the women rated their confidence to quit smoking (self-efficacy) as 5 or greater. According to the Burnam Depression Screener, 56.7% were depressed. CONCLUSIONS This is the largest study describing the smoking patterns of women hospitalized with CVD. These women were older, white, had smoked for many years, were moderately to highly addicted to tobacco, had few financial resources, and a large proportion were depressed. These important psychosocial factors need to be taken into account when planning smoking cessation interventions for women with CVD.
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Affiliation(s)
- Erika Sivarajan Froelicher
- Department of Physiological Nursing, School of Nursing, University of California-San Francisco, 94143-0610, USA
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