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Domić A, Pilipović-Broćeta N, Grabež M, Divac N, Igić R, Škrbić R. Intensive Intervention on Smoking Cessation in Patients Undergoing Elective Surgery: The Role of Family Physicians. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:965. [PMID: 38929582 PMCID: PMC11205568 DOI: 10.3390/medicina60060965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/29/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: The aim of this study was to determine the role of physicians in the intensive intervention and education regarding the smoking cessation of patients undergoing elective surgery under general anaesthesia. Materials and Methods: A randomised prospective study was conducted in family physicians' clinics in which smokers of both sexes, aged 21-65 years, without cognitive impairments, and who were not addicted to psychoactive substances voluntarily participated. Four weeks preoperatively, 120 smokers were randomised into two equal groups; the intervention group (IG) underwent an intervention for the purpose of smoking cessation and the control group (CG) underwent no intervention. Biochemical tests were performed in order to determine the smoking status of the participants in the phase of randomisation, one week preoperatively, as well as 40, 120, and 180 days and 12 months postoperatively. The examinees of the IG talked to the physician five times and received 140 telephone messages, leaflets, and motivational letters along with the pharmacotherapy, while the participants in the CG received little or no advice on smoking cessation. Results: The results of this study confirmed a significant influence of the intervention and education on the smoking abstinence in the IG compared to the CG (p < 0.001). The smokers in the IG had 7.31 (95% CI: 2.32-23.04) times greater odds of abstinence upon the 12-month follow-up than the smokers in the CG. The smokers in the IG who did not stop smoking had a lower degree of dependence and smoked fewer cigarettes (p < 0.0001) compared to those in the CG, as well as a multiple times higher prevalence of short- and long-term abstinence. Conclusions: It can be concluded that the intensive intervention and education can motivate patients preparing for elective surgery to stop smoking in the short- and long term.
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Affiliation(s)
- Anto Domić
- Primary Health Care Centre, 76100 Brčko, Bosnia and Herzegovina;
| | - Nataša Pilipović-Broćeta
- Department of Family Medicine, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
| | - Milkica Grabež
- Department of Hygiene, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
| | - Nevena Divac
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Rajko Igić
- The Academy of Sciences and Arts of The Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina;
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Ranko Škrbić
- The Academy of Sciences and Arts of The Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina;
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
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2
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Bartholomew K, Aye PS, Aitken C, Chambers E, Neville C, Maxwell A, Sandiford P, Puloka A, Crengle S, Poppe K, Doughty RN, Hill A. Smoking data quality of primary care practices in comparison with smoking data from the New Zealand Māori and Pacific abdominal aortic aneurysm screening programme: an observational study. BMC Public Health 2024; 24:1513. [PMID: 38840063 PMCID: PMC11154981 DOI: 10.1186/s12889-024-19021-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 05/31/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Quality smoking data is crucial for assessing smoking-related health risk and eligibility for interventions related to that risk. Smoking information collected in primary care practices (PCPs) is a major data source; however, little is known about the PCP smoking data quality. This project compared PCP smoking data to that collected in the Māori and Pacific Abdominal Aortic Aneurysm (AAA) screening programme. METHODS A two stage review was conducted. In Stage 1, data quality was assessed by comparing the PCP smoking data recorded close to AAA screening episodes with the data collected from participants at the AAA screening session. Inter-rater reliability was analysed using Cohen's kappa scores. In Stage 2, an audit of longitudinal smoking status was conducted, of a subset of participants potentially misclassified in Stage 1. Data were compared in three groups: current smoker (smoke at least monthly), ex-smoker (stopped > 1 month ago) and never smoker (smoked < 100 cigarettes in lifetime). RESULTS Of the 1841 people who underwent AAA screening, 1716 (93%) had PCP smoking information. Stage 1 PCP smoking data showed 82% concordance with the AAA data (adjusted kappa 0.76). Fewer current or ex-smokers were recorded in PCP data. In the Stage 2 analysis of discordant and missing data (N = 313), 212 were enrolled in the 29 participating PCPs, and of these 13% were deceased and 41% had changed PCP. Of the 93 participants still enrolled in the participating PCPs, smoking status had been updated for 43%. Data on quantity, duration, or quit date of smoking were largely missing in PCP records. The AAA data of ex-smokers who were classified as never smokers in the Stage 2 PCP data (N = 27) showed a median smoking cessation duration of 32 years (range 0-50 years), with 85% (N = 23) having quit more than 15 years ago. CONCLUSIONS PCP smoking data quality compared with the AAA data is consistent with international findings. PCP data captured fewer current and ex-smokers, suggesting ongoing improvement is important. Intervention programmes based on smoking status should consider complementary mechanisms to ensure eligible individuals are not missed from programme invitation.
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Affiliation(s)
- Karen Bartholomew
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Phyu Sin Aye
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand.
- University of Auckland, Auckland, New Zealand.
| | - Charlotte Aitken
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Erin Chambers
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Cleo Neville
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Anna Maxwell
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Peter Sandiford
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Aivi Puloka
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | | | | | | | - Andrew Hill
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
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Aldhahir AM, Siraj RA, Alqarni AA, Alqahtani JS, Alyami MM, Majrshi MS, Alwafi H, Alqahtani MM, Monshi SS, Al-Zalabani AH, Alanazi AM. The prevalence and sociodemographic determinants of tobacco and nicotine use among students in healthcare disciplines in Saudi Arabian universities: a cross-sectional survey. Front Public Health 2024; 12:1348370. [PMID: 38515594 PMCID: PMC10954892 DOI: 10.3389/fpubh.2024.1348370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/28/2024] [Indexed: 03/23/2024] Open
Abstract
Background Tobacco smoking is one of the most significant health-related problems worldwide. However, the prevalence and sociodemographic determinants of tobacco and nicotine use among students on healthcare courses in Saudi Arabia are limited. Methods This cross-sectional study used a questionnaire that was distributed via SurveyMonkey between November 2022 and June 2023 to all student universities offering healthcare courses. Data are presented as frequency and percentages. The associated sociodemographic factors with current tobacco and nicotine use were subjected to logistic regression. Results Overall, 5,012, of whom 3,872 (77.25%) were males, responded to the online survey. The prevalence of current tobacco and nicotine use was 3,553 (71%). The majority of users used electronic nicotine delivery systems (1,622: 32.36%). The current use of cigarettes (AOR: 1.75 (1.42 to 2.15)), e-cigarettes (AOR: 1.17 (1.01 to 1.37)), and smokeless tobacco substances (AOR: 1.35 (1.02 to 1.90)) were more pronounced among males compared to female students. However, the current use of a hookah was less among males (AOR: 0.74 (95% CI: 61 to 0.91)). Smoking cigarettes was practiced less among students living in other regions compared to the Central Region. However, smokeless tobacco substances seem to be more prevalent in the Western, Southern, and Northern Regions, (AOR: 1.57 (95% CI: 1.09 to 2.26)), (AOR: 1.43 (95% CI: 1.04 to 1.95)), and (AOR: 1.57 (95% CI: 1.09 to 2.26)), respectively. Conclusion Smoking is prevalent among students in the healthcare disciplines, with electronic nicotine delivery systems being the most used product. Several sociodemographic factors were associated with higher tobacco or nicotine use.
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Affiliation(s)
- Abdulelah M. Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Rayan A. Siraj
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Abdullah A. Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Respiratory Therapy Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Jaber S. Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Mohammed M. Alyami
- Respiratory Therapy Department, Batterjee Medical College, Khamis Mushait, Saudi Arabia
| | - Mansour S. Majrshi
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom
| | - Hassan Alwafi
- Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Mohammed M. Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Sarah S. Monshi
- Department of Health Administration and Hospitals, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulmohsen H. Al-Zalabani
- Department of Family and Community Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia
| | - Abdullah M. Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Jørgensen CU, Løkke A, Hjorth P, Pisinger C, Farver-Vestergaard I. Barriers to implementation of smoking cessation support among healthcare professionals in the secondary healthcare sector: A qualitative and quantitative evaluation. Tob Prev Cessat 2024; 10:TPC-10-12. [PMID: 38389587 PMCID: PMC10882562 DOI: 10.18332/tpc/183775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
INTRODUCTION Smoking cessation support (SCS) in the hospital is essential; patients often struggle to maintain quit attempts, which necessitates assistance from healthcare professionals (HCPs). However, unknown barriers can obstruct the implementation of SCS in hospitals. This study aims to uncover barriers to the implementation of SCS in psychiatric, somatic, inpatient, and outpatient hospital settings. METHODS In the period from June to September 2021, HCPs in a large secondary care hospital in the Region of Southern Denmark completed an online, cross-sectional study, providing sociodemographic details and listing potential barriers to SCS. They also shared additional barriers in the form of free-text responses. Descriptive statistics and thematic analysis of free-text responses were performed. RESULTS Of 1645 HCPs surveyed, 409 elaborated their response in the free-text field assessing unlisted barriers. Top listed barriers, reported by more than one-third of participants, included: 'lack of time' (45.1%), 'lack of patient motivation' (34.3%), and 'insufficient knowledge on how to support' (32.2%). Free-text responses revealed three barrier-related, which we grouped under the themes of: 'Concerned about the patient', 'Not part of my job', and 'Inappropriate setting'. CONCLUSIONS This quantitative and qualitative study identifies barriers to SCS on multiple levels in the hospital setting, i.e. on the patient, provider, and organizational levels. These results can inform healthcare organizations and professionals in the implementation of SCS in routine hospital care.
