Purpose: To explore the assessment of patient readiness to receive smoking cessation interventions using the transtheoretical model (TTM) and the five stages of change; and to give the primary care provider an evidence-based toolkit to assist in evaluating for readiness and supporting the smoking cessation process.
Data sources: Evidence-based literature, theoretical framework, and peer-reviewed articles.
Conclusions: Utilizing the TTM along with proper training and education of the provider and patient increases the probability that smoking cessation will occur. Combinations of pharmaceutical and nonpharmaceutical interventions are the most effective in smoking cessation.
Implications for practice: Providers can be prepared at every patient visit to address the smoking cessation needs of all patients. The toolkit provided in this article will help facilitate evaluation of readiness and support of effective, long-term smoking cessation and reduce eventual smoking-related morbidities.
[Show abstract][Hide abstract] ABSTRACT: Purpose: This study was conducted to identify predictors of the stage of change for smoking cessation of male university students on the basis of the Transtheoretical model (TTM). Methods: The 388 current smokers or exsmokers who agreed to participate were recruited from three areas in Korea from August 2 to September 5, 2006. Data was analyzed using a SPSS program for descriptive statistics, ANOVA, and multiple logistic regression. Results: Most subjects (76.8%) were current smokers. According to stages of change, there were statistically significant differences in self efficacy, smoking temptation, decisional balance (cons, pros), and processes of change. The predictors of transition from contemplation to preparation were behavioral and experiential processes. The predictors of transition from preparation to action were pros of smoking and experiential process. The predictors of transition from action to maintenance were cons of smoking and behavioral process. Conclusion: Specific nursing interventions based on stages of change need to be developed for smoking cessation of male university students.
[Show abstract][Hide abstract] ABSTRACT: This randomized, controlled study (N = 256) was conducted to compare three interventions designed to promote hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination completion among clients undergoing methadone maintenance (MM) treatment. Participants were recruited from five MM treatment sites in Southern California and randomized into three groups: Motivational Interviewing-Single (MI-Single), Motivational Interviewing-Group (MI-Group); and Nurse-Led Hepatitis Health Promotion (HHP). All were offered the three-series HAV/HBV vaccine. A total of 148 participants completed the vaccine. Groups did not differ in rate of vaccination completion (73.6%, HHP group, vs. 65% and 69% for the MI-Single and MI-Group, respectively). The equivalence of findings across groups suggests the value of including nurses with a comprehensive health focus in promoting vaccination completion.
Research in Nursing & Health 04/2010; 33(2):120-32. DOI:10.1002/nur.20371 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Every year, more than 650,000 Europeans die because they smoke. Smoking is considered to be the single most preventable factor influencing health. General practitioners (GP) are encouraged to advise on smoking cessation at all suitable consultations. Unsolicited advice from GPs results in one of 40-60 smokers stopping smoking. Smoking cessation advice has traditionally been given on an individual basis. Our aim was to gain insights that may help general practitioners understand why people smoke, and why smokers stop and then remain quitting and, from this, to find fruitful approaches to the dialogue about stopping smoking.
Interviews with 18 elderly smokers and ex-smokers about their smoking and decisions to smoke or quit were analysed with qualitative content analysis across narratives. A narrative perspective was applied.
Six stages in the smoking story emerged, from the start of smoking, where friends had a huge influence, until maintenance of the possible cessation. The informants were influenced by "all the others" at all stages. Spouses had vital influence in stopping, relapses and continued smoking. The majority of quitters had stopped by themselves without medication, and had kept the tobacco handy for 3-6 months. Often smoking cessation seemed to happen unplanned, though sometimes it was planned. With an increasingly negative social attitude towards smoking, the informants became more aware of the risks of smoking.
"All the others" is a clue in the smoking story. For smoking cessation, it is essential to be aware of the influence of friends and family members, especially a spouse. People may stop smoking unplanned, even when motivation is not obvious. Information from the community and from doctors on the negative aspects of smoking should continue. Eliciting life-long smoking narratives may open up for a fruitful dialogue, as well as prompting reflection about smoking and adding to the motivation to stop.
BMC Family Practice 05/2011; 12(1):42. DOI:10.1186/1471-2296-12-42 · 1.67 Impact Factor
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