慢性阻塞性肺病患者戒菸行為及其相關因素探討

背景：戒菸是避免慢性阻塞性肺病持續惡化，最經濟有效的方法，但部分病人仍持續吸菸。目的：探討慢性阻塞性肺病患者之戒菸行為及其相關因素。方法：採相關性研究設計，以方便取樣於胸腔科門診進行收案，共招募100位罹患慢性阻塞性肺病病人參與研究，以自填式問卷進行資料收集，內容包括人口學與疾病特性、戒菸行為階段量表、戒菸健康信念量表、戒菸自我效能量表及尼古丁成癮程度測試量表。結果：研究對象中已戒菸者佔59%，而仍在吸菸者佔41%。卡方檢定與t檢定分析結果顯示性別、教育程度、職業狀況、COPD分期、戒菸自我效能及戒菸健康信念與戒菸行為皆有相關性。逐步複羅輯斯迴歸向前法分析結果顯示，僅戒菸自我效能進入模式中，單一變項可解釋戒菸行為58.5%的變異量。另迴歸模式的ROC曲線顯示在曲線下方的面積為0.973（p ＜ .001），代表有極佳的鑑別力。結論/實務應用：戒菸自我效能為戒菸行為之重要預測因子，醫護人員應強化患者的戒菸動機，增強戒菸的信心，進而提升戒菸成功率。

關鍵字

慢性阻塞性肺病；戒菸行為；戒菸自我效能；戒菸健康信念

並列摘要

Background: Smoking cessation is the most cost effective way of preventing deterioration of lung conditions in patients with chronic obstructive pulmonary disease (COPD). However, some patients still keep smoking. Purpose: To explore smoking cessation behavior and its related factors in patients with COPD. Methods: Using a predictive correlation study design, a convenient sample of 100 adults diagnosed with COPD was recruited from the pulmonary clinics of a medical center in Taiwan. Data were collected using self-reported questionnaires, which included questions on demographics and disease characteristics, the smoking cessation stage scale, the smoking cessation health belief scale, the smoking cessation self-efficacy scale, and the Fagerstrom test for nicotine dependence scale. Results: Among the study participants, 59% of them have quit smoking successfully and 41% of them continued to smoke. Gender, educational level, employment status, COPD stage, smoking cessation self-efficacy, and smoking cessation health beliefs were associated with smoking cessation. Results of the forward stepwise logistic regression analysis showed that smoking cessation self-efficacy was the most important predictor of smoking cessation and explained 58.5% of the variance in smoking cessation behaviors. The area under ROC curve was 0.973 (р ＜ 0.001), indicating outstanding discrimination. Conclusions/Implications for Practice: Smoking cessation self-efficacy is the most important predictor for smoking cessation behavior in patients with COPD. Health care professionals should boost patients' motivation and confidence to quit smoking in order to increase the success rate of smoking cessation.

並列關鍵字

COPD ； smoking cessation behavior ； smoking cessation self-efficacy ； smoking cessation health belief

參考文獻

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慢性阻塞性肺病患者戒菸行為及其相關因素探討

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