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Affiliation(s)
| | - Anders Løkke
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Peter Hjorth
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Psychiatric Department, Mental Health Services, University Hospital of Southern Denmark, Odense, Denmark
| | - Charlotta Pisinger
- Center of Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ingeborg Farver-Vestergaard
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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5
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Znyk M, Kostrzewski S, Kaleta D. Nurse-led lifestyle counseling in Polish primary care: the effect of current health status and perceived barriers. Front Public Health 2024; 12:1301982. [PMID: 38439750 PMCID: PMC10910074 DOI: 10.3389/fpubh.2024.1301982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction Our study included counseling on diet and physical activity, smoking, e-cigarette use, and alcohol consumption. The aim was to examine the correlates of counseling provided by primary care nurses with the health status/health behaviors of nurses and the barriers in the advice provided. Materials and methods In 2022, we conducted a cross-sectional survey among 331 nurses employed in the primary care sector in Lodz. The questionnaire consisted of three sections: characteristics of the patient population receiving treatment and provided with healthy lifestyle counseling by nurses, barriers to the process of assessing, controlling, and guiding patients, and health status/health behaviors of nurses. Results Eighty percent of the nurses in our study provided advice on diet and physical activity to primary care patients. Over 70% of the survey participants performed minimal anti-smoking interventions forsmokers, 67.7% for alcohol drinkers, and 56.8% for e-cigarette users. The correlates of counseling in the field of diet and physical activity turned out to be the knowledge and skills, which enabled nurses to provide advice (OR = 2.57, p < 0.01). The correlates of the conducted minimal anti-smoking interventions in smoking patients were: subjective assessment of overweight and obesity in nurses, knowledge and skills in conducting counseling (OR = 1.92, p < 0.05), and measuring body weight, height and BMI (OR = 2.18, p < 0.01). Among the three most common barriers identified by the nurses in the process of assessing, monitoring, and guiding patients were the opinion that patients are not interested in improving their diet, physical activity, and weight loss (60.7%), lack of time (51.4%), as well as the belief that patients find it too difficult to change their current habits (54.1%). Conclusion The results of our survey indicate that nurses' participation in healthy lifestyle counseling in adult patients is unsatisfactory. Interventions in primary care should be designed considering the specific obstacles nurses may face in leading healthy lifestyles. Further training of nursing staff is required to increase their knowledge on healthy lifestyles.
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Affiliation(s)
- Małgorzata Znyk
- Department of Hygiene and Epidemiology, Medical University of Lodz, Lodz, Poland
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6
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Cazalis A, Lambert L, Auriacombe M. Stigmatization of people with addiction by health professionals: Current knowledge. A scoping review. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 9:100196. [PMID: 38023342 PMCID: PMC10656222 DOI: 10.1016/j.dadr.2023.100196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023]
Abstract
Background Stigma of people with substance and non-substance use disorders (SNSUD) is a long-known phenomenon. The aim of this review was to assess the stigmatization, by health professionals, of people with SNSUD, its characteristics and change over time. Methods A scoping review of literature reviews was conducted with systematic search of PubMed, Scopus and PsycINFO databases. Results From the 19 selected reviews, all focused on people with SUD (PWSUD) only and 20 % to 51 % of health professionals had negative attitudes/beliefs about SUD. Addiction training and clinical experience with PWSUD were associated with a less negative attitude. Health professionals' negative beliefs, lack of time or support were associated with less involvement in addiction care. Tobacco use disorder, SUDs other than alcohol and tobacco, relapse, psychiatric comorbidity or criminal records were associated with a more negative attitude. The influence of several variables potentially related to stigmatization was inconsistent across selected reviews. The evolution of stigmatization over time was not systematically assessed and showed mixed results. Conclusions The stigmatization of PWSUD has an impact on their care, and a change in some variables could reduce its importance: moral model of addiction, health professionals' negative beliefs, lack of training, time, and role support. Teaching what addiction is according to the medical chronic disease model, and developing stigma-focused training could improve caregivers' attitudes and further reduce stigma. Further studies are needed to determine whether stigma of PWSUD by health professionals has changed over time and to characterize stigma for people with non-substance use disorders.
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Affiliation(s)
- Anthony Cazalis
- University of Bordeaux, Bordeaux, France
- Addiction Team, Sleep, Addiction and Neuropsychiatry, (Sanpsy), Centre National de la Recherche Scientifique (CNRS) Unité mixte de recherche (UMR) 6033, University of Bordeaux, Bordeaux, France
- Pôle interétablissement d'Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Laura Lambert
- University of Bordeaux, Bordeaux, France
- Addiction Team, Sleep, Addiction and Neuropsychiatry, (Sanpsy), Centre National de la Recherche Scientifique (CNRS) Unité mixte de recherche (UMR) 6033, University of Bordeaux, Bordeaux, France
- Pôle interétablissement d'Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Marc Auriacombe
- University of Bordeaux, Bordeaux, France
- Addiction Team, Sleep, Addiction and Neuropsychiatry, (Sanpsy), Centre National de la Recherche Scientifique (CNRS) Unité mixte de recherche (UMR) 6033, University of Bordeaux, Bordeaux, France
- Pôle interétablissement d'Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
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7
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Priya H, Deb Barma M, Purohit BM, Agarwal D, Bhadauria US, Tewari N, Gupta S, Mishra D, Morankar R, Mathur VP, Duggal R. Global Status of Knowledge, Attitude and Practice on Tobacco Cessation Interventions Among Dental Professionals: A Systematic Review. Tob Use Insights 2022; 15:1179173X221137218. [PMID: 36601000 PMCID: PMC9806401 DOI: 10.1177/1179173x221137218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 10/19/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND With the emergence of the WHO Framework Convention on Tobacco Control, globally the use of tobacco has decreased notably, although, it still requires efforts at individual, organizational, community level to decrease the rate further. Dental professionals are at an excellent position to provide tobacco cessation counselling and interventions, however, it is not practiced much due to lack of training and lack of knowledge. Therefore, this systematic review was conducted to assess the global status of knowledge, attitude and practice on tobacco cessation interventions among dental professionals. MATERIALS AND METHOD A systematic search of 6 databases with no language restriction since 2000 was undertaken. Studies were included if they assessed knowledge, attitude and practice on tobacco cessation interventions among dental professionals using a validated or prevalidated tool. The data obtained for assessment of knowledge, attitude, practice, curriculum and barriers were represented through heatmaps. Quality assessment of the studies was done using Newcastle Ottawa scale. RESULTS Fifty six studies were included in this systematic review. Majority of the studies were found to be of moderate quality. Knowledge regarding the tobacco cessation interventions was more theoretical than practical. All the studies showed a favorable attitude among dental professionals towards tobacco cessation intervention. CONCLUSION The included studies lack homogeneity in assessing knowledge, attitude and practice on tobacco cessation interventions. The development and validation of a standardized questionnaire to assess knowledge, attitude and practice on tobacco cessation interventions could be a potentially effective way to uniformly gather data on the subject.
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Affiliation(s)
- Harsh Priya
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India.,Harsh Priya, Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of
Medical Sciences, 110029, CDER, New Delhi 110029, India.
| | - Manali Deb Barma
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Bharathi M Purohit
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Deepali Agarwal
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Upendra Singh Bhadauria
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Nitesh Tewari
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Shalini Gupta
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Deepika Mishra
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Rahul Morankar
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
| | - Ritu Duggal
- Division of Public Health
Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. National Oral Health
Program, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Pedodontics
and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral Medicine
and Radiology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Division of Oral
Pathology, Centre for Dental Education and Research, All India Institute of Medical
Sciences, New Delhi, India. Chief, Centre for Dental
Education and Research, All India Institute of Medical
Sciences, New Delhi, India
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Chen Y, Wang P, He Y, Jiang F, Liu H, Liu Y, Liu T, Tang YL, Zhu J. Gender differences in the association between lifestyle behaviors and mental health among psychiatrists in China. J Affect Disord 2022; 318:196-203. [PMID: 36041580 DOI: 10.1016/j.jad.2022.08.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Mental health symptoms are common among health professionals and the influence of lifestyle behaviors on psychiatrists' mental health is insufficiently understood. Based on a nationwide sample, we aimed to survey the lifestyle behaviors and mental health status among psychiatrists, and to identify the co-occurrence and gender differences in lifestyle behaviors. METHODS Data were collected through an anonymous questionnaire among psychiatrists in China. Depression, Anxiety and Stress Scale - 21 (DASS-21) was used to evaluate mental health symptoms. Latent class analysis (LCA) was used to explore the co-occurrence of lifestyle behaviors. The multivariate logistic regression model was used to examine the effects of demographic and lifestyle factors. RESULTS 4520 psychiatrists were included in the analysis with 11.5 % of them reporting smoking, 10 % reporting alcohol misuse, 35.2 % reporting physical inactivity, and 23.1 % reporting insomnia. The prevalence of depression, anxiety and stress symptoms were 29.2 %, 34.5 %, and 12.2 %, respectively. Significant gender differences were found in smoking (P < 0.001), alcohol misuse (P < 0.001), and physical inactivity (P < 0.001), but not in insomnia. Based on these four high-risk health behaviors above, three lifestyle behavior clusters with huge gender differences were identified through the LCA. Accordingly, the unhealthy lifestyle classes, though defined differently for males and females, were significantly associated with depression, anxiety, and stress. CONCLUSIONS The co-occurrence and significant gender differences in multiple lifestyle behaviors exist in this group, highlighting the need for gender-specific comprehensive interventions against mental health symptoms and the urgency of promoting their well-being.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, USA; Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioural Sciences, Emory University, Atlanta, USA.
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Zapata I, Maté-Muñoz JL, Higueras A, Hernández-Lougedo J, Martín-Fidalgo N, García-Fernández P, Redondo-Vega MV, Ruiz-Tovar J. Toxic Habits and Well-Being Measures in Spanish Healthcare University Students during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013213. [PMID: 36293793 PMCID: PMC9603594 DOI: 10.3390/ijerph192013213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND Unhealthy lifestyles are strongly entrenched in healthcare universities and have sometimes been linked to stress or lack of sleep. This study investigated the prevalence of toxic habits (smoking, patterns of harmful alcohol use, and illicit drug use), stress levels, perceived health status, and sleep duration and assessed the connections between toxic habits and said well-being measures, as well as healthcare students' perception of the influence of the COVID-19 pandemic on these health-related behaviors. METHODS In a cross-sectional study, healthcare students from Alfonso X University (Spain) completed a health survey composed of Alcohol Use Disorders Identification Test (AUDIT-C), Perceived Stress Scale (PSS-10), self-perceived health status, and the number of hours of sleep. RESULTS A total of 997 healthcare students completed the survey, of which 982 were analyzed. Being a smoker (32.2%) was associated with worse health status and insufficient sleep. Risk drinkers (33.2%) were associated with being female, and the consumption of cannabinoids (6.7%), with being male. These three toxic habits were related to each other. High levels of stress (28.2%) were correlated with worse ratings in the perception of health status (29.2%) and with insufficient sleep (45.8%), and all of them were associated with the female sex. Respectively, 49.3% and 44.2% of students recognized a worsening in their perception of stress and their sleep habits during the pandemic. CONCLUSION Healthcare universities must carry out health promotion programs for stress management, sleep habits, and unhealthy lifestyles.
