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Ghali H, Rejeb OB, Fredj SB, Khéfacha S, Dhidah L, Rejeb MB, Latiri HS. Smoking dependence and anxio-depressive disorders in Tunisian smokers attending the smoking cessation clinic in a university hospital. J Egypt Public Health Assoc 2019; 94:9. [PMID: 32813151 PMCID: PMC7364776 DOI: 10.1186/s42506-019-0012-y] [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: 10/16/2018] [Accepted: 02/07/2019] [Indexed: 11/29/2022]
Abstract
Background Smokers with comorbid anxio-depressive disorders are more prone to progress to a more severe level of dependence and to experience more severe nicotine withdrawal symptoms than smokers without anxio-depressive disorders. Aim of the study To determine the relationship between tobacco dependence and anxio-depressive disorders as well as assessing their impact on the withdrawal. Methods We conducted a cross-sectional study among attendees of the smoking cessation clinic of Sahloul University Hospital, Sousse, Tunisia, from December 2009 to May 2015. The monitoring of the attendees was performed through retrieving the records until May 2016 in order to verify their smoking cessation status at 1 year. Results Overall, 534 smokers were included. We identified 315 smokers (59%) presenting an anxio-depressive disorder. Based on the HAD scale, we found 231 patients (43.4%) with anxiety disorders, 200 (37.6%) patients with depressive disorders, and 116 (21.8%) patients with anxio-depressive disorder. In multivariate analysis, only a high number of consultation was associated with a better rate of tobacco cessation at 6 months. However, no factor was found linked to the relapse at 1 year. Conclusion According to our results, only a high number of consultation was revealed as an independent factor of withdrawal for anxio-depressed smokers. It is necessary to simultaneously use the nicotinic substitutions and anxio-depressive treatment to ensure the tobacco cessation.
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Affiliation(s)
- Héla Ghali
- Department of Prevention and Security of Care, Hospital of Sahloul, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.
| | - Oussama Ben Rejeb
- Department of Cardiology, Hospital of Farhat Hached, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Sihem Ben Fredj
- Department of Prevention and Security of Care, Hospital of Sahloul, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Salwa Khéfacha
- Department of Prevention and Security of Care, Hospital of Sahloul, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Lamine Dhidah
- Department of Prevention and Security of Care, Hospital of Sahloul, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Mohamed Ben Rejeb
- Department of Prevention and Security of Care, Hospital of Sahloul, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Houyem Said Latiri
- Department of Prevention and Security of Care, Hospital of Sahloul, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Monteiro Mantovani V, Rodríguez Acelas AL, Klockner Boaz S, Cañon-Montañez W, Lucena ADF, Echer IC. Evaluation of Patients in a Smoking Cessation Support Group Using the Nursing Outcomes Classification. Int J Nurs Knowl 2018; 30:125-130. [PMID: 29847016 DOI: 10.1111/2047-3095.12213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate patients in a smoking cessation support group using the Nursing Outcomes Classification (NOC). METHODS Prospective observational cohort study conducted with 21 patients participating in a smoking cessation support group. Data were collected using an instrument consisting of 2 NOC outcomes and 20 indicators, applied during each of the six support group meetings. FINDINGS The two NOC outcomes, Smoking Cessation Behavior (1625) and Substance Withdrawal Severity (2108), showed statistically significant differences over time in many of their indicators. CONCLUSIONS The NOC outcomes demonstrated the clinical evolution and behavioral improvement of patients during the smoking cessation process. IMPLICATIONS FOR NURSING PRACTICE The findings highlight important elements of the evaluation of behavioral change and severity of withdrawal symptoms.
