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Cheung YTD, Zhang G, Luk TT, Zhang M, Lam VSF, Chan MMK, Wang MP, Chan SSC. Effect of narrative videos and mini-VR games in nursing smoking cessation training on empathy and self-efficacy of smoking cessation counseling: A randomized controlled trial. NURSE EDUCATION TODAY 2024; 140:106272. [PMID: 38851019 DOI: 10.1016/j.nedt.2024.106272] [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: 02/15/2024] [Revised: 05/09/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Empathy and self-efficacy for smoking cessation counseling can be enhanced through smoking cessation training. Narrative videos and virtual reality (VR) games have been applied in medical education, but their application in smoking cessation training is limited and understudied. OBJECTIVES To evaluate the effect of smokers' narrative videos and mini-VR games on nursing students' empathy towards smokers (State Empathy Scale), confidence in practicing empathy, self-efficacy in smoking cessation counseling, and learning satisfaction. DESIGN An open-labeled randomized controlled trial, registration number: NCT05440877 (ClinicalTrials.gov). SETTING AND PARTICIPANTS Master of nursing students from the University in Hong Kong who enrolled in a smoking cessation course. METHODS All students attended a tutorial including case-based discussions and role-play. The intervention group could additionally access the narrative videos and mini-VR games of smokers' cases. Linear mixed models and Cohen's d were used to evaluate the intervention effect on the self-reported learning outcomes after the intervention. RESULTS 26 students enrolled in this trial, with 13 in each trial arm. All completed the trial. Post-test state empathy scores were significantly higher in the control group than in the intervention group (Cohen's d = 0.814, p = 0.049). No significant group differences were observed in the change of confidence in practicing empathy (β = -11.154, p = 0.073), self-efficacy (β = 4.846, p = 0.096), and students' learning satisfaction (Cohen's d = 0.041, p = 0.917). Both groups showed a significant increase in self-efficacy post-test (p < 0.001). CONCLUSIONS Narrative videos showing smoking scenes and reluctance to quit, and our mini-VR games may weaken nursing students' empathy towards smokers. Smoking cessation training involving narrative videos should be modified. Debriefing and guidance to understand smokers' difficulties and express empathy are needed. VR games for smoking cessation training can involve more frame stories and challenging tasks to increase engagement.
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Affiliation(s)
- Yee Tak Derek Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Guowen Zhang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Tzu Tsun Luk
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Minjin Zhang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Veronica Suk Fun Lam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Maggie Mee Kie Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Man Ping Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sophia Siu Chee Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Zhang G, Zhou J, Luk TT, Lam VSF, Yao Z, Wang MP, Cheung YTD. The learning outcomes of smoking cessation training in undergraduate nursing students: A systematic review. Nurse Educ Pract 2024; 75:103907. [PMID: 38308947 DOI: 10.1016/j.nepr.2024.103907] [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: 10/27/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
AIM To systematically evaluate the effect of smoking cessation training on nursing students' learning outcomes. DESIGN This systematic review followed the PRISMA guidelines and was registered with PROSPERO (CRD42022373280). METHODS Ten electronic English and Chinese databases were searched to identify articles on nursing students' smoking cessation training from inception to October 2022. Medical Education Research Study Quality Instrument was used to assess the methodological quality of eligible studies. RESULTS Twelve moderate methodological quality studies (three randomized controlled trials and nine quasi-experimental studies) with 2114 undergraduate nursing students were included. Teaching strategies included didactic lectures, collaborative learning, blended learning and the service-learning approach. Eight studies showed that the training significantly increased nursing students' knowledge of smoking cessation (p < 0.05) and three of them showed a large effect size (Cohen's d: 0.83-1.31). Seven studies showed that training enhanced students' attitudes/motivation towards smoking cessation interventions significantly (p < 0.05) and two of them showed a large effect size (Cohen's d: 1.11-1.84). Nine studies reported that students' self-efficacy improved significantly after training (p < 0.05) and six of them showed a large effect size (Cohen's d: 0.98-2.18). Two one-group pre-post studies showed training significantly improved students' practice of 5 A's behavior (p < 0.05), with a small effect size (Cohen's d < 0.50). CONCLUSIONS This review showed that smoking cessation training had a positive and large effect on undergraduate nursing students' knowledge, attitudes/motivation and self-efficacy towards smoking cessation intervention, but the effect of changing the practice of 5 A's was modest. We noted that very few RCTs were done and most studies only used subjective measures. More robust experimental studies with long-term follow-up are warranted in evaluating nursing students' practice/behavior of smoking cessation intervention and patients' quitting outcomes. Blended and collaborative learning are recommended in smoking cessation education.