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Affiliation(s)
- Irene Zapata
- Department of Medicine, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - José Luis Maté-Muñoz
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
| | | | - Juan Hernández-Lougedo
- Department of Physical Activity and Sports Science, Alfonso X El Sabio University, 28691 Madrid, Spain
| | | | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
- IdISSC, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
| | | | - Jaime Ruiz-Tovar
- Department of Medicine, Alfonso X El Sabio University, 28691 Madrid, Spain
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10
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Keyworth C, Epton T, Goldthorpe J, Calam R, Armitage CJ. Delivering Opportunistic Behavior Change Interventions: a Systematic Review of Systematic Reviews. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:319-331. [PMID: 32067156 PMCID: PMC7056685 DOI: 10.1007/s11121-020-01087-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Opportunities for healthcare professionals to deliver health behavior change interventions are often missed, but understanding the barriers and enablers to this activity is limited by a focus on defined specialisms/health conditions. This systematic review of systematic reviews collates all the evidence across professional groups to provide guidance to policy makers for implementing healthcare professional delivery of behavior change interventions. Eight electronic databases were searched for systematic reviews reporting patient-facing healthcare professionals’ (e.g., general practitioners, nurses) barriers and enablers to delivering behavior change interventions (diet, physical activity, alcohol reduction, smoking cessation, and weight management). A narrative synthesis was conducted. Thirty-six systematic reviews were included. Four themes emerged as both barriers and enablers: (1) perceptions of the knowledge or skills needed to support behavior change with patients, (2) perceptions of the healthcare professional role, (3) beliefs about resources and support needed, and (4) healthcare professionals’ own health behavior. There were four cross-disciplinary barriers: (1) perceived lack of time, (2) perceived lack of prioritization of health behavior change, (3) negative attitudes towards patients and perceptions of patient risk, and (4) perceptions of patient motivation. The three enablers were as follows: (1) training, (2) context, and (3) attitudes towards delivering interventions. To enhance healthcare professionals’ delivery of behavior change interventions, policy makers should (a) address perceptions about patient need for interventions, (b) support diverse professional groups to identify opportunities to deliver interventions, and (c) encourage professionals to focus on prevention and management of health conditions.
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Affiliation(s)
- Chris Keyworth
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Coupland 1 Building-Room G3, Oxford Road, Manchester, M13 9PL, UK.
| | - Tracy Epton
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Coupland 1 Building-Room G3, Oxford Road, Manchester, M13 9PL, UK
| | - Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Coupland 1 Building-Room G3, Oxford Road, Manchester, M13 9PL, UK
| | - Rachel Calam
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Coupland 1 Building-Room G3, Oxford Road, Manchester, M13 9PL, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Coupland 1 Building-Room G3, Oxford Road, Manchester, M13 9PL, UK.,Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, M13 9PL, Manchester, UK
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11
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AlMulla A, Kouyoumjian S, ElNakib N. Cross-sectional online survey to determine the prevalence, knowledge, attitude and practice of tobacco cessation among governmental healthcare workers in Qatar. BMJ Open 2021; 11:e044379. [PMID: 33795305 PMCID: PMC8023729 DOI: 10.1136/bmjopen-2020-044379] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES One effective approach of tobacco control is to encourage the role and the participation of healthcare workers in the prevention efforts against tobacco use. This study aimed to determine the prevalence of tobacco use among governmental healthcare workers in Qatar, to assess healthcare workers' knowledge, attitude and practice of tobacco cessation and to predict factors associated with above average tobacco cessation practice scores. DESIGN A cross-sectional survey study was conducted among healthcare workers working in Hamad Medical Corporation and Primary Healthcare Centres in Qatar using a self-administered online questionnaire in 2019. SETTING Hamad Medical Corporation and Primary Healthcare Centres in Qatar. PARTICIPANTS Governmental healthcare workers aged 18 years and above (n=7214). RESULTS The response rate of our online survey was 20.6% (7214/35 000). Of the 7214 healthcare workers, 16.3% (n=1178) were current tobacco users. In particular, the prevalence of tobacco use among physicians was 11.0%. Fifty-two per cent of healthcare workers (n=2338) attained an average knowledge score (12-17), 71.8% (n=3094) attained positive attitude scores (8-12) and 57.1% (n=3052) attained above average practice scores (12-26). Among the different professions, physicians were having the highest mean knowledge (15.3±4.7), attitude (9.4±1.9) and practice (13.7±6.1) scores. Multivariate analysis showed that having good knowledge (adjusted OR (AOR)=2.8; p<0.0001) and training (AOR=2.4; p<0.0001) were the strongest factors associated positively with above average tobacco cessation practice scores. CONCLUSIONS Healthcare workers in Qatar have a relatively similar prevalence of tobacco use than earlier studies with no significant increase. Investing more in training programmes for healthcare workers are needed to root out this negative behaviour and to increase their skills to assist users to quit.
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Affiliation(s)
- Ahmad AlMulla
- Medicine, Tobacco Control Center, WHO Collaborative Center, Hamad Medical Corporation, Doha, Qatar
| | - Silva Kouyoumjian
- Medicine, Tobacco Control Center, WHO Collaborative Center, Hamad Medical Corporation, Doha, Qatar
| | - Nour ElNakib
- Medicine, Tobacco Control Center, WHO Collaborative Center, Hamad Medical Corporation, Doha, Qatar
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12
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Meijer E, Chavannes NH. Lacking willpower? A latent class analysis of healthcare providers' perceptions of smokers' responsibility for smoking. PATIENT EDUCATION AND COUNSELING 2021; 104:620-626. [PMID: 32943247 DOI: 10.1016/j.pec.2020.08.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/29/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Healthcare providers' (HCPs) perceptions of smokers' responsibility for smoking may affect implementation of smoking cessation care (SCC), but are understudied. This study examined Dutch HCPs' perceptions of smokers' responsibility for smoking, and how many and which subgroups exist with regard to these perceptions. METHODS Observational cross-sectional study among physicians and other HCPs (N = 570). Latent class analysis was used to analyse data. RESULTS Results showed two latent classes of HCPs: a majority (77 %) that appeared to hold smokers themselves more accountable for their smoking, and a minority (23 %) that seemed more inclined to believe that people smoked as a consequence of factors such as addiction, and smoking initiation when people were young and could not foresee consequences. The two-class model showed excellent certainty in classification. Class membership was associated with age, working experience, and smoking status. The majority class experienced more barriers to SCC than the minority class and provided SCC tasks to fewer patients. CONCLUSIONS HCPs' perceptions of smokers' responsibility for smoking relate to HCP background characteristics, barriers to SCC and implementation of SCC. PRACTICE IMPLICATIONS New approaches to improving SCC might be needed that take HCP's perceptions of smokers' responsibility into account.
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Affiliation(s)
- E Meijer
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - N H Chavannes
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands.
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13
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Balogh E, Wagner Z, Faubl N, Riemenschneider H, Voigt K, Terebessy A, Horváth F, Füzesi Z, Kiss I. Tobacco Smoking and Smokeless Tobacco Use among Domestic and International Medical Students in Hungary. Subst Use Misuse 2021; 56:493-500. [PMID: 33557674 DOI: 10.1080/10826084.2021.1879150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Medical students as future physicians will have an important role in tobacco control; therefore, their tobacco use behavior is of particular interest. Consumption of combustible tobacco (cigarettes, waterpipes, cigars, and pipes) is prevalent throughout Europe, whereas smokeless tobacco use is common mainly in the Nordic countries. Objectives: Aim of our study is to assess tobacco use among medical students from different countries studying in Hungary with special focus on students from Norway where smokeless tobacco is widely used. A self-administered questionnaire survey was carried out to measure current tobacco use. Results: The survey included 1337 students from Hungary, Norway, Germany, and from other countries (Multinational group). The lowest prevalence of cigarette smoking was found among students from Norway (13.0%) when compared with students from Hungary (21.5%), Germany (34.2%), or with students in the Multinational group (29.5%). Conversely, prevalence of smokeless tobacco use was the highest among students from Norway (40.9%) when compared with students from Hungary (1.4%), Germany (2.6%), or with students in the Multinational group (6.2%). Waterpipes, cigars, and pipes were rarely used, mostly only 1-3 times a month in all groups. More than half of Norwegian students used some form of tobacco (smokeless and/or combustible tobacco). Conclusions: Considering the impending role of medical students in tobacco control, faculties of medicine should sensitize their students on the topic of possible health risks associated with combustible and smokeless tobacco products. Culturally tailored tobacco cessation programs need to be offered to medical students coming from different cultural backgrounds.
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Affiliation(s)
- Erika Balogh
- Department of Public Health Medicine, University of Pécs Medical School, Pécs, Hungary
| | - Zoltán Wagner
- Diabetes Outpatient Clinic, United Health Institutions, Pécs, Hungary
| | - Nóra Faubl
- Department of Behavioral Sciences, University of Pécs Medical School, Pécs, Hungary
| | - Henna Riemenschneider
- Department of General Practice, Medical Clinic 3, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Karen Voigt
- Department of General Practice, Medical Clinic 3, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - András Terebessy
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Ferenc Horváth
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Zsuzsanna Füzesi
- Department of Behavioral Sciences, University of Pécs Medical School, Pécs, Hungary
| | - István Kiss
- Department of Public Health Medicine, University of Pécs Medical School, Pécs, Hungary
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Chakraborty A, Chatterjee K, Ray A. Authors' reply to Ghosh et al. and Biswas. CANCER RESEARCH, STATISTICS, AND TREATMENT 2021. [DOI: 10.4103/crst.crst_312_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Gucuk S, Tokur Kesgin M, Turken Gel K, Yorgun S. Determining The Relationship Between Smoking Habits and Healthy Lifestyle Behaviors of Health Workers: Smoke-Free Hospital, Healthy Life. EURASIAN JOURNAL OF FAMILY MEDICINE 2020. [DOI: 10.33880/ejfm.2020090402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Using tobacco and tobacco products is an important public health issue. This study aims to determine the smoking status of hospital staff and to examine the relationship between their smoking habits and healthy lifestyle behaviors.
