生活质量和抑郁情绪对现患疾病吸烟者戒烟的影响

2010/07/07

    现患疾病和较低生活质量是促进戒烟的因素,但仍然有许多患者选择继续吸烟,这可能与患者的抑郁情绪部分相关。本项前瞻性研究抑郁情绪对患者生活质量(PQoL)与戒烟关系的影响。我们认为,生活质量较差与戒烟有关,但仅限于轻度或无抑郁情绪的患者。护士向因病住院治疗后仍坚持吸烟的患者(N = 273)提供戒烟咨询。在基线状态、干预后2612个月后对参与者进行评价。PQoL与抑郁情绪的交互作用能预测:1)干预后2个月和12个月7天时间点的戒断率(2个月:校正后OR=1.005, 95%CI 1.001-1.009, P<0.0512个月:校正后OR = 1.007, 95%CI 1.002-1.011, P<0.005);2)干预后2个月和12个月持续戒断率(2个月:校正后1.011, 95%CI 1.004-1.019, P<0.005;12个月:校正后OR = 1.006, 95%CI 1.001-1.011, P<0.05),及时对协变量进行控制后上述关系不变。PQoL每下降一个单位,戒断优势比即出现增加,但仅限于轻度或无抑郁情绪患者。对生活质量较差的吸烟者应该给予更为有力的戒烟措施,其中包括调整情绪促进戒断。

(陈欣 审校)

Hayes RB, et al. J Behav Med. 2010 Mar 4. [Epub ahead of print]

 

 

The influence of quality of life and depressed mood on smoking cessation among medically ill smokers.

 

Hayes RB, Dunsiger S, Borrelli B.

Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA, Rashelle.Hayes@umassmed.edu.

 

Disease diagnosis and poor quality of life has been suggested as a "teachable moment" that facilitates smoking cessation, yet many patients continue to smoke. One reason for this inconsistency may be the potential moderating role of depressed mood. This study prospectively examined the role of depressed mood on the relationship between physical quality of life (PQoL) and smoking cessation among medically ill smokers. We hypothesized that poorer PQoL will be associated with smoking cessation, but only among those with little to no depressed mood. Nurses delivered smoking cessation counseling to medically ill patients (N = 273) who continued to smoke despite past hospitalization. Participants were assessed at baseline and at 2, 6, and 12-months later. The interaction between PQoL and depressed mood significantly predicted 1) 7-day point prevalence abstinence rates at both 2 and 12 months post-treatment [2 months: adjusted OR = 1.005, 95%CI 1.001-1.009, p < .05; 12 months: adjusted OR = 1.007, 95%CI 1.002-1.011, p < .005)] and 2) continuous abstinence rates at both 2 and 12 months post-treatment [2 months: adjusted OR = 1.011, 95%CI 1.004-1.019, p < .005; 12 months: adjusted OR = 1.006, 95%CI 1.001-1.011, p < .05] even after controlling for important covariates. The odds of quitting smoking increased for every one-unit decrease in PQoL, but only among those with little to no depressed mood. Medically ill smokers with poor quality of life may need more intensive smoking cessation interventions that include mood management to help them quit smoking.

 


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