题名

冠狀動脈心臟病住院病人戒菸行為相關因素之研究

并列篇名

Factors Associated with Smoking Cessation Among Hospitalized Patients with Coronary Artery Disease

DOI

10.6540/NTJN.2018.1.003

作者

蔡晏平(Yen-Ping Tsai);柯文欽(Wen-Chin Ko);李碧霞(Pi-Hsia Lee);苗迺芳(Nae-Fang Miao)

关键词

冠狀動脈心臟病 ; 戒菸 ; 社會支持 ; 疾病嚴重度 ; 住院病人 ; coronary artery disease ; smoking cessation ; social support ; severity of illness ; inpatient

期刊名称

新臺北護理期刊

卷期/出版年月

20卷1期(2018 / 03 / 01)

页次

27 - 39

内容语文

繁體中文

中文摘要

背景:吸菸與冠狀動脈心臟病息息相關,是造成冠狀動脈心臟病的危險因子之一,而吸菸是人類社會普遍存在的一種成癮性行為,藉由瞭解影響戒菸的因素將有助於吸菸者戒菸。目的:探討冠狀動脈心臟病住院病人戒菸行為之影響因素。方法:採橫斷式研究,研究對象為台灣北部某醫學中心年滿二十歲(含)以上有吸菸經驗之122名冠狀動脈心臟病住院病人,以自填式問卷收集資料。結果:研究對象以46-65歲、菸齡21-30年、吸菸量11-20支、中度尼古丁成癮者居多,其戒菸行為不會受到人口學變項、吸菸相關變項、及疾病嚴重度的不同而有影響。社會支持的程度可以有效影響戒菸行為,功能性構面中的評價性支持得分最高,對象性構面中的家庭成員給予的社會支持得分最高,而情緒性支持、評價性支持和家庭成員支持均與戒菸行為之間達到統計上的顯著差異(p<.05),尤其是在家庭成員的情緒性(p<.05)、評價性(p<.05)及實質性(p<.05)支持皆有明顯的影響,且以考慮一個月內戒菸者及已戒菸者受到社會支持的影響為最大。結論:戒菸行為是動態的過程,依據不同的戒菸階段、結合重要對象給予不同的社會支持和教育宣導,將有助於冠狀動脈心臟病住院病人成功戒菸。

