Strukturiertes Training zur Tabakentwöhnung in einem Haus der Maximalversorgung: eine prospektive Studie
Structured smoking cessation training for health professionals on cardiology wards: a prospective study
by Jan Falk
Date of Examination:2014-10-14
Date of issue:2014-10-07
Advisor:PD Dr. Tobias Raupach
Referee:PD Dr. Tobias Raupach
Referee:Prof. Dr. Wolfgang Himmel
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Abstract
English
Background: Smoking is a major cardiovascular risk factor, and smoking cessation is imperative for patients hospitalised with a cardiovascular event. This study aimed to evaluate a systems-based approach to helping hospitalised smokers quit and to identify implementation barriers. Design: Prospective intervention study followed by qualitative analysis of staff interviews Methods: The prospective intervention study assessed the effects of implementing standard operating procedures (SOPs) for the provision of counselling and pharmacotherapy to smokers admitted to cardiology wards on counselling frequency. In addition, a qualitative analysis of staff interviews was undertaken to examine determinants of physician and nurse behaviour; this sought to understand barriers in terms of motivation, capability and/or opportunity. Results: A total of 150 smoking patients were included in the study (75 before and 75 after SOP implementation). Before the implementation of SOPs, the proportion of patients reporting to have received cessation counselling from physicians and nurses was 6.7% and 1.3%, respectively. Following SOP implementation, these proportions increased to 38.7% (p < 0.001) and 2.7% (p = 0.56), respectively. Qualitative analysis revealed that lack of motivation, e.g. role incongruence, appeared to be a major barrier. Conclusions: Introduction of a set of standard operating procedures for smoking cessation advice was effective with physicians but not nurses. Analysis of barriers to implementation highlighted lack of motivation rather than capability or opportunity as a major factor that would need to be addressed.
Keywords: smoking cessation; smoking; hospitalised smokers; physician counselling; nurse counselling; cardiovascular disease