입원 환자 금연 진료에 대한 의사 인식도
Physicians’ Perspectives on the Smoking Cessation Service for Inpatient Smokers
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연구배경: 입원 환자를 위한 금연지원 프로그램은 다학제간 협력에 의해 이루어질 때 효과적이다. 임상 의사는 입원환자의 금연 상담 및 치료에 있어서 중심적 역할을 한다. 본 연구의 목적은 임상 의사들이 입원 환자의 금연지원 프로그램에 대한 어떤 인식을 갖고 있는지 조사해 보고자 한것이다.방법: 서울 소재 1개 의과대학 병원과 충남 소재 1개 의과대학 임상교수들을 대상으로 개인 면담 및 포커스 그룹 면담을 시행하였다. 면담은 반구조화된 설문지에 의해 이루어졌으며, 면담 내용은 녹화되어 축어적으로 전사되었다. 전사된 자료에 대한 질적 내용분석을 시행하였다. 결과: 의사들은 입원 환자 금연지원 서비스에 대해 필요하다고 인식하였으며, 환자가 호흡기질환, 순환기질환 등과같이 흡연과 연관된 질병을 갖고 있을 때 입원 금연 치료가효과적이었다고 인식하였다. 또한, 병원에서 입원 환자 금연지원을 위한 의지가 필요하다고 인식하였으며, 금연 코디네이터와 같은 전담 인력이 있는 것이 효과적인 것으로 인식하였다. 입원 금연 프로그램에 대한 의사의 요구도를 4가지 지지 유형에 따라 나눌 수 있었으며, 적극적 참여형, 소극적 지지형, 소극적 무관심형, 적극적 거부형이었다. 결론: 입원 환자의 금연 진료의 효과적 시행을 위해서 의사들의 역할이 중요하다. 입원 환자 금연 상담을 위한 금연전담팀, 입원 환자 금연 진료의 효과에 대한 근거자료 구축, 환자의 질병 및 중증도를 고려한 맞춤형 금연 프로그램 개발 등은 의사의 역할 제고를 위해 매우 중요할 것이다
Abstract
Background: Smoking cessation services for inpatients can be provided effectively through interdisciplinary collaborations. Physicians could play a central role in smoking cessation counseling and treatment for recovery from illness and health promotion of the inpatient. This study aimed to investigate the perspectives of physicians on inpatient smoking cessation services. Methods: We conducted one personal and two focus group interviews with clinical faculties at a university hospital in Seoul and a university hospital in Chungnam using semi-structured questionnaires. Interviews were recorded, and the transcribed verbatim was analyzed qualitatively. Results: The physicians recognized the need for inpatient smoking cessation services and recognized that smoking cessation was effective when the patient had a smoking-related illness such as respiratory or cardiovascular disease Additionally, the physicians recognized the need for hospital management to support smoking cessation in hospitalized patients and recognized that it was effective to have a dedicated workforce with a smoking cessation coordinator. There was support from four types of physicians in the smoking cessation program: active participant, passive supporter, passive ignorer, and active refuser. Conclusions: The physician is important for the effective implementation of inpatient smoking cessation services. A dedicated team for the smoking cessation of the inpatient, the establishment of evidence-based data on the effectiveness of the inpatient smoking cessation services, and development of customized smoking cessation services will be necessary to strengthen the role of physicians.
참고문헌 (13)
- Stead LF, "Physician advice for smoking cessation", Cochrane Database Syst Rev, (5), pp.CD000165~ (2013)
- Wolfenden L, "Smoking cessation interventions for in-patients: a selective review with recommendations for hospital-based health professionals", Drug Alcohol Rev, 22(4), pp.437~452 (2003)
- Rigotti NA, "Interventions for smoking cessation in hospitalised patients", Cochrane Database Syst Rev, (5), pp.CD001837~ (2012)
- Crabtree BF, "Doing qualitative research" (1999), Sage Publications, Inc
- McCarty MC, "Barriers among nurses to providing smoking cessation advice to hospitalized smokers", Am J Health Promot, 16(2), pp.85~87 (2001)
- Ruiz CAJ, "Guideline for the treatment of smoking in hospitalized patients", Arch Bronconeumol, 53(7), pp.387~394 (2017)
- Rice VH, "Nursing interventions for smoking cessation", Cochrane Database Syst Rev, (1), pp.CD001188~ (2008)
- Rigotti NA, "Smoking cessation interventions for hospitalized smokers: a systematic review", Arch Intern Med, 168(18), pp.1950~1960 (2008)
- Miller NH, "Smoking cessation in hospitalized patients. Results of a randomized trial", Arch Intern Med, 157(4), pp.409~415 (1997)
- Mohiuddin SM, "Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease", Chest, 131(2), pp.446~452 (2007)
- Mills EJ, "Cardiovascular events associated with smoking cessation pharmacotherapies: a network meta-analysis", Circulation, 129(1), pp.28~41 (2014)
- Benowitz NL, "Cardiovascular safety of varenicline, bupropion, and nicotine patch in smokers: a randomized clinical trial", JAMA Intern Med, 178(5), pp.622~631 (2018)
- Chehab OM, "Intervention for smoking cessation in patients admitted with acute coronary syndrome: a review", Postgrad Med J, 94(1108), pp.116~120 (2018)