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Affiliation(s)
- Vanessa Monteiro Mantovani
- School of Nursing, Universidade Federal do Rio Grande do Sul (UFRGS), Nurse at the Hospital São Lucas, Member of the Nursing Research Group on the Care of Adults and the Elderly (GEPECADI-CNPq), Porto Alegre, RS, Brazil
| | | | | | | | - Amália de Fátima Lucena
- School of Nursing, UFRGS, Coordinator of the Committee of Nursing Process, HCPA, Researcher at the GEPECADI-CNPq, Porto Alegre, RS, Brazil
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Almeida-Brasil CC, Silveira MR, Silva KR, Lima MG, Faria CDCDM, Cardoso CL, Menzel HJK, Ceccato MDGB. Quality of life and associated characteristics: application of WHOQOL-BREF in the context of Primary Health Care. CIENCIA & SAUDE COLETIVA 2018; 22:1705-1716. [PMID: 28538939 DOI: 10.1590/1413-81232017225.20362015] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 11/24/2015] [Indexed: 11/21/2022] Open
Abstract
This study aimed to identify the characteristics associated to quality of life (QOL) in users of four Basic Health Units (Unidades Básicas de Saúde, UBS) in Belo Horizonte, Minas Gerais. We conducted a cross-sectional study with 930 adult users enrolled in the selected UBS, using a questionnaire containing the WHOQOL-bref instrument and questions about sociodemographic characteristics, lifestyle and health conditions. Following descriptive analysis, we performed simple and multiple linear regression to evaluate the association between the exposure variables and the QOL domains. The highest mean values of QOL were observed in the social relationships domain. The lowest means were observed in the environment domain, with a statistically significant difference between some of the UBS. The worst perceptions of QOL were related to worse health, housing, education and income conditions, as well as problems in social relationships and psychological conditions. Actions are needed to improve QOL in Primary Health Care users through actions promoted by both health professionals and public managers.
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Affiliation(s)
- Celline Cardoso Almeida-Brasil
- Departamento de Farmácia Social. Faculdade de Farmácia. Universidade Federal de Minas Gerais (UFMG). Av Antônio Carlos 6627/1027, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Micheline Rosa Silveira
- Departamento de Farmácia Social. Faculdade de Farmácia. Universidade Federal de Minas Gerais (UFMG). Av Antônio Carlos 6627/1027, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Kátia Rodrigues Silva
- Departamento de Farmácia Social. Faculdade de Farmácia. Universidade Federal de Minas Gerais (UFMG). Av Antônio Carlos 6627/1027, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Marina Guimarães Lima
- Departamento de Farmácia Social. Faculdade de Farmácia. Universidade Federal de Minas Gerais (UFMG). Av Antônio Carlos 6627/1027, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | | | | | - Hans-Joachim Karl Menzel
- Departamento de Esportes, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, UFMG. Belo Horizonte MG Brasil
| | - Maria das Graças Braga Ceccato
- Departamento de Farmácia Social. Faculdade de Farmácia. Universidade Federal de Minas Gerais (UFMG). Av Antônio Carlos 6627/1027, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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Pawlina MMC, Rondina RDC, Espinosa MM, Botelho C. Depression, anxiety, stress, and motivation over the course of smoking cessation treatment. J Bras Pneumol 2016; 41:433-9. [PMID: 26578135 PMCID: PMC4635090 DOI: 10.1590/s1806-37132015000004527] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 04/08/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. METHODS This cohort study involved patients enrolled in a smoking cessation program in Cuiabá, Brazil. We selected patients who completed the program in six months or less (n = 142). Patient evaluations were conducted at enrollment (evaluation 1 [E1]); after 45 days of treatment with medication and cognitive-behavioral therapy (E2); and at the end of the six-month study period (E3). Patients were evaluated with a standardized questionnaire (to collect sociodemographic data and determine smoking status), as well as with the University of Rhode Island Change Assessment scale, Beck Anxiety Inventory, Beck Depression Inventory, and Lipp Inventory of Stress Symptoms for Adults. The data were analyzed with the nonparametric Wilcoxon test for paired comparisons. To compare treatment success (smoking cessation) with treatment failure, the test for two proportions was used. RESULTS Among the 142 patients evaluated, there were improvements, in terms of the levels of anxiety, depression, motivation, and stress, between E1 and E2, as well as between E1 and E3. In addition, treatment success correlated significantly with the levels of motivation and anxiety throughout the study period, whereas it correlated significantly with the level of depression only at E2 and E3. CONCLUSIONS We conclude that there are in fact changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Those changes appear to be more pronounced in patients in whom the treatment succeeded.
