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  • 學位論文

菸害防制高階訓練對健康照護人員戒菸知識、態度與諮商行為之成效

Effects of An Advanced Tobacco Control Training on Healthcare Professionals’ Smoking Cessation Knowledge, Attitudes and Counseling

指導教授 : 賴裕和

摘要


研究背景:吸菸不僅對健康造成威脅,同時也造成龐大醫療支出並阻礙經濟的發展。由於吸菸依賴是一個包含行為、認知、生理的複雜現象,所以要協助吸菸者成功的戒菸,就必須要有專業人員的協助。研究目的: (1)探討健康照護人員執行戒菸諮商行為的影響因素;(2)探討菸害防制高階訓練介入後,對健康照護人員戒菸知識、態度與諮商行為的成效。研究方法:本研究為健康成效研究(health outcomes research),以單組前、後測的方式進行。研究對象包括全臺北、中、南、東各區已受過戒菸衛教人員初階及進階訓練,欲參加高階訓練的健康照護人員為研究對象。共發問卷395份,回收有效問卷383份,以自填問卷的方式於介入措施前及介入措施後三個月及六個月收集資料。推論性統計以廣義估計方程式(Generalized estimating equation;GEE)進行分析。研究結果:(1)影響整體戒菸諮商行為的因素包括「戒菸知識」、「協助戒菸促進因素」、「協助戒菸障礙因素」以及「自我效能」,其中協助戒菸障礙因素為負向的影響。戒菸諮商行為三個子量表進階諮商、基本諮商以及轉介服務共同的影響因素為「協助戒菸障礙因素」、「協助戒菸促進因素」以及「自我效能」。(2)訓練成效為整體戒菸諮商行為及其三個子量表、協助戒菸障礙因素及戒菸知識在三個月及六個月的平均分數皆顯著高於前測。自我效能為三個月的平均分數顯著高於前測。結論及建議:菸害防制高階訓練介入後三個月及六個月對戒菸諮商行為及戒菸知識有顯著的成效。未來建議須進一步了解自我效能下降的原因,並探討如何維持自我效能?同時也要發展評量工具,以協助菸害防制成效的評值。行政方面建議機構內應有適當的獎勵機制,以促使大家願意投入菸害防制的工作。

並列摘要


Introductions: Smoking not only poses a threat to health, but also results in substantial medical expenses and hinders economic development. Since nicotine dependence is a complex state that involves behavioral, cognitive, and physiological factors, smokers must be assisted by professionals to achieve successful smoking cessation (SC).Objectives: To (a) explore the influencing factors regarding offering SC counseling interventions among healthcare professionals; (b) explore the effects of an advanced tobacco control (TC) training for healthcare professionals with SC knowledge, attitudes and SC counseling interventions. Methods: A health outcomes research with pretest-post-test design was adopted. The research participants comprised healthcare professionals’ in Taiwan who had received training in the basic and intermediate courses of TC and intended to participate in the advanced course. This study distributed a total of 395 questionnaires and retrieved 383 valid questionnaires. The self-report questionnaire was used for data collection 3 and 6 months before and after the intervention. A generalized estimating equation was used for inferential statistics. Results: (1) The factors associated with SC counseling behaviors including SC knowledge, facilitation of TC, barriers regarding TC, and self-efficacy. Beside, SC counseling interventions subgroup (advanced, basic and refer) have the same influencing factors, that including facilitation of TC, barriers regarding TC, and self-efficacy. (2) The SC knowledge, barriers regarding TC, and SC counseling interventions mean scores significantly increased at post-test 3 and 6 months compared with pretest. And the self-efficacy mean scores significantly increased at post-test 3 months compared with pretest. Conclusion: The advanced TC training has short-term and delayed effects on smoking cessation counseling interventions. Further research need to explore the affect for the decline in self-efficacy. The outcome indicators should be established to assess the effectiveness of TC. The study also suggests that incentive mechanisms should be established in institutions to encourage implement TC.

參考文獻


中文文獻
中華民國護理師護士公會全國聯合會(2017)‧臺閩地區護理人員統計表. http://www.nurse.org.tw/publicUI/H/H10201.aspx?arg=8D5E10444B88FD3005
江宜珍、李蘭(2010)‧認會認知理論‧於李蘭等著,健康行為與健康教育(四版,104-122頁)‧台北巿:巨流。
李景美(2008)‧菸幕不再-談青少年菸害預防教育策略‧學校衛生,52,89-105。
國民健康署戒菸治療管理中心(2018)‧戒菸服務申請流程‧ http://ttc.hpa.gov.tw/news/news_detail.aspx?type=5&no=CES00802820170413001&page=1

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