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  • 學位論文

社區藥師提供戒菸諮詢服務之相關因素探討

Related Factors of Community Pharmacist’ Smoking Cessation Practices

指導教授 : 黃芷苓

摘要


背景:社區藥師在民眾戒菸上所扮演的角色日益受到重視,但是國內較少探討社區藥師參與戒菸服務的研究,以促進藥師參與戒菸服務。 目的:探討社區藥師提供戒菸諮詢服務情形及其相關影響因素。 方法:本研究設計為橫斷性研究,在全國16個縣市衛生局與國民健康局網站上所登錄之社區藥局戒菸諮詢站及二代戒菸合約藥局共有1162家,依照縣市以分層隨機取樣,有效樣本數為208位。研究工具為結構式問卷共73題,由研究者郵寄給受訪藥師,並以電話提醒提高問卷回收率。問卷內容包括戒菸諮詢服務、戒菸諮詢之知識、態度、技能、自我效能、菸害防制政策、諮詢時間、尼古丁替代藥物之產品設置及人口學變項,統計方法為描述性統計、t檢定、單因子變異數分析、相關係數與複迴歸分析。 結果:本研究結果發現二代戒菸之合約藥局提供戒菸諮詢服務高於非合約藥局,達統計上的顯著差異(p<.0001),另外有接受戒菸各種衛教人員訓練課程的藥師在提供戒菸諮詢服務分別高於未接受訓練課程者,達統計上的顯著差異(p<.001)。另外在回歸模式方面,本論文發現社區藥師的戒菸諮詢技能(β=.36, p=.01)與態度(β=.15, p=.017)是影響社區藥師提供諮詢服務的重要變項。 結論/實務應用:由於課程訓練可以提高社區藥師的戒菸諮詢服務,而且建議健康政策決策者應該針對戒菸諮詢技能與態度來設計相關課程,以提升社區藥師參與戒菸諮詢服務,才能落實「戒菸治療全面啟動」的政策口號。

並列摘要


Background: Community pharmacists have increasingly important roles in helping smokers quit. However, research about their practice and influencing factors regarding offering smoking cessation counseling is lacking. Purpose: To determine the current smoking cessation practices of community pharmacists in Taiwan and to examine related factors of their practices. Method: A cross-sectional survey was conducted. A total of 1162 community pharmacies made the contracts with Department of Health across 16 counties and Bureau of Health Promotion, Department of Health, Executive Yuan to provide smoking cessation counseling. Two hundred and eleven participants were included using stratified random sampling. A questionnaire was mailed to community pharmacist and a following phone call was conducted to increase the response rate. The 69-item structured questionnaire included demographic information, setting smoking cessation products, and cessation counseling regarding knowledge, attitudes, skills, self-efficacy, and practices. Data analyses were conducted using descriptive analyses, t test, ANOVA, correlation and multiple regression in JMP 9.0 statistic software. Result: The results showed that the contract pharmacists had more practice than non-contract pharmacists ( p<.0001). Participants receiving cessation counseling training provided more services than those who not receiving (p<.001). A multiple regression model showed that skills (β = .36, p = .01) and attitudes (β = .15, p = .017) were important factors influencing pharmacists' cessation counseling practice. Conclusion: The cessation training courses promoted pharmacists' practice. Health policy makers should develop cessation training courses specific to skills and attitudes of cessation counseling to promote pharmacists' cessation practice. Therefore, policy slogan "Inception of Cessation Treatment" was carried out.

參考文獻


[Chiang, Y. M., & Guo, J. L. & Chueh, Y. C., & Chiu, & Y. L., & Huang C. M. (2009). Preliminary evaluation of a smoking cessation counseling program provided by community pharmacists. Taiwan Journal of Public Health, 28(2),93-101. ]
莊佳雯、陳稚尹、黃芷苓、陳美杏、蘇惠卿(2011) ‧社區藥師參予戒菸服務:一個發展中的角色‧彰化護理,18(4),17-21。
姜郁美、郭鐘龍、闕妤榛、邱怡玲、黃久美(2009)‧社區藥局戒菸諮詢站之成效評估初探‧台灣衛誌,28(2),93-101。
[Chuang, C. W., & Chen, C. Y., & Huang C. L., & Chen, M. C., &
Ashley, M. J., Brewster, J. M., & Victor, J. C. (2006). Pharmacists' smoking cessation practices: Relationship to their knowledge and skills, attitudes, and perceptions of roles. Journal of the American Pharmacists Association(2003), 46(6), 729-737.

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