防制孩童暴露於家庭二手菸害之介入成效：系統性文獻回顧

Effectiveness of Intervention on Preventing Children from Second-hand Smoke Exposure at Home : A Systematic Literature Review

孩童暴露於二手菸害造成身心各方面影響，而家庭二手菸是最主要的暴露來源；國外陸續有針對父母提供介入以防制孩童二手菸暴露之研究成果。本文茲透過系統性文獻回顧，評析國外相關之介入設計與研究成效。 透過Medline、Pub/Med 、CINAHL等三個資料庫搜尋西元2000年至2012年之研究文獻，搜尋原則為以父母為研究對象，介入內容為相關降低孩童二手菸暴露之隨機控制實驗研究。共17篇符合搜尋條件。 文獻回顧顯示，國外在孩童二手菸防制之介入方式皆為一對一介入，介入設計以衛教以及行為修正為主，且多能依據理論設計介入內容，介入之次數從單次至14次不等，以多療程合併面對面以及電話諮商居多。成效比較發現以理論依據，設計為多療程之介入方式，較能達到降低孩童的二手菸暴露或提升父母的戒菸率。 本文評析結果建議健康從業人員或相關機構未來設計及推廣孩童二手菸暴露防制措施時，能以吸菸父母、或非吸菸但與暴露於二手菸害之孩童同住之父母為對象，並提供依理論設計、涵蓋多療程之措施。

Exposure of second-hand smoke causes children’s physical and psychological harm. Household smoking is the major source of children’s exposure. There have been various intervention programs towards parents in preventing children’s exposure. This study is to systematically review literatures in preventing children’s exposure to second-hand smoke, and appraise content of intervention and the effects. Literatures were searched from electronic database of Medline, CINHAL, and PubMed through 2000-2012. Searching strategies include parents as participants, preventing/reducing children’s second-hand smoke as content of intervention, and randomized controlled trial as study design. A total of 17 articles were included and reviewed. The majority of intervention designs in these articles are individual-approached, education- or behavioral modification-oriented with theoretical basis. There were single and multiple sessions of intervention between one to 14 sessions, with the majority of face-to-face plus telephone counseling. Studies that intervention based on theory and multiple-sessions design are more effective in reducing children’s exposure to second-hand smoke or improving parental smokers’ quitting rates. Results of this review suggests future intervention program in targeting parental smokers or parents who live with children exposed to secondhand smoke, designing program based on appropriate theories with multiple sessions.