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Affiliation(s)
- Guowen Zhang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jie Zhou
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Tzu Tsun Luk
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Veronica Suk Fun Lam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Zhuangyan Yao
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Man Ping Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yee Tak Derek Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Palakai R, Sornpaisarn B, Sawangdee Y, Chuanwan S, Saonuam P, Katewongsa P, Rehm J. The cost-effectiveness of improved brief interventions for tobacco cessation in Thailand. Front Public Health 2023; 11:1289561. [PMID: 38074714 PMCID: PMC10701387 DOI: 10.3389/fpubh.2023.1289561] [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: 09/06/2023] [Accepted: 11/10/2023] [Indexed: 12/18/2023] Open
Abstract
Background This study estimated the cost-effectiveness of four strategies enhancing the quality and accessibility of Brief Intervention (BI) service for smoking cessation in Thailand during 2022-2030: (1) current-BI (status quo), (2) the effective-training standard-BI, (3) the current-BI plus the village health volunteers (VHV) mobilization, and (4) the effective-training BI plus VHV mobilization. Methods By interviewing five public health officers, nine healthcare professionals aiding these services, and fifteen BI service experts, we explored the status quo situation of the Thai smoking cessation service system, including main activities, their quantity assumptions, and activities' unit prices needed to operate the current cessation service system. Then, we modeled additional activities needed to implement the other three simulated scenarios. We estimated the costs and impacts of implementing these strategies over a nine-year operating horizon (2022-2030), covering 3 years of service system preparation and 6 years of full implementation. The modeled costs of these four strategies included intervention and program costs. The study focused on current smokers age 15 years or older. The assessed impact parameters encompassed smoking prevalence, deaths averted, and healthy life-years gained. An Incremental Cost-Effectiveness Analysis compared the four simulated strategies was employed. Data analysis was performed using the One Health Tool software, which the World Health Organization developed. Results The findings of this investigation reveal that all three intervention strategies exhibited cost-effectiveness compared to the prevailing status quo. Among these strategies, Strategy 2, enhancing BI service quality, emerged as the most efficient and efficacious option. Therefore, the expansion of quality services should be synergistically aligned with augmented training, service delivery optimization, and managerial enhancements. Conclusion This approach is particularly poised to enhance accessibility to and the efficacy of smoking cessation interventions across Thailand.
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Affiliation(s)
- Rungrat Palakai
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Bundit Sornpaisarn
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Yothin Sawangdee
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Sutthida Chuanwan
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Pairoj Saonuam
- Healthy Lifestyle Promotion Section, Thai Health Promotion Foundation, Bangkok, Thailand
| | - Piyawat Katewongsa
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
- Thailand Physical Activity Knowledge Development Centre (TPAK), Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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Pardavila-Belio MI, Moreno-Arroyo C, Romero-Clará O, Tricas-Sauras S, Barroso T, Duaso M, Vilaplana J, Agüera Z, Canga-Armayor N, Demedts D, Elliott R, Godin I, Fernández E, Hawkins S, Marques MID, Lavedan-Santamaria A, Pueyo-Garrigues M, Puig M, Roca J, Sancho R, Torne-Ruiz A, Martínez C. Adaptation, implementation, and evaluation of an online health sciences training program for brief smoking intervention: A pre-post study in four European countries. NURSE EDUCATION TODAY 2023; 130:105924. [PMID: 37677986 DOI: 10.1016/j.nedt.2023.105924] [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: 03/06/2023] [Revised: 07/01/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Tobacco cessation intervention has a positive impact on quality of care. For health professionals, limited competency in this area may be associated with poor training during their academic programs. There is a clear need to further