Methods: This cross-sectional study was carried out between March and September 2018 with 387 health workers in Izzet Baysal Training and Research Hospital affiliated to Bolu Abant Izzet Baysal University. Data were collected using the Healthy Lifestyle Behaviors Scale II and the Fagerstrom Test for Nicotine Dependence, which were applied via face-to-face interview technique to health workers who accepted to participate in the study.
Results: The study sample consisted of 387 health workers. Of them, 58.7% of the participants were exposed to smoking in the workplace, and 75.9% of the nonsmokers were exposed to smoking environment, which was statistically significantly high. A statistically significant difference was found between the health workers’ Healthy Lifestyle Behaviors Scale mean scores with respect to gender, smoking status, being in a smoking environment, and duration of smoking.
Conclusion: Determining the relationship between smoking habits and healthy lifestyle behaviors of health workers, identifying their negative or incomplete behaviors in this regard, and developing training and support programs for their relevant needs are considered to positively affect the images of health workers in society, and thus to increase healthcare quality and satisfaction.
Keywords: health personnel, smoking cessation, healthy lifestyle
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Affiliation(s)
| | | | | | - Songul Yorgun
- Bolu Abant Izzet Baysal University Training and Research Hospital
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16
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Sendall MC, Brodie A. Postgraduate health promotion students' perceptions of at-risk populations: Those who smoke tobacco, are overweight or obese or drink alcohol at hazardous levels. PLoS One 2020; 15:e0241076. [PMID: 33091087 PMCID: PMC7580928 DOI: 10.1371/journal.pone.0241076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/07/2020] [Indexed: 11/19/2022] Open
Abstract
Perceptions acquired during tertiary health promotion education can influence students’ interactions with their future service-users. Reflective practice can highlight these perceptions. Here we describe the findings of a reflective exercise conducted with postgraduate health promotion students as part of a learning activity. Students (n = 44) reflected on their understandings of at-risk populations in three priority areas—tobacco, obesity and alcohol. The activity aimed to deconstruct students’ understandings of these populations and identify understandings juxtaposed to the philosophical underpinnings of health promotion, for addressing through teaching and learning. Thematic analysis revealed students’ understanding of all three at-risk populations fit within five themes: apathy/lack of altruism, complexity/choice, pressure/control, escaping /excuses, and environmental contexts. Students also have varying levels of tolerance to at-risk populations, expressing greatest tolerance towards those whose addiction undermines choice and self-control, and least towards those who are overweight/obese or whose behaviour causes risk to others. Our findings show reflective practice is a valuable tool to help educators understand students’ attitudes and values and implement changes to support their future role in the community.
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Affiliation(s)
- Marguerite C. Sendall
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- * E-mail:
| | - Alison Brodie
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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17
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Martin-Cantera C, Sanmartín JMI, Martínez AF, Lorenzo CM, Cohen VB, Jiménez MLC, Pérez-Teijón SC, Osca JARI, García RC, Fernández JL, Domenech MAG, Navascues MAM, Chaves ES, Ibañez MLR, Rubio VG, Rayo SM, Otero BM, Lopez LG, Guillem FC, Fuente FM, Ruiz DB, Rodríguez AIH, Caballero JDDG, Moreno CB, Pubil MP, Grau ML. Good practice regarding smoking cessation management in Spain: Challenges and opportunities for primary care physicians and nurses. Tob Prev Cessat 2020; 6:55. [PMID: 33083683 PMCID: PMC7552853 DOI: 10.18332/tpc/126630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/27/2020] [Accepted: 08/21/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION We analyze the activities carried out by primary care (PC) physicians and nurses with respect to smoking cessation and evaluate their self-reported training, knowledge, and behavior. METHODS A cross-sectional study was conducted including 1514 PC physicians and nurses from June 2016 to March 2017, in Spain. The main variable was Good Practice (GP) in attention to smokers. To identify associated factors, a multilevel logistic regression model was used adjusted for sex, age, type of center, contract, years of employment, tobacco consumption, and self-reported training/knowledge. RESULTS Of the 792 physicians and 722 nurses, 48.6% referred to GP in smoking cessation management. The finding related to: being a non-smoker (OR=1.8; 95% CI: 1.2–2.5) or ex-smoker (OR=1.4; 95% CI: 1.02–2.1), having a good level of knowledge (OR=1.8; 95% CI: 1.3–2.4) and training (OR=2.4; 95% CI: 1.8–3.2), and, to a lesser extent, being female (OR=1.3; 95% CI: 1.03–1.7), and work experience >10 years (OR=1.4; 95% CI: 1.03–1.9). The main GP barriers were: lack of time (45.5%), organizational problems (48.4%), and 35.4% lack of training. CONCLUSIONS The GP of PC physicians and nurses regarding smoking cessation management is related to being non-smokers or ex-smokers, and having sufficient training and knowledge. Lack of time and organizational problems were considered to be the main barriers. The promotion of training activities in the Spanish National Health Service with the support of scientific societies is required.
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Affiliation(s)
- Carlos Martin-Cantera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain.,Grupo Abordaje al Tabaquismo SemFYC, Barcelona, Spain
| | - Jose M Iglesias Sanmartín
- Unidad Especializada de Tabaquismo del Área Sanitaria IV del Principado de Asturias, Asturias, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Diego Beni Ruiz
- Consultorio de Aldeanueva de Ebro, Centro de Salud Alfaro, La Rioja, Spain
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18
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Bauer-Kemeny C, Lis IV, Raupach T, Kreuter M. Tobacco Use, Knowledge about Smoking-Associated Risks, and Cessation Programs among Dental Students in Germany - ToDent. Respiration 2020; 99:764-770. [PMID: 33045709 DOI: 10.1159/000509611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/22/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Professional and consistent smoking prevention and cessation may avoid many smoking-associated deaths worldwide. Dentists can exert a decisive influence on smoking behavior, as most people regularly visit a dentist. However, only if dentists have been trained sufficiently about the consequences of smoking and of smoking cessation methods might they fulfill this task appropriately. OBJECTIVES The aim of our study was therefore to examine the prevalence of smokers among dental students in Germany, their attitude toward smoking in general, and their knowledge about tobacco-related diseases and smoking cessation programs. METHODS A cross-sectional survey among dental students in Germany was conducted in 2016. Students of the first and tenth semesters were asked to participate in this anonymous survey. The questionnaire included items concerning their own smoking habits, their knowledge about effects of smoking on health, and their attitude toward prevention and cessation in a dental setting. RESULTS Seven hundred and thirty dental students participated in this survey; 21% of the participating students were smokers. Their knowledge about smoking-related diseases was widespread. Some diseases were rarely known (only in 34% of students) and others were well known (in 99% of the students). Knowledge about health risks of e-cigarettes was low. About 30% of the participating students felt competent to encourage and support patients in cessation strategies; 2 out of 3 students were willing to improve their knowledge in that area. More than 85% confirmed that advice for smoking cessation should be one of the tasks of a dentist. CONCLUSIONS Smoking is common among dental students, their knowledge about smoking-related health risks is moderate, and self-perceived smoking cessation skills are poor. More emphasis should be placed on education regarding smoking prevention and cessation methods.
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Affiliation(s)
- Claudia Bauer-Kemeny
- Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, German Center for Lung Research, Heidelberg, Germany,
| | - Ilona Verena Lis
- Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, German Center for Lung Research, Heidelberg, Germany.,Dental Office, Bruchsal, Germany
| | - Tobias Raupach
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany.,Division of Medical Education Research and Curriculum Development, Study Deanery of University Medical Centre Göttingen, Göttingen, Germany
| | - Michael Kreuter
- Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, German Center for Lung Research, Heidelberg, Germany
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19
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Hichisson AD, Corkery JM. Alcohol/substance use and occupational/post-traumatic stress in paramedics. ACTA ACUST UNITED AC 2020. [DOI: 10.12968/jpar.2020.12.10.388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Paramedics work in high-pressure environments and experience traumatic events, which contribute to high levels of occupational and post-traumatic stress. Such stress can result in alcohol and substance misuse in other health professionals, but this relationship has not been examined in paramedics. This review is the first exploration of the literature on this. Methods: A systematic literature review was conducted using PRISMA guidelines, with databases searched using terms relevant to paramedics and alcohol/substance use. Studies were analysed using descriptive statistics for quantitative data and thematic analysis for qualitative information. Findings: Eleven studies were identified. Nine studies examined alcohol use; seven examined substance use; five examined both. Alcohol and smoking may be linked to occupational stress. Conclusions: The nature and extent of alcohol and substance use in relation to occupational and post-traumatic stress among paramedics need further investigation to facilitate advice and support.
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Affiliation(s)
- Andrew David Hichisson
- Advanced Paramedic Practitioner (Urgent Care), Medical Directorate, London Ambulance Service NHS Trust
| | - John Martin Corkery
- Senior Lecturer in Pharmacy Practice and Module Lead for Online Masters in Public Health, University of Hertfordshire, Hatfield
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20
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Abstract
Accruing evidence strongly suggests that the motivation to give up smoking is a crucial predictor of tobacco cessation attempt. However, even motivated people often fail in their attempts and relapse is very common, even if most people who smoke are confident that the desire to quit is enough to change and maintain abstinence. According to this framework, the main objective of the current study was to identify psychological and lifestyle patterns that might characterize people who smoke cigarettes with different motivations to quit. A secondary aim was to compare the characteristics of people who are currently smoking with people who stopped or never smoked. A convenient sample of 360 volunteers (179 women, 181 men), with a mean age of 55 years (SD = 14.33), participated in this study. Participants completed a battery of psychological and behavioral scales aimed at assessing psychological characteristics as well as dependence level and readiness to stop. Our results strongly suggest that the behavior of people who smoke differs as a function of specific psychological variables. People who currently smoke may fall into two different clusters: In the first one, they have a healthy lifestyle and high self-perceived vitality and vigor, whereas those who fall in the second report lower psychological well-being and an unhealthier lifestyle. Unfortunately, the actual lifestyle does not seem to modulate the motivation to quit, and consequently, people keep on smoking anyway, although some participants tend to adopt compensative behaviors. However, the adoption of a healthier lifestyle might favor a successful cessation attempt once a ready-to-stop motivation level is achieved.
