Health worker and patient views on implementation of smoking cessation in routine tuberculosis care

被引：8

作者：

Boeckmann, Melanie ^{[1
,2
,3
]}

Warsi, Sahil

Noors, Maryam ^{[4
]}

Dogar, Omara ^{[2
]}

Mustagfira, Esha Haowa ^{[5
]}

Firoze, Fariza ^{[6
]}

Zahid, Raana ^{[4
]}

Readshaw, Anne ^{[2
]}

Siddiqi, Kamran ^{[2
]}

Kotz, Daniel ^{[1
,7
,8
]}

Keding, Ada ^{[2
]}

Gabe, Rhian ^{[2
]}

Marshall, Anna ^{[2
]}

Parrott, Steve ^{[2
]}

Swami, Shilpi ^{[2
]}

Khan, Amina ^{[4
]}

Raja, Sonia ^{[4
]}

Sohail, Salman ^{[4
]}

Huque, Rumana ^{[6
]}

Barua, Deepa ^{[6
]}

Huque, Samina ^{[6
]}

Jahan, Iashrat ^{[6
]}

Fatima, Razia ^{[9
]}

Qadeer, Ejaz ^{[9
]}

Sheikh, Aziz ^{[7
]}

Elsey, Helen ^{[10
]}

Karki, Jiban ^{[10
]}

Kralikova, Eva ^{[11
]}

Nohavova, Iveta ^{[11
]}

Zvolska, Kamila ^{[11
]}

Pankova, Alexandra ^{[11
]}

Baral, Sushil ^{[12
]}

Regmi, Shophika ^{[12
]}

Shrestha, Prabin ^{[12
]}

Khanal, Sudeepa ^{[12
]}

Joshi, Basant ^{[12
]}

机构：

[1] Heinrich Heine Univ, Med Fac, Addict Res & Clin Epidemiol Unit, Inst Gen Practice, Werdener Str 4, D-40227 Dusseldorf, Germany

[2] Univ York, Dept Hlth Sci, Seebohm Rowntree Bldg, York YO10 5DD, N Yorkshire, England

[3] Bielefeld Univ, Sch Publ Hlth, Dept Environm & Hlth, Univ Str 25, D-33615 Bielefeld, Germany

[4] Orange Grove Farm, Main Korung Rd, Islamabad 44000, Pakistan

[5] Plan Int, Dhaka, Bangladesh

[6] ARK Fdn, Suite C-3 & C-4,House 06,Rd 109,Gulshan 2, Dhaka 1212, Bangladesh

[7] Univ Edinburgh, Old Med Sch, Usher Inst Populat Hlth Sci & Informat, Teviot Pl, Edinburgh EH8 9AG, Midlothian, Scotland

[8] Maastricht Univ, CAPHRI Sch Publ Hlth & Primary Care, Dept Family Med, POB 616, NL-6200 MD Maastricht, Netherlands

[9] NTP Pakistan, Islamabad, Pakistan

[10] Univ Leeds, Leeds, W Yorkshire, England

[11] VFN Praze, Prague, Czech Republic

[12] HERD Int, Kathmandu, Nepal

来源：

NPJ PRIMARY CARE RESPIRATORY MEDICINE | 2019年 / 29卷 / 1期

基金：

欧盟地平线“2020”;

关键词：

CIGARETTE-SMOKING; TOBACCO CESSATION; INTERVENTIONS;

D O I：

10.1038/s41533-019-0146-6

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Smoking worsens tuberculosis (TB) outcomes. Persons with TB who smoke can benefit from smoking cessation. We report findings of a multi-country qualitative process evaluation assessing barriers and facilitators to implementation of smoking cessation behaviour support in TB clinics in Bangladesh and Pakistan. We conducted semi-structured qualitative interviews at five case study clinics with 35 patients and 8 health workers over a period of 11 months (2017-2018) at different time points during the intervention implementation phase. Interviews were conducted by trained researchers in the native languages, audio-recorded, transcribed into English and analysed using a combined deductive-inductive approach guided by the Consolidated Framework for Implementation Research and Theoretical Domains Framework. All patients report willingness to quit smoking and recent quit attempts. Individuals' main motivations to quit are their health and the need to financially provide for a family. Behavioural regulation such as avoiding exposure to cigarettes and social influences from friends, family and colleagues are main themes of the interviews. Most male patients do not feel shy admitting to smoking, for the sole female patient interviewee stigma was an issue. Health workers report structural characteristics such as high workload and limited time per patient as primary barriers to offering behavioural support. Self-efficacy to discuss tobacco use with women varies by health worker. Systemic barriers to implementation such as staff workload and socio-cultural barriers to cessation like gender relations, stigma or social influences should be dealt with creatively to optimize the behaviour support for sustainability and scale-up.

引用

页数：12

共 39 条

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