develop and implement training programs to improve tobacco cessation knowledge, skills, and attitudes among healthcare students. OBJECTIVES The aim of this study was to assess the effectiveness of the innovative online training program "Brief Intervention in Smoking Cessation" for healthcare students to improve their knowledge, skills, and attitudes. DESIGN A pre-post evaluation study with a satisfaction assessment tool was used. SETTING Seven universities from four European countries, including Belgium, Portugal, Spain, and the United Kingdom, participated. PARTICIPANTS One thousand and seventy-two (1072) undergraduate students participated, with 851 completing the online program. METHODS All participants completed the "Brief Intervention in Smoking Cessation" online program, which consisted of five theoretical modules, five videos, and three virtual simulation cases between January 2020 and June 2022. Knowledge was assessed by a multiple-choice test, and practical skills were assessed by a simulation algorithm, both of which were developed by education and smoking cessation experts. Competency was achieved when students successfully completed both assessments. Satisfaction was measured using an ad hoc 16-item questionnaire. Pre-post changes in knowledge were assessed using a paired Student's t-test. RESULTS Eighty-six percent of the students achieved smoking cessation competency. Students significantly improved their knowledge score on a scale of 0 to 10 points, with a mean pre-program score of 3.79 vs a mean post-program score of 7.33 ([-3.7 - -3.4] p < 0.001), acquiring sufficient attitudes and skills (simulation mean of 7.4 out of 10 points). Students were highly satisfied with the program (8.2 out of 10) and recommended it to other students (8.4 out of 10). CONCLUSIONS The "Brief Intervention in Smoking Cessation" online training program is effective for the acquisition of smoking cessation competencies among European health profession students.
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Affiliation(s)
- Miren Idoia Pardavila-Belio
- University of Navarra, School of Nursing, Department of Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research.
| | - Carmen Moreno-Arroyo
- Department of Fundamental Care and Medical-Surgical Nursing, Faculty of Nursing, University of Barcelona, Barcelona, Spain; Department of Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain.
| | - Olga Romero-Clará
- E-oncologia Virtual Training Unit, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Spain.
| | - Sandra Tricas-Sauras
- Social Approaches to Health Research Center (CRISS-CR5), School of Public Health, Université Libre de Bruxelles, Brussels, Belgium; Eurocare, The European Alcohol Policy Alliance, Brussels, Belgium.
| | - Tereza Barroso
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.
| | - María Duaso
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
| | - Jordi Vilaplana
- Department of Computer Science, University of Lleida, Lleida, Spain.
| | - Zaida Agüera
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28015 Madrid, Spain.
| | - Navidad Canga-Armayor
- University of Navarra, School of Nursing, Department of Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research.
| | - Dennis Demedts
- BRUCHI Expertise Center, Department of Health, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.
| | - Rebecca Elliott
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
| | - Isabelle Godin
- Social Approaches to Health Research Center (CRISS-CR5), School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
| | - Esteve Fernández
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet del Llobregat, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Sian Hawkins
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
| | - Maria Isabel Dias Marques
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.
| | - Ana Lavedan-Santamaria
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, Lleida, Spain.
| | - María Pueyo-Garrigues
- University of Navarra, School of Nursing, Department of Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research.
| | - Montse Puig
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain.
| | - Judith Roca
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, Lleida, Spain.
| | - Raúl Sancho
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain.
| | - Alba Torne-Ruiz
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain.
| | - Cristina Martínez
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, L'Hospitalet del Llobregat, Spain; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, United States of America.
