術前病人接受不同戒菸衛教方式之成效 及戒菸成功相關因子之研究

Effectiveness of Different Types of Smoking Cessation Health Education for Preoperative Patents and the Factors Correlated with Cessation Success Rate

目的：探討預計接受手術之病人接受不同戒菸衛教方式之戒菸成功率與影響因子分析。

方法：本研究為臨床介入前瞻性隨機分配研究。研究對象為2016年10月至2020年1月某醫學中心預計進行常規手術的吸菸病人，隨機分配為影片衛教組及單張衛教組，進行戒菸衛教介入，並分別於戒菸衛教介入後三個月、六個月、十二個月以電話追蹤個案的吸菸狀況，監測點戒菸成功率。以統計方式分析兩組類別變項差異，以及與點戒菸成功率之相關性。

結果：本研究共收案79人（接受單張衛教組為44人，男性佔95.5%，平均年齡為49.47±13.52歲；接受影片衛教組為35人，男性佔100%，平均年齡為49.25±12.96歲）。結果顯示戒菸成功率，在3個月點戒菸成功率中，影片衛教組顯著高於單張衛教組，但在6個月及12個月點戒菸成功率則無顯著差異。進一步以羅吉斯迴歸分析發現有使用戒菸藥物者其手術前戒菸衛教3個月點戒菸成功率較高，有糖尿病者手術前戒菸衛教3個月點戒菸成功率較低。而術前接受單張衛教介入者3個月點戒菸成功率較接受影片衛教者低。12個月點戒菸成功率部分則發現罹患心血管疾病者、罹患癌症者其手術前戒菸衛教12個月點戒菸成功率較高；吸菸時間較長者其手術前戒菸衛教12個月點戒菸成功率較低。

結論：手術前接受戒菸衛教能提升戒菸意願，增加戒菸成功率，其中使用傳統衛教單張作為戒菸衛教的媒材相較於衛教影片的戒菸成功率低，故也許能嘗試使用衛教影片作為媒材以期提升短期戒菸成功率。

 

Purpose: To explore the success rates and influencing factors of different smoking cessation education methods among patients scheduled for surgery.

Methods: This study is a clinical intervention prospective randomized controlled trial. The study population consisted of smokers scheduled for elective surgery at a medical center between October 2016 and January 2020. Participants were randomly assigned to either a video education group or a pamphlet education group for smoking cessation intervention. Follow-ups were conducted via phone at three months, six months, and twelve months after the intervention to monitor smoking status and assess point cessation success rates. Statistical analyses were performed to compare categorical variables between the two groups of participants and assess correlations with point cessation success rates.

Results: A total of 79 participants were enrolled (44 in the pamphlet education group, 95.5% male, mean age 49.47±13.52 years; 35 in the video education group, 100% male, mean age 49.25±12.96 years). Results indicated that, at the 3-month follow-up, the video education group exhibited a significantly higher smoking cessation success rate than the pamphlet education group. However, no significant differences were observed at the 6-month and 12-month follow-ups. Further analysis using logistic regression revealed that individuals using smoking cessation medication reported a higher smoking cessation success rate at the 3-month follow-up after preoperative smoking cessation education; the success rate, however, was lower for diabetes patients. Moreover, the success rate at the 3-month follow-up remained lower in those receiving pamphlet education as compared to those receiving video education. At the 12-month follow-up, the success rate after operative smoking cessation education was higher among participants with cardiovascular disease and cancer but lower in those with a longer smoking history.

Conclusion: Preoperative smoking cessation education enhances the motivation and success rates of smoking cessation for patients scheduled for surgery, and traditional health education pamphlets appear to be less effective than health education videos. Therefore, it may be worth trying health education videos as a medium to enhance short-term smoking cessation success rates.