Nurse-delivered stage-matched smoking cessation intervention for cardiac patients : a randomized controlled trial
Abstract of thesis entitled
Nurse-delivered stage-matched smoking cessation intervention for cardiac patients: A randomized controlled trial
Chan Chung-Chi, Sabrina
For the degree of Master of Philosophy
at the University of Hong Kong
in Dec 2003
Introduction: Smoking is a major risk factor for cardiovascular diseases. Cessation in cardiac smokers has immense benefits both in improving the health of the patients and in reducing public healthcare costs. Nurses, who have the most contact with patients who are smokers, have a pivotal role in helping patients quit smoking. Smoking cessation intervention matching a smoker? readiness to quit has been suggested to be effective. Research on the effectiveness of a stage-matched smoking cessation intervention delivered by nurses to cardiac patients has been limited and no such study has been conducted on Chinese cardiac patients in Hong Kong.
Objectives: The objectives of this study are: (1) To describe: (a) current and previous smoking status, (b) nicotine dependence, (c) quitting history, (d) stages of readiness to quit, (e) motivation, perceived difficulties, and confidence to quit, (f) self-efficacy, (g) knowledge and attitudes towards smoking, and (h) stress level in patients with cardiac diseases; (2) To study the effectiveness of a stage-matched cessation intervention provided by nurses in motivating Chinese cardiac patients to: (a) quit smoking, (b) reduce the amount of cigarettes smoked, and (c) progress to a higher stage of
readiness to quit; and (3) To analyze demographic, clinical, and tobacco use factors associated with quitting.
Methods: This study used a randomized controlled trial design, and took place at the cardiac wards/SOPD of six public hospitals in Hong Kong. Eligible patients who were daily smokers and had a cardiac diagnosis completed a baseline questionnaire describing their tobacco use history. Participants were then randomized into either intervention or control group. Participants in the intervention group received stage-matched education pamphlets and brief smoking cessation counseling delivered by a research nurse who was a smoking cessation counselor, and a 1 week and 1 month telephone reminders. The control group received a placebo healthy diet pamphlet. All participants were telephoned at 3 months following the baseline interview to assess the outcomes.
Results: A total of 965 participants were randomized into the study. There were no significant differences between the intervention and the control on all baseline variables. At 3 months follow-up, 745 participants were follow-up with an attrition of 10%. It was found that at 3-month follow-up, significantly more participants in the intervention group (25.1% vs.18.5%, p=0.02) achieved 24-hour point-prevalence abstinence, reduced the number of cigarettes smoked per week (53.8% vs. 39.7%, p=0.002) and progressed to a higher stage of readiness to quit than the control (34.8% vs. 28.3%, p=0.045). Logistic regression modeling showed that the intervention, number of cigarettes smoked per day, nicotine dependence, previous life time quit attempt, perceived difficulty to quit, and stage of readiness to quit were baseline predictors for quitting at 3-month follow-up.
Conclusion: The stage-matched smoking cessation intervention delivered by nurses for cardiac patients in this study was effective in increasing quitting, reducing number of cigarettes smoked and increasing readiness to quit. These findings support the development of evidence-based clinical practice guidelines for nurses to deliver smoking cessation intervention in Hong Kong.
School:The University of Hong Kong
School Location:China - Hong Kong SAR
Source Type:Master's Thesis
Keywords:smoking cessation china hong kong heart diseases patients nurses
Date of Publication:01/01/2004