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Zhang L, Li J, Lv Y, Yang X, Bai L, Luo Y, Chen Y, Zhao Y. Impact of tobacco control auxiliary resources on the 5As behavior in nursing interns: Self-reports from students. Tob Induc Dis 2020; 18:65. [PMID: 32818028 PMCID: PMC7425755 DOI: 10.18332/tid/125231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/04/2020] [Accepted: 07/12/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The help of healthcare professionals for smokers to quit is critically important to increase quit rates. In the future, internship nursing students will potentially become the largest population of medical professionals. This study explored the impact of the use and awareness of universal tobacco control auxiliary resources on nursing students’ 5As behavior in helping patients to quit smoking during a 40-week clinical internship in the last year of nursing school in Chongqing, China. METHODS A survey was conducted in 13 teaching hospitals selected from 29 in Chongqing, China, in 2019, by a random cluster sampling method. It investigated, by self-reported questionnaires, student 5As behavior in helping patients to quit smoking and use and knowledge of tobacco cessation auxiliary resources (tobacco cessation self-education manual, tobacco cessation guidelines, tobacco cessation drugs, tobacco cessation websites, and hotline). The relationship between tobacco cessation auxiliary resources and 5As behavior in helping patients to quit smoking was analyzed with a multivariate linear mixed-effect model. RESULTS In all, 534 (39.3%) students, of a total of 1358, reported that the majority of internship units provided a tobacco control self-education manual; 674 (49.6%) ever skimmed through tobacco cessation guidelines; 641 (47.2%) browsed tobacco cessation websites; 738 (54.3%) knew some cessation-assistance drugs; and 93 (6.8%) knew of and could recall the tobacco cessation hotline. Except for tobacco cessation websites, tobacco cessation auxiliary resources affected nursing interns’ 5As behavior in helping patients to quit (p<0.05). CONCLUSIONS Tobacco cessation auxiliary resources influenced students’ 5As behavior in helping patients to quit smoking. Students knew a little of tobacco cessation auxiliary resources. To improve students’ 5As behavior for helping patients to quit, more tobacco cessation resources need to be developed and more students need to become acquainted with them.
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Affiliation(s)
- Li Zhang
- College of Nursing, Chongqing Medical University, Chongqing, China
| | - Jun Li
- The Office of Chongqing Medical University, Chongqing, China
| | - Yalan Lv
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Xia Yang
- College of Nursing, Chongqing Medical University, Chongqing, China
| | - Li Bai
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Yetao Luo
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital, Chongqing Medical University, Chongqing, China
| | - Yanhan Chen
- College of Nursing, Chongqing Medical University, Chongqing, China
| | - Yong Zhao
- School of Public Health and Health Management, Chongqing Medical University, Chongqing, China
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Malin M, Jaakkola N, Luukkonen R, Heloma A, Lamminpää A, Reijula K. Occupational health professionals' attitudes, knowledge, and motivation concerning smoking cessation-Cross-sectional survey. J Occup Health 2020; 62:e12145. [PMID: 32701202 PMCID: PMC7377039 DOI: 10.1002/1348-9585.12145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Occupational health (OH) professionals could play a prominent role in smoking cessation treatment and support (SCTS) and help individuals and workplaces become smoke free. However, their role has not been evaluated. The aim of this study was to assess differences between OH professionals' perceptions of their role in SCTS by measuring three groups of OH professionals' attitudes, knowledge, and motivation concerning SCTS. METHODS We collected data through an online survey completed by a cross-sectional sample of OH professionals: OH physicians (n = 182), OH nurses (n = 296), and OH physiotherapists (n = 96), collected from national trade union registers. The differences between the OH professional groups were analyzed using ANOVA, the Kruskal-Wallis, and chi-square tests. RESULTS The OH professionals had a positive attitude toward offering SCTS and were highly motivated to enhance their knowledge of this topic and acquire further training. The OH physicians and OH nurses assessed their current knowledge as sufficient. Conversely, the OH physiotherapists' level of knowledge was seen as insufficient. Traditionally, OH physicians and OH nurses have been responsible for carrying out SCTS, but the majority of the OH physiotherapists thought that SCTS should also be included in their job description. CONCLUSIONS All the OH professionals were highly motivated to deepen their knowledge of SCTS. The barriers between different professionals need to be recognized in occupational health services (OHS). OHS should organize its SCTS more effectively, strengthen their contributions to smoking cessation programs, and recognize the potential of OH physiotherapists for providing SCTS and enable them to expand their training.
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Affiliation(s)
- Maarit Malin
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Nina Jaakkola
- The Social Insurance Institution of FinlandHelsinkiFinland
| | - Ritva Luukkonen
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Antero Heloma
- National Institute for Health and WelfareHelsinkiFinland
| | - Anne Lamminpää
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Kari Reijula
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
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Xia L, Jiang F, Rakofsky J, Zhang Y, Zhang K, Liu T, Liu Y, Liu H, Tang YL. Cigarette Smoking, Health-Related Behaviors, and Burnout Among Mental Health Professionals in China: A Nationwide Survey. Front Psychiatry 2020; 11:706. [PMID: 32765329 PMCID: PMC7379885 DOI: 10.3389/fpsyt.2020.00706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/06/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Mental health professionals (MHPs) play an important role in treating patients with nicotine addiction. However, data on MHPs' cigarette smoking habits are scarce. This survey aimed to collect such data and to examine the correlates of smoking among MHPs working in China. METHODS A cross-sectional survey was conducted in all 41 provincial, tertiary psychiatric hospitals, and MHPs from these hospitals were targeted. An anonymous questionnaire was designed to collect socio-demographic and occupational factors, and the Maslach Burnout Inventory-Human Service Survey was used to assess burnout. Data about smoking and other health behaviors were also collected. RESULTS In total, 13,614 MHPs were included in the analysis. The overall rate of current smoking was 8.6% (31.3% in males, and 1.1% in females). A substantial proportion (28.0%) of life-time smokers had abstained for more than 3 months. Those who were male (OR=37.73), older (OR=1.02), divorced or widowed (OR=1.72), working in West (OR=1.45), and Northeast China (OR=1.65), were nurses (OR=1.44), had a high income (OR=1.31), experienced burnout (OR=1.29), frequent insomnia (OR=1.39), and used alcohol (OR=2.76) were significantly more likely to be smokers, while those who had a higher level of education (OR=0.67, 0.47, and 0.43 for college, master, and doctorate degrees, respectively), and exercised regularly (OR=0.73) were significantly less likely to be smokers. CONCLUSION Although lower than that of the general population in China, smoking is still relatively high among MPHs. Efforts to lower smoking rates among MHPs in China should continue and should incorporate strategies that target burnout, sleep, alcohol use, exercise and other factors associated with smoking.
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Affiliation(s)
- Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Feng Jiang
- Public Health School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Research Center for Public Health, Tsinghua University, Beijing, China
| | - Jeffrey Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Yuanli Liu
- Public Health School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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Facilitating smoking cessation in patients who smoke: a large-scale cross-sectional comparison of fourteen groups of healthcare providers. BMC Health Serv Res 2019; 19:750. [PMID: 31653215 PMCID: PMC6815021 DOI: 10.1186/s12913-019-4527-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 09/11/2019] [Indexed: 01/10/2023] Open
Abstract
Background Although healthcare providers are well placed to help smokers quit, implementation of smoking cessation care is still suboptimal. The Ask-Advise-Refer tasks are important aspects of smoking cessation care. We examined to which extent a large and diverse sample of healthcare providers expressed the intention to implement smoking cessation care and which barriers they encountered. We moreover examined to which extent the Ask-Advise-Refer tasks were implemented as intended, and which determinants (in interaction) influenced intentions and the implementation of Ask-Advise-Refer. Methods Cross-sectional survey among addiction specialists, anaesthesiologists, cardiologists, general practitioners, internists, neurologists, paediatricians, pulmonologists, ophthalmologists, surgeons, youth specialists, dental hygienists, dentists, and midwives (N = 883). Data were analysed using multivariate linear and logistic regression analyses and regression tree analyses. Results The Ask-Advice-Refer tasks were best implemented among general practitioners, pulmonologists, midwives, and addiction specialists. Overall we found a large discrepancy between asking patients about smoking status and advising smokers to quit. Participants mentioned lack of time, lack of training, lack of motivation to quit in patients, and smoking being a sensitive subject as barriers to smoking cessation care. Regression analyses showed that the most important determinants of intentions and implementation of Ask-Advise-Refer were profession, role identity, skills, guideline familiarity and collaboration agreements for smoking cessation care with primary care. Determinants interacted in explaining outcomes. Conclusions There is much to be gained in smoking cessation care, given that implementation of Ask-Advise-Refer is still relatively low. In order to improve smoking cessation care, changes are needed at the level of the healthcare provider (i.e., facilitate role identity and skills) and the organization (i.e., facilitate collaboration agreements and guideline familiarity). Change efforts should be directed towards the specific barriers encountered by healthcare providers, the contexts that they work in, and the patients that they work with.
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25
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Bourbon A, Boyer L, Auquier P, Boucekine M, Barrow V, Lançon C, Fond G. Anxiolytic consumption is associated with tobacco smoking and severe nicotine dependence. Results from the national French medical students (BOURBON) study. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109645. [PMID: 31082413 DOI: 10.1016/j.pnpbp.2019.109645] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/28/2019] [Accepted: 05/06/2019] [Indexed: 10/26/2022]
Abstract
UNLABELLED Tobacco smoking remains common among medical students, something which may impact on their abililty to promote smoking cessation during their future careers. OBJECTIVES To determine the prevalence of smoking and consumption among French medical students and explore the link between both the presence of psychosocial factors and consumption of psychotropic medication and the severity of nicotine dependence and daily smoking behavior. METHODS Medical students were recruited from 35 French universities of medicine through administration mailing lists and social networks, between December 13, 2016 and May 15, 2017. Data was collected via anonymized Internet questionnaire which included questions regarding current daily tobacco smoking behaviors. Severe nicotine dependence was defined by a short Fagerström test equal or >4. RESULTS 10,985 medical students with a mean aged of 21.8 years (+/-3.3) were included, 31.6% of which were male. 2078 (18.9%) were identified as current daily tobacco smokers and 59 (2.8%) were classed as having severe nicotine dependence. In multivariate analyses, tobacco smoking was independently associated with anxiolytic consumption, alcohol use disorder, cannabis use disorder, financial difficulties, and history of sexual and physical assault. Severe nicotine dependence was independently associated with anxiolytic consumption, cannabis use disorder, domestic violence, physical assault and financial difficulties. CONCLUSION Tobacco smoking has been found in almost one on 5 medical students and is associated with anxiolytic consumption as well as professional and personal factors.