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Affiliation(s)
| | | | | | - Clóvis Botelho
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
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Pawlina MMC, Rondina RC, Espinosa MM, Botelho C. Abandonment of nicotine dependence treatment: A cohort study. SAO PAULO MED J 2016; 134:47-55. [PMID: 26786610 PMCID: PMC10496578 DOI: 10.1590/1516-3180.2015.00830309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 05/04/2015] [Accepted: 09/03/2015] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Non-adherence to treatment is one of the hindering factors in the process of smoking cessation. This study aimed to compare sociodemographic characteristics, smoking status and motivation among smokers who maintained or abandoned treatment to stop smoking, and to analyze associations between sociodemographic factors and smoking. DESIGN AND SETTING Cohort study on 216 smokers who were attended at healthcare units in Cuiabá, Mato Grosso. METHODS The instruments used were the Fagerström, URICA and CAGE questionnaires. Data from the initial evaluation was analyzed using the two-proportion test (α < 0.05). The patients were monitored for six months and those who abandoned treatment were accounted for. Bivariate analysis was conducted, using crude prevalence ratios and 5% significance level (P < 0.05), with abandonment of treatment as the outcome variable. Associations with P < 0.20 were selected for multiple robust Poisson regression (RPa). RESULTS The abandonment rate was 34.26%. Males and individuals in the 20-39 age group, in employment, with low motivation, with shorter time smoking and lower tobacco intake predominated in the dropout group. In the final model, gender (RPa 1.47; 95% CI: 1.03-2.10) and age group (RPa 3.77; 95% CI: 1.47-9.67) remained associated with abandonment. CONCLUSION Males and individuals in the 20-39 age group, in employment, with low motivation, with shorter time smoking and lower tobacco intake more frequently abandoned the treatment. Male gender and younger age group were associated with abandonment of nicotine dependence treatment.
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Affiliation(s)
| | - Regina Cássia Rondina
- PhD. Professor of Educational Psychology and Human Development, Department of Educational Psychology, Universidade Estadual Paulista (UNIP), Marília, São Paulo, Brazil.
| | - Mariano Martinez Espinosa
- PhD. Professor of Statistics, Department of Statistics and Biostatistics, Institute of Public Health, Universidade Federal de Mato Grosso (UFMT). Cuiabá, Mato Grosso, Brazil.
| | - Clóvis Botelho
- MD, PhD. Professor of Pulmonology, Department of Medicine, Universidade Federal de Mato Grosso (UFMT). Cuiabá, Mato Grosso, Brazil.
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Pawlina MMC, Rondina RDC, Espinosa MM, Botelho C. Ansiedade e baixo nível motivacional associados ao fracasso na cessação do tabagismo. JORNAL BRASILEIRO DE PSIQUIATRIA 2014. [DOI: 10.1590/0047-2085000000014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo Analisar a associação entre as características sociodemográficas, status do tabagismo, grau de motivação, nível de ansiedade, depressão e de estresse com o fracasso em pacientes de um programa de cessação de tabagismo. Métodos Estudo de corte transversal realizado com pacientes que procuraram os programas de cessação do tabagismo de Cuiabá/MT, Brasil. Todos os fumantes matriculados no início desses programas, durante o período de maio a agosto de 2012, foram convidados a participar deste estudo, totalizando 216 pacientes. Os instrumentos utilizados foram o questionário Perfil Sociodemográfico, Teste de Fagerström (FTND), URICA, Inventário de Ansiedade de Beck (BAI), Inventário de Depressão de Beck (BDI) e Inventário de Sintomas de Stress de Lipp (ISSL). Os dados foram digitados duplamente em programa Epidata versão 3.1, e para análise dos dados foi utilizado um modelo de regressão de Poisson. Resultados Foram encontradas associações do fracasso terapêutico com as seguintes variáveis: faixa etária jovem (RP = 1,68; IC 95% 1,11-2,56); menor tempo de tabagismo (RP = 1,32; IC 95% 1,09-1,61); maior consumo de cigarros/dia (RP = 1,24; IC 95% 1,01-1,52) e menor grau de motivação (RP = 1,55; IC 95% 1,04-2,30). No modelo final (RPa), ficaram associadas ao fracasso as variáveis: menor tempo de tabagismo (RPa 1,53; IC 95% 1,07-2,32), maior carga tabágica (RPa 1,48; IC 95% 1,12-1,95), baixo nível de motivação (RPa 1,58; IC 95% 1,07-2,32) e alto nível de ansiedade (RPa 1,22; IC 95% 1,01-1,48). Conclusão Baixo nível motivacional (Contemplação e Pré-contemplação), alto nível de ansiedade (moderado/grave), menor tempo de tabagismo e alta carga tabágica estão associados ao fracasso terapêutico.
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