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Song J, Chen Y, Zhang Z, Cao Y, Zhang L. Study on the participation of nursing staff in tobacco cessation support and related influencing factors: A survey from Chongqing, China. Tob Induc Dis 2023; 21:131. [PMID: 37842547 PMCID: PMC10568683 DOI: 10.18332/tid/170753] [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: 06/15/2023] [Revised: 08/06/2023] [Accepted: 08/09/2023] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION Nursing staff's assistance for smokers to quit smoking can increase the rate of quitting. The smoking cessation help can be affected by many factors. This study surveyed the use of the 5As (Asking, Advising, Assessing, Assisting, Arranging) approach to support smoking cessation by the nursing staff in Chongqing, China, and analyzed the corresponding influencing factors. METHODS A stratified random cluster sampling method was used to select nursing staff from 8 tertiary hospitals, 5 secondary hospitals, 12 community health centers, and 35 township health centers in different geographical regions of Chongqing. A questionnaire survey was conducted among the nursing staff to investigate their participation in smoking cessation. Binary logistic regression analysis was employed to analyze the influencing factors of smoking cessation 5As behavior of the nursing staff. RESULTS The 1669 participants were 44 males (2.6%) and 1625 females (97.4%), with an average age of 37.00 ± 10.89 years. Among the participants, 55.2% were from tertiary hospitals, 23.2% from secondary hospitals, 14.2% from township health centers, and 7.4 from community health centers. The often or always used behaviors were: Asking, 69.2%; Advising, 53.0%; Assessing, 39.5%; Assisting, 33.7%; and Arranging, 25.1%. The factors that affected all the 5As were: smoking cessation training (AOR=1.60; 95% CI: 1.22-2.11), knowledge of smoking cessation guidelines (AOR=1.75; 95% CI: 1.32-2.32) and the use of smoking cessation Apps (AOR=1.50; 95% CI: 1.09-2.06), and smokers' willingness to quit (AOR=2.20; 95% CI: 1.60-3.02). CONCLUSIONS Smoker's motivation to quit smoking and nurses' knowledge of tobacco cessation resources affected nurses' participation in smoking control behavior. While encouraging smokers to quit smoking, clinical nursing staff should be provided with related resources to advocate smoking cessation. Guided by the Chinese Clinical Tobacco Cessation Guidelines, smoking control knowledge and skills training should be provided for nursing staff to increase their positive attitude towards smoking control, so as to promote their active participation.
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Affiliation(s)
- Jun Song
- Department of Ophthalmology, Chongqing General Hospital, Chongqing, People’s Republic of China
| | - Yanhan Chen
- College of Nursing, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhiyong Zhang
- Integrated Traditional Chinese Medicine and Western Medicine Department, Healthcare Center, Jinlong Town, People’s Republic of China
| | - Yang Cao
- The First People's Hospital of Chongqing High-tech Zone, Chongqing, People’s Republic of China
| | - Li Zhang
- College of Nursing, Chongqing Medical University, Chongqing, People’s Republic of China
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Čivljak M, Ačkar L, Puljak L. The knowledge, attitudes and behaviors of hospital nurses on smoking cessation interventions: a cross-sectional study. BMC Nurs 2023; 22:228. [PMID: 37394472 DOI: 10.1186/s12912-023-01394-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Smoking is a major public health problem in Croatia. It is unknown to what extent nurses in Croatia use interventions for smoking cessation to help their patients. This study aimed to analyze the knowledge, attitudes and behaviors of hospital nurses on smoking cessation interventions. METHODS We conducted a cross-sectional study in Zagreb, Croatia, in 2022 on a convenient sample of hospital nurses. We collected data with a questionnaire that included sociodemographic questions and questions about the frequency of implementation of 5 A's (Ask, Advise, Assess, Assist, Arrange) interventions for smoking cessation during their work using the Helping Smokers Quit (HSQ) survey, participants' attitudes and knowledge about smoking cessation skills and the smoking status of the nurses. RESULTS There were 824 nurses employed in the targeted departments; 258 nurses participated in the study (response rate: 31%). Among them, 43% responded that they always ask patients about their use of tobacco products. Only 2.7% indicated that they always help the patient to stop smoking. Very few (2%) attended any training in the past two years about helping patients to quit smoking, and 82% never had such training. 44% of the included nurses were smokers. Nurses who smoked stated more frequently than nonsmokers they should not be role models for their patients by avoiding smoking (P 0.001). Additionally, patients were less frequently questioned about their inability to stop smoking by nurses who smoked than nurses who did not smoke (P = 0.010). CONCLUSION Even though smoking cessation interventions delivered by nurses were proven effective, such interventions are used by a small number of surveyed nurses. A small number of nurses have received training to help them support smokers in quitting. The high smoking prevalence among nurses may impact their attitudes and the implementation of workplace smoking cessation efforts.