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Affiliation(s)
- A Bourbon
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - L Boyer
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - P Auquier
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - M Boucekine
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - V Barrow
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - C Lançon
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - G Fond
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France.
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Nishi SPE, Zhou J, Kuo YF, Sharma G, Goodwin J. Trends in tobacco use and tobacco cessation counselling codes among Medicare beneficiaries, 2001-2014. BMC Health Serv Res 2019; 19:548. [PMID: 31382958 PMCID: PMC6683517 DOI: 10.1186/s12913-019-4368-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 07/23/2019] [Indexed: 11/30/2022] Open
Abstract
Background Analysis of Medicare data is often used to determine epidemiology, healthcare utilization and effectiveness of disease treatments. We were interested in whether Medicare data could be used to estimate prevalence of tobacco use. Currently, data regarding tobacco use is derived from Behavioral Risk Factor Surveillance System (BRFSS) survey data. We compare administrative claims data for tobacco diagnosis among Medicare beneficiaries to survey (BRFSS) estimates of tobacco use from 2001 to 2014. Methods Retrospective cross-sectional study comparing tobacco diagnoses using International Classification of Disease, Ninth Revision (ICD-9) codes for tobacco use in Medicare data to BRFSS data from 2001 to 2014 in adults age ≥ 65 years. Beneficiary data included age, gender, race, socioeconomic status, and comorbidities. Tobacco cessation counselling was also examined using Healthcare Common Procedure Coding System codes. Results The prevalence of Medicare enrollees aged ≥65 years who had a diagnosis of current tobacco use increased from 2.01% in 2001 to 4.8% in 2014, while the estimates of current tobacco use from BRFSS decreased somewhat (10.03% in 2001 vs. 8.77% in 2014). However, current tobacco use based on Medicare data remained well below the estimates from BRFSS. Use of tobacco cessation counselling increased over the study period with largest increases after 2010. Conclusions The use of tobacco-related diagnosis codes increased from 2001 to 2014 in Medicare but still substantially underestimated the prevalence of tobacco use compared to BRFSS data.
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Affiliation(s)
- Shawn P E Nishi
- Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA. .,Department of Preventive Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA. .,Division of Pulmonary Critical Care Medicine & Sleep, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0561, USA.
| | - Jie Zhou
- Department of Preventive Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Young-Fang Kuo
- Department of Preventive Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Gulshan Sharma
- Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA.,Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - James Goodwin
- Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA.,Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
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Keyworth C, Epton T, Goldthorpe J, Calam R, Armitage CJ. 'It's difficult, I think it's complicated': Health care professionals' barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations. Br J Health Psychol 2019; 24:571-592. [PMID: 30977291 PMCID: PMC6766974 DOI: 10.1111/bjhp.12368] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 02/15/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Internationally, public health strategies encourage health care professionals to deliver opportunistic behaviour change interventions. The present study: (1) examines the barriers and enablers to delivering interventions during routine consultations, and (2) provides recommendations for the design of interventions to increase delivery of opportunistic behaviour change interventions. DESIGN Qualitative interview study. METHODS Twenty-eight semi-structured interviews were conducted with patient-facing health care professionals. The Behaviour Change Wheel informed a framework analysis in which findings were mapped onto the Theoretical Domains Framework (TDF). Intervention functions and behaviour change techniques (BCTs) targeting each TDF domain were identified. RESULTS Health care professionals understood the importance of opportunistic behaviour change interventions (beliefs about consequences), but were sceptical about their capabilities to facilitate behaviour change with patients (beliefs about capabilities). Some clinicians were unwilling to discuss behaviours perceived as unrelated to the patient's visit (social/professional role and identity). Discipline-specific tasks were prioritized, and delivering interventions was perceived as psychologically burdensome. One-to-one contact was favoured over busy hospital settings (environmental context and resources). Seven intervention functions (training, restriction, environmental restructuring, enablement, education, persuasion, and modelling) and eight BCT groupings (antecedents, associations, comparison of outcomes, covert learning, feedback and monitoring, natural consequences, reward and threat, and self-belief) were identified. CONCLUSIONS Across disciplines, health care professionals see the value of opportunistic behaviour change interventions. Barriers related to workload, the clinical environment, competence, and perceptions of the health care professional role must be addressed, using appropriate intervention functions and BCTs, in order to support health care professionals to increase the delivery of interventions in routine practice. Statement of contribution What is already known on this subject? Brief, opportunistic interventions can be a cost effective way of addressing population health problems. Public health policies compel health care professionals to deliver behaviour change interventions opportunistically. Health care professionals do not always deliver interventions opportunistically during routine medical consultations; however the barriers and enablers are currently unclear. What does this study add? This is the first study to examine cross-disciplinary barriers and enablers to delivering opportunistic behaviour change interventions. Across diverse professional groups, working in different medical professions, participants saw the value of delivering opportunistic behaviour change interventions. Targeting key theoretical domains that are shared across professional groups may be useful for increasing the delivery of opportunistic behaviour change interventions.
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Affiliation(s)
- Chris Keyworth
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Tracy Epton
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Rachel Calam
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre and Manchester University NHS Foundation Trust (MFT), and NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, UK
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Hopman P, Springvloet L, de Josselin de Jong S, van Laar M. Quit-smoking counselling in Dutch midwifery practices: Barriers to the implementation of national guidelines. Midwifery 2018; 71:1-11. [PMID: 30623790 DOI: 10.1016/j.midw.2018.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 12/12/2018] [Accepted: 12/22/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Although smoking during pregnancy can have severe health consequences for the (unborn) child, 9% of Dutch pregnant women smoke at any time during their pregnancy. Midwives in the Netherlands are a responsible party in the provision of quit-smoking counselling for pregnant women by means of the 7-step `V-MIS' intervention, but in practice the implementation appears to be suboptimal. The purpose of the present study was to assess the provision of quit-smoking counselling by midwives, and to clarify the nature and extent of any existing barriers and needs in the provision of quit-smoking counselling in Dutch midwifery settings. METHODS An online questionnaire to the target population of Dutch midwives (N ≈ 3150) was set out in the spring of 2016. The questionnaire included items on the provision of quit-smoking counselling for pregnant women, and on possible barriers and needs regarding the provision of this counselling. Descriptive statistics were used to analyse weighed data from 135 midwives representative for the Dutch setting in terms of age, function, and region. RESULTS Eighty-one percent of the midwives inquire about smoking profile (V-MIS step 1) but only 10% go through all the V-MIS counselling steps (i.e. up to discussing postnatal passive smoking and smoke free breastfeeding, step 7). Although 74% of the midwives regard it as their task to provide quit-smoking guidance to pregnant women, 77% perceive referral to a professional as a useful strategy (mostly to the GP; 74%). For 61% of the midwives, their clients' lack of motivation undermines the provision of quit-smoking counselling. Other hindering factors are the perceived lack of free brochures (54%), simple tools or gadgets (51%), and financial consequences for the midwife (37%) and/or the client (22%). CONCLUSION The smoking cessation intervention strategy currently imposed in Dutch midwifery practices (V-MIS) is being used by midwives, however its implementation may considerably benefit from strengthening skills in motivational interviewing techniques, provision of supporting materials, and structural embedding of GP referral. Based on the study's findings, practical recommendations are made to facilitate the provision of quit-smoking counselling in (international) midwifery settings.
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Affiliation(s)
- Petra Hopman
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), da Costakade 45, Utrecht, VS 3521, the Netherlands; Netherlands Expertise Centre for Tobacco Control, Utrecht, the Netherlands.
| | - Linda Springvloet
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), da Costakade 45, Utrecht, VS 3521, the Netherlands; Netherlands Expertise Centre for Tobacco Control, Utrecht, the Netherlands
| | - Sanne de Josselin de Jong
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), da Costakade 45, Utrecht, VS 3521, the Netherlands
| | - Margriet van Laar
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), da Costakade 45, Utrecht, VS 3521, the Netherlands; Netherlands Expertise Centre for Tobacco Control, Utrecht, the Netherlands
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Meijer E, Kampman M, Geisler MS, Chavannes NH. "It's on everyone's plate": a qualitative study into physicians' perceptions of responsibility for smoking cessation. Subst Abuse Treat Prev Policy 2018; 13:48. [PMID: 30541580 PMCID: PMC6290505 DOI: 10.1186/s13011-018-0186-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little research has investigated in-depth how physicians perceive their role in smoking cessation care. This qualitative study sought to understand physicians' perceptions of responsibility for smoking cessation. METHODS Data were collected through individual semi-structured interviews and focus group interviews between June and November 2017 in The Netherlands. We interviewed 5 addiction specialists, 5 anesthesiologist, 4 cardiologists, 8 GPs, 5 internists, 5 neurologists, 2 pediatricians, 6 pulmonologists, 7 surgeons, and 8 youth healthcare physicians (N = 55). Data analysis followed the framework approach. RESULTS The analysis showed that three actors were perceived as responsible for smoking cessation: physicians, patients, and the government. Participants perceived physicians as responsible for facilitating smoking cessation -albeit to different extents-, patients as carrying the ultimate responsibility for quitting smoking, and the government as responsible for creating a society in which smoking uptake is more difficult and quitting smoking easier. Perceptions of smoking itself were found to be important for how participants viewed responsibility for smoking cessation. It remained unclear for many participants which healthcare provider is responsible for smoking cessation care. CONCLUSIONS The organization of smoking cessation care within health systems should be a focus of intervention, to better define physician roles and perceptions of responsibility. In addition, it seems important to target perceptions of smoking itself on the level of physicians and -as suggested by comments by several participants- the government.