英文摘要

Background: Smoking is correlated with coronary heart disease, and further, is one of the risk factors. As smoking is a common addictive behavior in human society, understanding the factors behind the process of smoking cessation will aid current smokers in quitting. Purpose: The study aimed to investigate the influences that motivated inpatients with coronary heart disease to quit smoking. Methods: In this cross-sectional study, inpatients with coronary heart disease were surveyed in a northern Taiwanese hospital. The 122 participants of the study were above 20 years of age (inclusive) and had a history of smoking. The information was gathered with a self-reporting questionnaire. Results: The subjects of the study were mostly aged between 46-65, had been smoking for 21-30 years, smoked 11-20 cigarettes a day, and had an intermediate level of nicotine addiction. The behavior of smoking cessation among the subjects was no significant difference with demographic variables, smoking-related variables, and the severity of the disease. According to the four functions of social support, appraisal support ranked the highest, and the most common source of support was the family members. There were significant differences (p<.05) between the smoking cessation and emotional support, appraisal support and support from family members (p<.05, respectively). Especially, there were significant influences in the emotional support (p<.05), appraisal support (p<.05) and tangible support (p <.05) from family members. The subjects who considered quitting within one month or who successfully quit were found to benefit from social support mostly. Conclusion: Smoking cessation is an active process. At different stages, the target person should be given different types of social support and education in order to aid the target person in achieving his or her goal.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Wang, H.L.,Harrell, J.,Funk, S.(2008).Factors associated with smoking cessation among male adults with coronary heart disease in Taiwan.Journal of Nursing Research,16(1),55-64.
    連結:
  2. 朱育增,吳肖琪(2010)。回顧與探討次級資料適用之共病測量方法。台灣衛誌,29(1),8-21。
    連結:
  3. 林芸安,蔡仲弘(2011)。台灣中老年男性戒菸因素之探討。台灣衛誌,30(1),36-44。
    連結:
  4. American Heart Association(2015). Why Quit Smoking?(2016, April 19) Retrieved from http://www.heart.org/HEARTORG/HealthyLiving/QuitSmoking/QuittingSmoking/Why-Quit-Smoking_UCM_307847_Article.jsp#.VxWaO9R95k
  5. Arlene, S. A.,Michael, A. P.,Jeanne, S.,Shakira, F.,Andrew, C. Y.,Lindsey, B.(2003).Using claims data to examine mortality trends following hospitalization for heart attack in medicare.Health Services Research,38(5),1253-1262.
  6. Barefoot, J. C.,Brummett, B. H.,Williams, R. B.,Siegler, I. C.,Helms, M. J.,Boyle, S. H.,Mark, D. B.(2011).Recovery expectations and long-term prognosis of patients with coronary heart disease.Archives of Internal Medicine,171(10),929-935.
  7. Brummett, B. H.,Mark, D. B.,William, R. B.,Babyak, M. A.,Clapp-Channing, N. E.,Barefoot, J. C.(2005).Perceived social support as a predictor of mortality in coronary patients: Effects of smoking, sedentary behavior, and depressive symptoms.Journal of Psychosomatic Research,67(1),40-45.
  8. Centers for Disease Control and Prevention (2015). Division for heart disease and stroke prevention, heart disease risk factors. Retrieved from http://www.cdc.gov/dhdsp/data_statistics/fact_sheet/fs_heart_disease.htm
  9. Chen, F. C.,Su, C. M.,Li, C. J.,Le, W. H.,Kung, C. T.(2009).The use of charlson comorbidity index for patients receiving inhospital unexpected resuscitation by a cardiac arrest team: Clinical outcome and implications.Journal of Emergency Medicine,11(2),35-42.
  10. Cohen, S.(Ed.),Syme, S. L. (Ed.)(1985).Social support and health.New York:Academic Press, Inc..
  11. Deyo, R. A.,Cherkin, D. C.,Ciol, M. A.(1992).Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases.Journal of Clinical Epidemiology,45,613-619.
  12. Faul, F.,Erdfelder, E.,Buchner, A.,Lang, A. G.(2009).Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses.Behavior Research Methods,41(4),1149-1160.
  13. Fu, M.,Fernández, E.,Pascual, J. A.,Martínez-Sánchez, J. M.,Agudo, A.,Moncada, A.,Borràs, J. M.(2011).Stages of change, smoking characteristics, and cotinine concentrations in smokers: Setting priorities for smoking cessation.Preventive Medicine,52(2),139-145.
  14. Mackay, J.,Eriksen, M.,Schluger, N.(2015).The Tobacco Atlas.Atlanta:American Cancer Society.
  15. Miller, J. F.(Ed.)(1992).Coping with chronic illness overcoming powerness.
  16. Peng, E. Y.,Yu, P. T.,Fu, H. Y.,Lyu, S. Y.(2009).Smoking behavior and perception of smoking cessation among elderly community residents of Shi-Hu township, Miaoli.Taipei City Medical Journal,6,23-34.
  17. Prochaska, J. O.,DiClement, C. C.(1982).Transtheoretical therapy: Toward a more integrative model of change.Psychology and Psychotherapy: Theory, Research and Practice,19,276-288.
  18. Prochaska, J. O.,Norcross, J. C.,DiClemente, C. C.(1994).Changing for good.New York:Morrow.
  19. Sirri, L.,Magelli, C.,Grandi, S.(2011).Predictors of perceived social support in long-term survivors of cardiac transplant: The role of psychological distress, quality of life, demographic characteristics and clinical course.Journal of Health Psychology,26(1),77-94.
  20. Thyrian, J. R.,Panagiotakos, D. B.,Polychronopoulos, E.,West, R.,Zatonski, W.,John , U.(2008).The relationship between smokers' motivation to quit and intensity of tobacco control at the population level: A comparison of five European countries.BMC Public Health,8(2),87-92.
  21. World Health Organization. (1946). What is WHO's definition of health?.(2014, November08) Retrieved from http://www.who.int/kobe_centre/about/faq/en/
  22. World Health Organization(2013).Report on the global tobacco epidemic 2013-Warning about the dangers of tobacco.
  23. World Health Organization. (2016). Cardiovascular harms from tobacco use and secondhand smoke. Retrieved from http://www.who.int/tobacco/publications/surveillance/cardiovascular_harms_tobacco_use/zh/
  24. 吳怡恩(2011)。運用跨理論模式協助一位門診個案戒菸之護理經驗。彰化護理,18(1),21-31。
  25. 吳秉勳,郭美娟(2014)。台灣高齡透析病患死亡率、罹病率、及醫療支出概況。腎臟與透析,26(1),7-10。
  26. 汪素敏,顧乃平,林幸台,魏崢(1998)。心臟移植術後病人症狀困擾、社會支持與自我照顧行為相關之探討。護理研究,6(1),4-18。
  27. 崔禾(2011)。國立臺北護理學院護理研究所。
  28. 張茵畬,劉樹泉,黃獻樑(2013)。年長者戒菸成功影響因子之初探。臺灣老年醫學暨老年學雜誌,8(3),160-171。
  29. 張雪鳳(2009)。長榮大學醫務管理學研究所。
  30. 陳研如(2001)。中山醫學院醫學研究所。
  31. 董氏基金會華文戒菸網(2014)‧吸菸對人體造成的疾病‧取自http://www.e-quit.org/CustomPage/HtmlEditorPage.aspx?MId=21
  32. 蔡怡靜(2005)。慈濟大學公共衛生研究所。
  33. 衛生福利部國民健康署(2012)‧尼古丁成癮度量表‧取自http://health99.hpa.gov.tw/OnlinkHealth/Quiz_nicotine.aspx
  34. 衛生福利部國民健康署(2014a)‧吸菸與健康危害‧取自http://health99.hpa.gov.tw/educZone/edu_detail.aspx?CatId=40242&Type=002&kind=Sub
  35. 衛生福利部國民健康署(2014b)‧國人吸菸行為調查‧取自http://tobacco.hpa.gov.tw/Show.aspx?MenuId=581
  36. 衛生福利部統計處(2015)‧民國103年度死因統計‧取自http://www.mohw.gov.tw/news/531349778