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Affiliation(s)
- Marta Čivljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, Zagreb, 10000, Croatia
| | - Lovro Ačkar
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, Zagreb, 10000, Croatia
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, Zagreb, 10000, Croatia.
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Moxham L, Thomas T, Curtis E, Mackay M, Pratt H, Livingstone K. Nursing students' attitudes, behaviour, and knowledge toward smoking cessation: Results from a descriptive survey at a regional university. NURSE EDUCATION TODAY 2023; 125:105798. [PMID: 36933373 DOI: 10.1016/j.nedt.2023.105798] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Smoking is the largest single cause of lifestyle-related preventable morbidity and mortality. Nurses form the largest cohort of health professionals and are strategically placed to implement smoking cessation interventions. However their capacity is underutilised, particularly in rural and remote areas in countries such as Australia where the incidence of smoking in is higher than average and access to healthcare is limited. One strategy to address the underutilisation of nurses in smoking cessation interventions is to include training in the university/college nursing curriculum. To effectively implement this training, it is vital to have an in-depth knowledge of student nurses' attitudes towards smoking including the role of healthcare professionals in smoking cessation, their smoking behaviour and that of their peers, and knowledge regarding smoking cessation techniques and resources. OBJECTIVES Investigate nursing students' attitudes, behaviour, and knowledge towards smoking cessation, determine the impact of demographics and educational experienced on these, and develop recommendations for future research and educational practice. DESIGN Descriptive survey. PARTICIPANTS Non-probability sample of undergraduate nursing students (n = 247) from a regional Australian university. RESULTS Significantly more participants had tried smoking cigarettes than had not (p = 0.026). There were no significant relationships between gender and smoking (p = 0.169) or e-cigarette use (p = 0.200), but a significant relationship was found between age and smoking status where older participants (48-57 years) were more likely to smoke (p < 0.001). Most participants (70 %) were supportive of public health measures to reduce cigarette smoking but felt that they lacked specific knowledge to assist their patients to cease smoking. CONCLUSIONS Within education there needs to be an emphasis on the central role that nurses play in smoking cessation with a greater focus on training nursing students about smoking cessation strategies and resources. There is also a need to ensure that students know it falls within their duty of care to address smoking cessation with patients.
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Affiliation(s)
- Lorna Moxham
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Tamsin Thomas
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Elizabeth Curtis
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Maria Mackay
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Helen Pratt
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Kimberley Livingstone
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
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Pueyo-Garrigues M, Agüera Z, Andrés A, Lluch-Canut MT, Tricas-Sauras S, Duaso MJ, Feliu A, Pardavila-Belio MI, Antón L, Cornejo-Ovalle M, Puig-Llobet M, Moreno-Arroyo C, Barroso T, Roca J, Martínez C. Knowledge, attitudes, behavioral and organizational factors of health professions students for a competent smoking cessation practice: An instrument adaptation and psychometric validation study in Spanish and English samples. Nurse Educ Pract 2023; 70:103647. [PMID: 37121026 DOI: 10.1016/j.nepr.2023.103647] [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: 01/07/2023] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND To improve smoking cessation, training of health professions students is essential. However, no specific instrument is available to assess factors that may affect students' learning about smoking cessation practice. AIM To adapt and validate the Knowledge, Attitudes, Behaviors and Organization questionnaire in the population of undergraduate health professions students. DESIGN Methodological research. METHODS The researchers conducted this study with 511 Spanish and 186 English health professions students from four different universities. We used a four-step approach: 1) adaptation of the items to the target population and validation of the content by a panel of experts; 2) a pilot study to test face validity; 3) linguistic adaptation of the Spanish version to English; and 4) the psychometric assessment based on construct validity, criterion validity and internal consistency. RESULTS Exploratory factor analysis revealed four subscales for the Spanish version, namely 'Individual knowledge and skills', 'Individual attitudes and beliefs', 'Organizational support' and 'Organizational resources', which accounted for 85.1% of the variance. Confirmatory factor analysis in the holdout Spanish and English samples revealed adequate goodness-of-fit values, supporting the factor structure. Hypotheses testing demonstrated significant differences by capacitation in smoking cessation interventions and degree courses, providing further evidence regarding construct validity. All the subscales correlated positively with the criterion variables (5 A's smoking cessation model), except for the 'Organizational resources' subscale, which was not significantly correlated with the 5 A's. The overall Cronbach's alpha was.83 for the Spanish version and.88 for the English one. CONCLUSIONS Our results provide empirical support for the use of the Knowledge, Attitudes, Behaviors and Organization questionnaire for Students as a reliable and valid instrument to assess knowledge, attitudes, behaviors and organization perceptions in health professions students, which is essential for competent smoking cessation practice. Interestingly, 'Organizational resources' subscale presented the lowest correlations among factors and did not correlate with any component of the 5 A's, suggesting the need of enhancing students' responsibility and involvement during their internships, as well as the interest of some organizations.