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Affiliation(s)
- E. Meijer
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - M. Kampman
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - M. S. Geisler
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - N. H. Chavannes
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands
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Nilan K, McNeill A, Murray RL, McKeever TM, Raw M. A survey of tobacco dependence treatment guidelines content in 61 countries. Addiction 2018; 113:1499-1506. [PMID: 29488266 PMCID: PMC6099485 DOI: 10.1111/add.14204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/18/2017] [Accepted: 02/20/2018] [Indexed: 11/26/2022]
Abstract
AIMS To assess tobacco dependence treatment guidelines content in accordance with Article 14 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) and its guidelines, and association between content and country income level. DESIGN Cross-sectional study. SETTING On-line survey from March to July 2016. PARTICIPANTS Contacts in 77 countries, including 68 FCTC Parties, six Signatories and three non-Parties which had indicated having guidelines in previous surveys, or had not been surveyed before. MEASUREMENTS A nine-item questionnaire on guidelines content, key recommendations, writing and dissemination. FINDINGS We received responses from contacts in 63 countries (82%); 61 had guidelines. The majority are for doctors (93%), primary care (92%) and nurses (75%). All recommend brief advice, 82% recording tobacco use in medical notes, 98% nicotine replacement therapy (NRT), 61% quitlines, 31% text messaging and 87% intensive specialist support, and 54% stress the importance of health-care workers not using tobacco. Only 57% have a dissemination strategy, and 62% have not been updated for 5 or more years. Compared with high-income countries, quitlines are less likely to be recommended in upper middle-income countries guidelines [odds ratio (OR) = 0.15, 95% confidence interval (CI) = 0.04-0.61] and intensive specialist support in lower middle-income countries guidelines (OR = 0.01, 95% CI = 0.00-0.20). Guidelines updating is associated positively with country income level (P = 0.027). CONCLUSIONS Although most tobacco dependence treatment guidelines in the 61 countries assessed in 2016 follow the World Health Organization's Framework Convention on Tobacco Control Article 14 recommendations and do not differ significantly by income level, improvements are needed in keeping guidelines up-to-date, applying good writing practices and developing a dissemination strategy.
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Affiliation(s)
- Kapka Nilan
- UK Centre for Tobacco and Alcohol Studies, School of MedicineUniversity of NottinghamNottinghamUK
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol StudiesInstitute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College LondonLondonUK
| | - Rachael L. Murray
- UK Centre for Tobacco and Alcohol Studies, School of MedicineUniversity of NottinghamNottinghamUK
| | - Tricia M. McKeever
- UK Centre for Tobacco and Alcohol Studies, School of MedicineUniversity of NottinghamNottinghamUK
| | - Martin Raw
- New York University College of Global Public Health and NYU Medical SchoolNew YorkNYUSA
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Muñoz-Cifuentes P, Córdoba R, Altisent R, Delgado-Marroquín MT. [Autonomy and heteronomy, a necessary alliance to address smoking cessation. Views of professionals and patients]. GACETA SANITARIA 2018; 33:401-407. [PMID: 30033093 DOI: 10.1016/j.gaceta.2018.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 04/19/2018] [Accepted: 04/24/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore the perception of professionals and patients with regard to ethical issues involved in addressing the habit of smoking in primary care consultations. METHOD A qualitative study was designed, consisting of 12 semi-structured interviews with professionals, 7 interviews with patients and 2 focus groups with 6 professionals and 7 primary care patients (a total of 32 participants). An intentional sampling was conducted, including profiles of professionals and patients of both sexes, different ages and experience in relation to smoking. A content analysis was performed with an inductive analytical approach from data to the creation of theoretical categories. RESULTS Four main categories were identified: 1) ethical issues related to the responsibility of the professional when treating patients who smoke; 2) issues related to attitude to patients who smoke; 3) issues related to fair and equitable distribution of resources and to the role of the different levels of government in relation to the control of smoking; and 4) issues related to smokers' autonomy regarding their habit and smoking cessation. CONCLUSIONS An alliance is needed between the ethics that support the autonomy of patients who smoke and the regulation of tobacco consumption. This approach should be included in clinical training programmes dealing with tobacco use, dependence and cessation.
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Affiliation(s)
- Pablo Muñoz-Cifuentes
- Grupo de investigación en Bioética, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, España.
| | - Rodrigo Córdoba
- Centro de Salud Delicias Sur, IIS Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Rogelio Altisent
- Centro de Salud Actur Sur, IIS Aragón, Cátedra de Profesionalismo y Ética Clínica, Universidad de Zaragoza, Zaragoza, España
| | - María Teresa Delgado-Marroquín
- Centro de Salud Delicias Norte, IIS Aragón, Cátedra de Profesionalismo y Ética Clínica, Universidad de Zaragoza, Zaragoza, España
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Girvalaki C, Papadakis S, Vardavas C, Petridou E, Pipe A, Lionis C. Smoking cessation delivery by general practitioners in Crete, Greece. Eur J Public Health 2018; 28:542-547. [PMID: 29140450 DOI: 10.1093/eurpub/ckx201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Tobacco dependence treatment in clinical settings is of prime public health importance, especially in Greece, a country experiencing one of the highest rates of tobacco use in Europe. Methods Our study aimed to examine the characteristics of tobacco users and document rates of tobacco treatment delivery in general practice settings in Crete, Greece. A cross-sectional sample of patients (n = 2, 261) was screened for current tobacco use in 25 general practices in Crete, Greece in 2015/16. Current tobacco users completed a survey following their clinic appointment that collected information on patient characteristics and rates at which the primary care physician delivered tobacco treatment using the evidence-based 4 A's (Ask, Advise, Assist, Arrange) model during their medical appointment and over the previous 12-month period. Multi-level modeling was used to analyze data and examine predictors of 4 A's delivery. Results Tobacco use prevalence was 38% among all patients screened. A total of 840 tobacco users completed the study survey [mean age 48.0 (SD 14.5) years, 57.6% male]. Approximately, half of the tobacco users reported their general practitioner 'asked' about their tobacco use and 'advised' them to quit smoking. Receiving 'assistance' with quitting (15.7%) and 'arranging' follow-up support (<3%) was infrequent. Patient education, presence of smoking-related illness, a positive screen for anxiety or depression and the type of medical appointment were associated with 4 A's delivery. Conclusion Given the fundamental importance of addressing tobacco treatment, increasing the rates of 4 A's treatment in primary care settings in Greece is an important target for improving patient care.
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Affiliation(s)
- Charis Girvalaki
- Department of Medicine, Clinic of Social and Family Medicine, University of Crete, Heraklion, Crete, Greece
| | - Sophia Papadakis
- Department of Medicine, Clinic of Social and Family Medicine, University of Crete, Heraklion, Crete, Greece.,Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Division of Cardiology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Constantine Vardavas
- Department of Medicine, Clinic of Social and Family Medicine, University of Crete, Heraklion, Crete, Greece
| | - Eleni Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Andrew Pipe
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Division of Cardiology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Christos Lionis
- Department of Medicine, Clinic of Social and Family Medicine, University of Crete, Heraklion, Crete, Greece
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Balogh E, Faubl N, Riemenschneider H, Balázs P, Bergmann A, Cseh K, Horváth F, Schelling J, Terebessy A, Wagner Z, Voigt K, Füzesi Z, Kiss I. Cigarette, waterpipe and e-cigarette use among an international sample of medical students. Cross-sectional multicenter study in Germany and Hungary. BMC Public Health 2018; 18:591. [PMID: 29724200 PMCID: PMC5934788 DOI: 10.1186/s12889-018-5494-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 04/20/2018] [Indexed: 11/25/2022] Open
Abstract
Background Tobacco use is the leading preventable cause of death worldwide. Besides cigarette smoking, waterpipe and e-cigarettes are gaining popularity among young adults. Medical students’ smoking behavior is of particular interest because of their impending role in health promotion as future physicians. Aim of our study is to examine the prevalence and predictors of cigarette, waterpipe and e-cigarette use and the association of tobacco use with self-reported health status in an international sample of medical students. Methods In a multicenter cross-sectional study data on different aspects of health behavior were collected from medical students of 65 nationalities using a self-administered questionnaire in Germany (Dresden, Munich) and Hungary (Budapest, Pécs). The survey was conducted among 1st, 3rd and 5th year students. To explore associations between smoking behavior and socio-cultural factors Pearson’s chi2-tests and multivariate binary logistic regression analyses were performed. Results The largest subpopulations were formed by German (n = 1289), Hungarian (n = 1055) and Norwegian (n = 147) students. Mean age was 22.5 ± 3.3 years. Females represented 61.6% of the sample. In the whole sample prevalence of cigarette smoking was 18.0% (95% CI 16.6–19.4%), prevalence of waterpipe use was 4.8% (95% CI 4.0–5.7%), that of e-cigarette 0.9% (95% CI 0.5–1.2%). More males (22.0%) than females (15.5%) reported cigarette smoking. The lowest prevalence of cigarette smoking was found among Norwegian students (6.2%). Cigarette smokers were older, waterpipe users were younger than non-users. E-cigarette use was not associated with age of the students. Religious involvement was protective only against cigarette smoking. Financial situation showed no association with any kind of tobacco consumption. Cigarette smokers and e-cigarette users were less likely to report very good or excellent health status. Conclusions Cigarette smoking is still the most popular way of consuming tobacco, although alternative tobacco use is also prevalent among medical students. To further health consciousness, medical schools should pay more attention to students’ health behavior, especially their smoking habits. Tobacco prevention and cessation programs for medical students should consider not only the health risks of cigarette smoking but the need to discourage other forms of tobacco use, such as waterpipe.
