Abstract:

Objective To explore the effects of a smoking cessation intervention based on Timing It Right in patients with chronic obstructive pulmonary disease（COPD）. Methods Totally 104 COPD patients with tobacco dependence hospitalized in the department of respiratory and critical care medicine in a tertiary hospital were selected by convenient sampling and allocated into an experimental group and a control group with 52 cases in each group by random number table. The control group received respiratory routine nursing care,and brief smoking cessation intervention on the basis of “Clinical Guideline for Smoking Cessation in China（2015 edition）”,and regular follow-up visits;the experimental group received interventions above and a cessation intervention based on Timing It Right. The rate of smoking cessation,nicotine dependence degree,anxiety and depression were compared between 2 groups at 1 month and 6 months after discharge. Results The rate of smoking cessation in the experimental group at 1 month after discharge was 72.34%,which was higher than 40.82% in the control group. The rate of smoking cessation in the experimental group at 6 months after discharge was 85.11%,which was higher than 48.98% in the control group; the differences were statistically significant（P<0.05）. The score of nicotine dependence degree of the experimental group was significantly lower than that of the control group at both time points（P<0.05）. There was no significant difference in anxiety and depression between 2 groups（P>0.05）. Conclusion The smoking cessation intervention based on Timing It Right can effectively improve the rate of smoking cessation and reduce the degree of nicotine dependence in COPD patients with tobacco dependence,but no improvement has been found in anxiety and depression.

Key words: Timing It Right, Smoking Cessation Intervention, Chronic Obstructive Pulmonary Disease, Nicotine Dependence, Anxiety, Depression, Nursing Care

摘要：

目的 探讨以时机理论为框架的戒烟干预对COPD患者戒烟效果的影响。方法 便利选取2018年1月—10月某三级甲等医院呼吸与危重症医学科住院治疗的COPD患者104例,按照随机数字表法分为试验组和对照组,每组52例。试验组在对照组干预的基础上接受基于时机理论的戒烟干预,对照组接受呼吸科常规护理,并依据《中国临床戒烟指南（2015版）》对其进行简短戒烟干预及定期随访,两组均于患者出院后1个月、6个月评定戒烟率、尼古丁依赖程度及焦虑、抑郁情况。 结果 试验组出院后1个月戒烟率为72.34%,高于对照组的戒烟率40.82%,试验组出院后6个月戒烟率为85.11%,高于对照组的戒烟率48.98%,两组比较,差异有统计学意义（P<0.05）;试验组尼古丁依赖程度分值均低于对照组,两组比较,差异均有统计学意义（P<0.05）;两组焦虑、抑郁情况比较,差异无统计学意义（P>0.05）。 结论 基于时机理论的戒烟干预可有效提高COPD患者戒烟率,降低尼古丁依赖程度,尚未发现其对焦虑、抑郁情况的改善。

关键词: 时机理论, 戒烟干预, 慢性阻塞性肺疾病, 尼古丁依赖, 焦虑, 抑郁, 护理