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Affiliation(s)
- María Pueyo-Garrigues
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Spain
| | - Zaida Agüera
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28015 Madrid, Spain.
| | - Ana Andrés
- Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, Blanquerna, 08022 Barcelona, Spain
| | - Maria Teresa Lluch-Canut
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain
| | - Sandra Tricas-Sauras
- Centre for Research in Social Approaches to Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium; Erasmus Hogeschool Brussel, Departement Gezondheidszorg, Belgium
| | - Maria José Duaso
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, SE1 8WA London, United Kingdom
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Miren Idoia Pardavila-Belio
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Spain
| | - Laura Antón
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Center for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Marco Cornejo-Ovalle
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Montserrat Puig-Llobet
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain
| | - Carmen Moreno-Arroyo
- Departament d'Infermeria Fonamental i Médico-Quirúrgica, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain
| | - Tereza Barroso
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Portugal
| | - Judith Roca
- Department of Nursing and Physiotherapy. Faculty of Nursing and Physiotherapy, University of Lleida, Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, Spain
| | - Cristina Martínez
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain; Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Center for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois St., 7th floor, San Francisco, CA 94158, United States.
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Yang C, He W, Deng R, Giri M, Dai H. Perceptions and preparedness toward tobacco cessation counseling amongst clinical medical students in Chongqing, Southwest China: A cross-sectional study. Front Public Health 2022; 10:934782. [PMID: 35979466 PMCID: PMC9376593 DOI: 10.3389/fpubh.2022.934782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMedical students play an indispensable role in providing smoking cessation counseling. Despite the rapid increase in tobacco use, there is little data on what Chinese medical students know or are taught about it. This study aims to investigate the relationship between medical students' tobacco education level, clinical experience, and tobacco cessation counseling (TCC) provided by medical students.MethodsThis cross-sectional study was carried out among clinical medical students of Chongqing medical university. An anonymous, self-administered questionnaire included items on demographic information, perceptions, and perceived preparedness, clinical medical students' self-reported level of education about alternative tobacco products, and traditional cigarettes. We assessed their perspectives toward TCC using a 5-point Likert scale. Descriptive and binary logistic regression analyses were carried out.ResultsA total of 1,263 medical students completed the questionnaire. The majority of students (85%) expressed a willingness to provide TCC to patients in need. However, only half of the students stated unequivocally that they knew some ways and methods of tobacco cessation, while 18% stated that they did not know methods of tobacco cessation. Tobacco education and clinical experience were significantly associated with the ability to provide TCC. Our findings revealed that students with more clinical experience (undergraduates: B = 0.326, P < 0.001; postgraduates: B = 0.518, P < 0.001) were significantly more likely to have a greater self-reported comprehensive ability to provide TCC.ConclusionTobacco education and clinical experience can enhance the ability of medical students to provide smoking cessation counseling. There is a need to focus on alternative tobacco products with changing times, and curriculum planners should collaborate to incorporate comprehensive tobacco prevention and cessation training into the medical school curriculum.
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Affiliation(s)
- Chuang Yang
- The First College of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Wenjin He
- The First College of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Ruihang Deng
- The First College of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Mohan Giri
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haiyun Dai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Haiyun Dai
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