보건진료원의 금연지도활동에 영향을 주는 요인 - 광주$\cdot$전남지역을 중심으로 -

Predictors of Smoking Cessation Counselling Activities among Community Health Practitioners

  • 김진선 (조선대학교 의과대학 간호학과)
  • 발행 : 2003.09.01

초록

Purposes: The purposes of this study were to investigate the smoking cessation counselling activities among community health practitioners(CHP) and to identify the predictors of their smoking cessation counselling activities. Method: A descriptive-correlation study using self-administered questionnaires was conducted. Questionnaires were mailed to all the CHP in a community. A total of 330 CHPs participated in this survey. Results: Of the CHPs surveyed, 245(74.2%) returned completed questionnaires. Most CHPs(90.7%) believed that if a health professional advises their patient to quit, the patient's chances of quitting smoking are increased. While the majority of CHPs “asked, advised, and assessed” their clients, a minority of CHPs “assisted, arranged, and recorded”. In the final stepwise multiple regression model, attitude about smoking cessation policies and counselling activities, self-efficacy of smoking cessation counselling knowledge and skills, and perceived barriers of smoking cessation counselling activities were identified as significant predictors of smoking cessation counselling activities among CHPs. Conclusion: Smoking cessation counselling activities are not a routine part of CHP practice. Efforts should be made to increase the self-efficacy of smoking cessation counselling knowledge and skills among CHPs. Helping CHPs to overcome their barriers to smoking counselling may open up new channels for smoking intervention.

키워드

참고문헌

  1. 김성원. 일차의료에서의 금연전략. 가정의학회지 2000;2l(4):443-454
  2. 김진선, 정 영, 박은영. 일 지역사회 간호사들의 금연지도활동에 대한 조사연구. 지역사회간호학회지 2003;14(2):211-222
  3. 맹광호. 금연운동과 보건의료인의 역할. 한국금연운동협의회 2002
  4. 보건복지부. 국민건강증진종합대책 2010. 보건복지부 2002
  5. 서홍관. 의사의 흡연율과 그것이 갖는 의미. 대한의사협회지 2002;45(6):685-694
  6. 이숙희, 하영호, 최현림. z. 가정의학회지 1995;16(1):38-48
  7. 이용옥 외 7명. 의무기록지의 흡연 상태 기입 여부가 의사의 흡연교육 행태에 미친 영향. 가정의학회지1996;17(9):810-815
  8. 한은정 외 6명. 의사들의 흡연실태 및 금연권고. 가정의학회지 1997;18(6):601-611
  9. Albert D, Ward A, Ahluwalia K, Sadowsky D. Addressing tobacco in managed care: a survey of dentists' knowledge, attitudes, and behaviors. Am J Public Health 2002;92(6):997-1001 https://doi.org/10.2105/AJPH.92.6.997
  10. Borrelli B, Hecht JP, Papandonatos GD, Emmons KM, Tatewosian LR, & Abrams, DB. Smoking-cessation counseling in the home attitudes, beliefs, and behaviors of home healthcare nurses. Am J Prev Med 2001;21(4):272-277 https://doi.org/10.1016/S0749-3797(01)00369-5
  11. Fiore MC, Jorenby DE, Schensky AE, Smith SS, Bauer RR, Baker TB. Smoking status as the new vital sign: effect on assessment and intervention in patients who smoke. Mayo Clin Proc 1995;70:209-213 https://doi.org/10.4065/70.3.209
  12. Fiore MC, Bailey WC, Cohen SJ. et al. Smoking cessation: Clinical Practice Guideline No.18. Rocksville, Md. US Dept of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research AHCPR Publication No. 96-0692, 1996
  13. Fiore MC, Bailey WC, Cohen SJ. et al. Treating Tobacco use and dependence. A Clinical Practice Guideline. Rocksville, Md: US Dept of Health and Human Services. AHRQ Publication No. 00-0032, 2000
  14. Lang T, Nicaud V, Slama K, Hirsch A, Inbernon E, Goldberg M, Calvel L, Desobry P, Favre-Trosson JP, Lhopita C, Mathevon P, Miara D, Miliani A, Panthier F, Pons G, Roitg C, Thoores M. Smoking cessation at the workplace. Results of a randomized controlled intervention study. J Epidemiol Commun H 2000;54(1):349-354 https://doi.org/10.1136/jech.54.5.349
  15. McCarty MC, Hennrikus DJ, Lando HA, & Vessey JT. Nurses' attitudes concerning the delivery of brief cessation advice to hospitalized smokers. J Prev Med 2001;33(1):674-681 https://doi.org/10.1006/pmed.2001.0944
  16. McEwen A, West R. Smoking cessation activities by general practitioners and practice nurses. J Tob Control 2001;10(1):27-32 https://doi.org/10.1136/tc.10.1.27
  17. Ohida T, Sakurai H, Mochizuki Y, Kamal AM, Takemura S, Minowa M, Kawahara K (2001). Smoking prevalence and attitudes toward smoking among Japanese physicians. J Med Assoc 2001;285(20):2643-2648 https://doi.org/10.1001/jama.285.20.2643
  18. Sarna L, Brown JK, Lillington L, Wewers ME, Brecht ML. Tobacco-control attitudes, advocacy, and smoking behaviors of oncology nurses. Oncol Nurs Forum 2000;27(10):1519-1528
  19. Sarna L, Wewers ME, Brown JK, Lillington, L, Brecht ML. Barriers to tobacco cessation in clinical practice: Report from a national Survey of oncology nurses. Nurs Outlook 2001;49(4):166-172 https://doi.org/10.1067/mno.2001.115448
  20. Warnakulasuriya S. Effectiveness of tobacco counseling in the dental office. J Dent Edu 2002;66(9):1079-1087
  21. West R, McNeill A, Raw M. Smoking cessation guideline for health professional: an update. health education authority. Journal of Thorax 2000;55(12):987-999 https://doi.org/10.1136/thorax.55.12.987
  22. Zahnd EG, Coates TJ, Richard RJ, & Cummings SR. Counseling Medical Patients about Cigarette Smoking: A Comparison of the Impact of Training on Nurse Practitioners and Physicians. J Nurse Pract 1990;15(3):10-18