應用社會認知理論提升心導管術後病人戒菸成功率

Applying Social Cognitive Theory in Smoking Cessation after Cardiac Catheterization

翁雪珊(Shiue-Shan Weng) ； 陳美如(Mei-Ju Chen)

《北市醫學雜誌》 15卷4期 (2018/12) Pp. 57-63

https://doi.org/10.6200/TCMJ.201812_15(4).0006

摘要

目的：戒菸是改善冠狀動脈疾病最有效益的方式之一。本專案以社會認知理論為依據，針對接受心導管手術後的病人為對象，讓感受到疾病威脅之個案於出院後接受戒菸服務之照護，以協助病人達到成功戒菸之目標。方法：主動接觸心導管後吸菸個案並提供以社會認知理論為基礎之戒菸服務，2014年至2016年期間於台灣北部某區域醫院接受心導管的患者共有567位，吸菸個案有124位，其中吸菸者87位出院時願意參與此專案，將依個案意願所選擇的多元戒菸服務分組以了解各組戒菸成效。結果：將75位有三個月追蹤後之完整資料納入分析，在介入前尚未戒菸者中，經三個月介入措施後，有戒菸意願者的戒菸率為37.5%(n=9)，而原本無戒菸意願經過電話戒菸衛教後，也有5.6%戒菸成功，使用兩種以上戒菸服務的戒菸率37.5%與使用一種以上戒菸成功率相似。介入前已自行戒菸但未滿3個月的個案其復抽率為6.1%(n=2)。結論：透過本專案之經驗分享，期望未來可有更多專業人員，投入於高風險族群出院後之連續性健康促進介入計畫。

關鍵字

社會認知理論 ； 心導管手術 ； 戒菸

並列摘要

Objectives: Quit smoking is one of the most effective ways to ameliorate coronary artery disease. Based on the social cognition theory, this project aimed to provide smoking cessation services to patients who perceived threat of illness on discharge to achieve the goal of successful smoking cessation. Methods: We actively approached patients who undergone cardiac catheterization and provided them a social cognition theory based tobacco cessation service. A total of 567 patients received cardiac catheters from a regional hospital in northern Taiwan from 2014 to 2016, of whom 124 were smokers. Eighty-seven of the smokers discharged from the hospital agreed to participate. They were grouped according to the types of cessation service chosen and effectiveness of smoking cessation was analyzed. Results: Data of 75 patients who completed a 3-month follow-up were analyzed. The cessation rate of the patients intended to quit smoking before this program was 37.5% (n=9) while those who did not intended to quit initially was 5.6% after telephone health education. The successful rate between patients who used more than two types of cessation service was similar to those who used one type of service. The relapse rate for those who quit smoking before intervention was 6.1% (n=2). Conclusion: From the experience of this project, we anticipate more professionals to involve in the continuous health promotion intervention program for the high-risk groups after discharge.

並列關鍵字

social cognitive theory ； cardiac catheterization ； quitting smoking