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Affiliation(s)
- Erika Balogh
- Department of Public Health Medicine, University of Pécs Medical School, Szigeti str 12, Pécs, 7624, Hungary.
| | - Nóra Faubl
- Department of Behavioral Sciences, University of Pécs Medical School, Szigeti str 12, Pécs, 7624, Hungary
| | - Henna Riemenschneider
- Department of General Practice, Medical Clinic 3, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Péter Balázs
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Antje Bergmann
- Department of General Practice, Medical Clinic 3, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Károly Cseh
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Ferenc Horváth
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Jörg Schelling
- Department of General and Family Medicine, Medical Faculty, Ludwig-Maximilians-Universität München, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - András Terebessy
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Zoltán Wagner
- Department of Public Health Medicine, University of Pécs Medical School, Szigeti str 12, Pécs, 7624, Hungary
| | - Karen Voigt
- Department of General Practice, Medical Clinic 3, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Zsuzsanna Füzesi
- Department of Behavioral Sciences, University of Pécs Medical School, Szigeti str 12, Pécs, 7624, Hungary
| | - István Kiss
- Department of Public Health Medicine, University of Pécs Medical School, Szigeti str 12, Pécs, 7624, Hungary
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Sharma R, Meurk C, Bell S, Ford P, Gartner C. Australian mental health care practitioners' practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness. Int J Ment Health Nurs 2018; 27:247-257. [PMID: 28160384 DOI: 10.1111/inm.12314] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 11/27/2022]
Abstract
Reducing the burden of physical illness among people living with severe mental illnesses (SMI) is a key priority. Smoking is strongly associated with SMIs resulting in excessive smoking related morbidity and mortality in smokers with SMI. Smoking cessation advice and assistance from mental health practitioners would assist with reducing smoking and smoking-related harms in this group. This study examined the attitudes and practices of Australian mental health practitioners towards smoking cessation and tobacco harm reduction for smokers with SMI, including adherence to the 5As (ask, assess, advise, assist and arrange follow up) of smoking cessation. We surveyed 267 Australian mental health practitioners using a cross-sectional, online survey. Most practitioners (77.5%) asked their clients about smoking and provided health education (66.7%) but fewer provided direct assistance (31.1-39.7%). Most believed that tobacco harm reduction strategies are effective for reducing smoking related risks (88.4%) and that abstinence from all nicotine should not be the only goal discussed with smokers with SMI (77.9%). Many respondents were unsure about the safety (56.9%) and efficacy (39.3%) of e-cigarettes. Practitioners trained in smoking cessation were more likely (OR: 2.9, CI: 1.5-5.9) to help their clients to stop smoking. Community mental health practitioners (OR: 0.3, CI: 0.1-0.9) and practitioners who were current smokers (OR: 0.3, CI: 0.1-0.9) were less likely to adhere to the 5As of smoking cessation intervention. The results of this study emphasize the importance and need for providing smoking cessation training to mental health practitioners especially community mental health practitioners.
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Affiliation(s)
- Ratika Sharma
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Carla Meurk
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Archerfield, Queensland, Australia
| | - Stephanie Bell
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Pauline Ford
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral Gartner
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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35
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Mujika A, Arantzamendi M, Lopez-Dicastillo O, Forbes A. Health professionals' personal behaviours hindering health promotion: A study of nurses who smoke. J Adv Nurs 2017; 73:2633-2641. [PMID: 28543954 DOI: 10.1111/jan.13343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2017] [Indexed: 11/28/2022]
Abstract
AIM To explore the views of current and ex-smoker nurses on their role in supporting patients to stop smoking. BACKGROUND Long-term conditions are closely linked to harmful lifestyle behaviours, including smoking and overeating. Health professionals have an important role to play in promoting healthier lifestyles. It has been described that nurses' health behaviours may be a barrier to their health promotion practice. There is a need to gain further understanding on why nurses' health promotion activity is influenced by their own health behaviour. DESIGN A secondary analysis of qualitative data gathered in 2010 in the context of a project that aimed to develop a smoking cessation intervention for nurses. METHODS Eleven transcripts of semi-structured interviews conducted with nurses (current and ex-smokers) working in one university hospital in Spain. Data were analysed using framework analysis. FINDINGS Nurses who smoked engaged in social justification in terms of social norms and work stress. Only nurses who had quit smoking were able to identify the negative feelings it generated and the effect that it had on their past health promotion practice. This was expressed by ex-smokers as an internal conflict that prevented them from supporting patients with their own habit. CONCLUSION Nurses who smoke may be inhibited as health promoters without being aware of it. Interventions that focus on helping these professionals deal with the challenges associated with these encounters are necessary if health promotion practices are to be enhanced. Targeting this conflict might also work to improve their lifestyle, which would expand the potential impact to professionals' own health.
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Affiliation(s)
- Agurtzane Mujika
- School of Nursing, University of Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,Impuls Research Group, University of Navarra, Pamplona, Spain
| | - María Arantzamendi
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Olga Lopez-Dicastillo
- School of Nursing, University of Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,Impuls Research Group, University of Navarra, Pamplona, Spain
| | - Angus Forbes
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
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Khubaib MU, Shahid ZY, Lodhi SK, Malik H, Jan MM. Prevalence and Associated Factors of Smoking Among Final Year Medical Students: A Multicentric Survey From Pakistan. Cureus 2016; 8:e701. [PMID: 27588223 PMCID: PMC4999151 DOI: 10.7759/cureus.701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction Smoking is the leading cause of lung cancer around the world. In a developing country like Pakistan with low levels of literacy and general awareness about adverse effects of smoking, doctors play a pivotal role in educating the masses about its harmful consequences and providing support for smoking cessation. However, their efficacy is affected if they smoke themselves, and oftentimes the habits cultivated during educational recourse are carried into the professional careers. The aim of this study was to document the prevalence of smoking among final year medical students of Lahore, Pakistan, and the factors associated with it. Methodology Study approval was obtained from Combined Military Hospital (CMH) Lahore Medical College, Ethics Review Committee. A cross-sectional survey was carried out in four medical colleges and hospitals of Lahore, Pakistan. A questionnaire consisting of 14 questions related to basic demographics and smoking was used after being pilot tested on 20 students of CMH. The overall response rate was 74.89%. Data was collected from 337 respondents, of which 38 forms were discarded and 299 forms were analyzed by SPSS V21. Results Among the 299 respondents, there were 128 males (42.81%) and 171 females (57.19%) with 32 (10.70%) smokers. Male students reported smoking (n = 27, 21.09%) more than their female counterparts (n = 5, 0.02%). The mean age of participants was 23.01 years. Students having an active smoker at home had statistically significant positive correlations with current smoking status and the number of cigarettes smoked per day. Students with household smoking contacts were also more likely to smoke if they belonged to the male gender. Conclusion Prevalence of smoking in medical students is lower than in the general population but still considerable in the male students. There is a need to target this particular population with interactive counseling sessions, education campaigns, and anti-smoking rules to decrease smoking among them and through them in the society.
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Affiliation(s)
- Mohammad U Khubaib
- Department of Rehabilitation Medicine, CMH Lahore Medical College and Institute of Dentistry
| | - Zuhaib Y Shahid
- House Officer, Jinnah Hospital Lahore (JHL)/Allama Iqbal Medical College (AIMC), Lahore, Pakistan
| | - Sameed K Lodhi
- House Officer, King Edward Medical University(KEMU)/Mayo Hospital, Lahore, Pakistan
| | - Hamza Malik
- Surgery, CMH Lahore Medical College and Institute of Dentistry
| | - Mohsin M Jan
- House Job, CMH Lahore Medical College and Institute of Dentistry
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Chang YY, Yu SM, Lai YJ, Wu PL, Huang KC, Huang HL. Improving smoking cessation outcomes in secondary care: Predictors of hospital staff willingness to provide smoking cessation referral. Prev Med Rep 2016; 3:229-33. [PMID: 27419019 PMCID: PMC4929235 DOI: 10.1016/j.pmedr.2016.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 02/01/2016] [Accepted: 02/29/2016] [Indexed: 01/06/2023] Open
Abstract
Since implementation of the New Smoking Cessation Policy in Taiwan, more patients are attending smoking cessation clinics. Many of these patients were referred by hospital staff. Thus, factors which influence the hospital staff's willingness to refer are important. In this study, we aim to understand the relation between smoking cessation knowledge and willingness for referral. A cross-sectional study using a questionnaire was conducted with staff of a community hospital during the year 2012–2013. Willingness to provide smoking cessation referral and relevant correlated variables including demographic data, knowledge of basic cigarette harm, and knowledge of resources and methods regarding smoking cessation were measured. A total of 848 of 1500 hospital staff returned the questionnaire: 249 physicians (29.4%), 402 nursing staff (47.4%), and 197 administration staff (23.2%). 790 (93.2%) staff members have never smoked, 19 (2.2%) had quit smoking, and 39 (4.6%) still smoke. 792 (93.4%) members had interest in receiving smoking cessation education. The mean total score (highest potential score of 6) of basic cigarette harm knowledge was 4.56 (± 1.25). The mean total score (highest potential score of 7) of resources and methods about smoking cessation was 4.79 (± 1.35). The significant variable correlated with willingness to refer was total score of resources and methods about smoking cessation. Hospital staff who knew more about resources and methods about smoking cessation were more willing to refer smoking patients to the smoking cessation service. Thus, continuing medical education for hospital staff should include resources and methods about smoking cessation to promote smoking cessation. Knowledge of methods and resources for smoking cessation increases referral rates. Just educating about smoking harm will not increase willingness for referral. Education should include resources and methods about smoking cessation.
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Affiliation(s)
- Yin-Yu Chang
- Department of Family Medicine, Taiwan Adventist Hospital, 424 Sec. 2 Bade Road, Songshan District, Taipei City 105, Taiwan
| | - Shu-Man Yu
- Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan
| | - Yun-Ju Lai
- Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan
| | - Ping-Lun Wu
- Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan; Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, 1 Changde Street, Zhongzheng District, Taipei City 100, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, 1 Changde Street, Zhongzheng District, Taipei City 100, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
| | - Hsien-Liang Huang
- Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan; Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, 1 Changde Street, Zhongzheng District, Taipei City 100, Taiwan; School of Medicine, Fu-Jen Catholic University, 510 Zhongzheng Road, Xinzhuang District, New Taipei City 242, Taiwan
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38
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While AE. Promoting healthy behaviours - do we need to practice what we preach? LONDON JOURNAL OF PRIMARY CARE 2015; 7:112-114. [PMID: 26807154 PMCID: PMC4706031 DOI: 10.1080/17571472.2015.1113716] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The UK faces a public health challenge arising from unhealthy behaviours. Some health care workers engage in the same unhealthy behaviours as the general population. This paper explores the issues arising from some primary care staff adopting unhealthy behaviours upon healthcare organisations, professional practice and patient perceptions in terms of the promotion of health in the primary care setting.
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Affiliation(s)
- Alison E While
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London , London , UK
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