慢性阻塞性肺疾病患者戒烟行为促进与障碍因素的质性研究

doi:10.3761/j.issn.0254-1769.2026.08.002

摘要/Abstract

摘要：

目的探究慢性阻塞性肺疾病患者戒烟行为的促进与障碍因素，为构建精准化戒烟干预策略提供参考依据。方法采用目的抽样法，基于能力-机会-动机-行为模型，于2025年6—9月对山西省某三级甲等医院呼吸科接受治疗的21例慢性阻塞性肺疾病患者进行半结构式访谈，并采用Colaizzi 7步分析法进行资料分析。结果共提炼出2个主题及14个亚主题。慢性阻塞性肺疾病患者戒烟行为促进因素主要包括以下3个方面：能力因素为自我调节能力，机会因素为约束性环境、家庭支持，动机因素为疾病严重性感知、戒烟益处感知。障碍因素主要包括以下3个方面：能力因素为戒烟知识缺乏、改变既往习惯的自我效能匮乏，机会因素为社交压力、烟草环境暴露、职场压力，动机因素为疾病威胁感知弱化、戒烟认知偏差、消极心态、决策权衡。结论慢性阻塞性肺疾病患者戒烟行为相关影响因素复杂多样，医护人员需综合评估影响慢性阻塞性肺疾病患者戒烟行为改变的多方面因素，并据此制订针对性策略，以促进其戒烟行为的改变。

关键词: 肺疾病，慢性阻塞性, 戒烟, 能力-机会-动机-行为模型, 质性研究, 慢性病护理

Abstract:

Objective To explore the influencing factors of smoking cessation behavior in patients with chronic obstructive pulmonary disease，so as to provide references for the construction of precise smoking cessation intervention strategies. Methods From June to September，2025，the purposive sampling was used to select 21 patients with chronic obstructive pulmonary disease in the respiratory department of a tertiary hospital in Shanxi Province for semi-structured interviews based on capability，opportunity，and motivation-behavior model. Data was analyzed by Colaizzi’s 7-step analysis method. Results Totally 2 themes and 14 sub themes were extracted. The factors that promote smoking cessation behavior in patients with chronic obstructive pulmonary disease mainly include capability factors（self-regulation ability），opportunity factors（restrictive environment，family support），and motivation factors（perception of disease severity，perception of smoking cessation benefits）. Obstacle factors mainly include capability factors（lack of knowledge about quitting smoking，lack of self-efficacy in changing past habits），opportunity factors（social pressure，tobacco environment，workplace stress），and motivation factors（weakened perception of disease threat，cognitive bias towards quitting smoking，negative mentality，decision-making balance）. Conclusion The influencing factors of smoking cessation behavior in patients with chronic obstructive pulmonary disease are complex and diverse. Medical staff need to comprehensively evaluate the multiple factors that affect the change of smoking cessation behavior in patients with chronic obstructive pulmonary disease，and develop targeted strategies based on this to promote the improvement of their smoking cessation behavior.

Key words: Pulmonary Disease， Chronic Obstructive, Smoking Cessation, Capability， Opportunity， and Motivation-Behavior Model, Qualitative Research, Chronic Disease Care

刘幸, 范文祥, 周庭戌, 商临萍. 慢性阻塞性肺疾病患者戒烟行为促进与障碍因素的质性研究[J]. 中华护理杂志, 2026, 61(8): 1021-1027.

LIU Xing, FAN Wenxiang, ZHOU Tingxu, SHANG Linping. Facilitators and barriers of smoking cessation in patients with chronic obstructive pulmonary disease：a qualitative study[J]. Chinese Journal of Nursing, 2026, 61(8): 1021-1027.

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