Bir üniversite hastanesinde görev yapan hekimlerin sigara bırakma tedavisi hakkındaki bilgi, tutum ve davranışlarının değerlendirilmesi
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Date
2023
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Düzce Üniversitesi
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Abstract
Giriş ve Amaç: Tütün kullanımı, bulaşıcı olmayan kronik hastalıklar açısından en önemli risk faktörlerinden birisi olmakla beraber önlenebilir bir morbidite ve mortalite sebebidir ve tüm dünyayı etkileyen küresel bir halk sağlığı sorunudur. Dünya genelinde ölümlerin en sık nedeni olan kardiyovasküler hastalıklar, kanser, kronik solunum sistemi hastalıkları ve diyabet gibi hastalıkların gelişmesinde risk faktörleri arasında sigara kullanımının önemli bir yeri vardır. Hekimler ve sağlık çalışanlarının temel görev ve sorumlulukları arasında hastalıkların önlenmesi ve mevcut sağlığın geliştirilmesi bulunmaktadır. Hekimlerin kendilerine başvuran her hastaya sigara kullanım durumunu sorması ve eğer kullanıyorsa bırakmasını tavsiye etmesi, tütün kontrolü kapsamında hem kolay hem de etkili bir yöntemdir. Hekimlerin sadece bu sorgulama ve tavsiyeyle bile hastaların %5-10'una sigarayı bıraktırabildikleri bilinmektedir. Özellikle topluma çeşitli sağlık hizmetleri sunmakta olan birinci basamak hekimleri olmak üzere tüm hekimlerin, dünyada önlenebilir hastalıkların birçoğu için risk faktörü olan sigara kullanımı konusunda farkındalıklarının artması, bilgi düzeylerinin yükselmesi, olumsuz tutum ve davranışlarının değişmesi gerekliliği açıktır. Bu çalışma, bir üniversite hastanesinde görev yapan hekimlerin sigara bırakma tedavileri ile ilgili bilgi, tutum ve davranışlarının değerlendirilmesi amacıyla planlanmıştır. Gereç ve Yöntem: Bu çalışma, tanımlayıcı ve kesitsel tipte bir araştırmadır. Çalışmanın evrenini, Düzce Üniversitesi Araştırma ve Uygulama Hastanesi'nde 1 Ocak 2023 – 1 Nisan 2023 arasında görev yapmakta olan hekimler (asistan, uzman, öğretim üyesi) oluşturmaktadır. Araştırmaya, katılmayı kabul eden 203 hekim dahil edilmiştir. Çalışmada veri toplamak amacıyla basılı anket formu kullanıldı. Oluşturulan anket formu tüm katılımcılara elden ulaştırıldı. Sigara kullanan katılımcıların nikotin bağımlılığı Fagerström nikotin bağımlılık testi (FNBT) ile değerlendirildi. Veriler SPSS 23.0 istatistik paket formunda değerlendirildi. İstatiksel anlamlılık için p<0,05 değeri kabul edildi. Bulgular: Çalışmaya toplam 203 hekim katıldı. Hekimlerin %47,8'i (n=97) kadın, %52,2'si (n=106) erkekti. Katılımcıların genel branşları incelendiğinde; %4,9'u (n=10) preklinik, %68,5'i (n=139) dahili, %26,6'sı (n=54) cerrahi branş hekimleriydi. Çalışmaya katılan hekimlerin %80,8'i (n=164) araştırma görevlisi, %2'si (n=4) uzman, %17,2'si (n=35) öğretim üyesiydi. Katılanların yaş ortalaması 31,34±6,87 (minimum=24, maksimum=61) idi. Katılımcıların sigara bırakma danışmanlığı ile ilgili bilgi düzeyini ölçen toplam 20 soruya verdikleri doğru cevap sayılarının ortalamasının 13,41±3,80 (minimum=1, maksimum=20) olduğu belirlendi. Çalışmaya katılan hekimlerin %15,8'i (n=32) sigara kullandığını, %8,4'ü (n=17) sigarayı bıraktığını, %75,9'u (n=154) hiç sigara içmediğini belirtti. Sigara kullanan 32 katılımcı; ortalama 9,81±6,32 yıldır sigara kullanıyor ve günde ortalama 13,78±6,86 adet sigara içiyordu. Paket/yıl değerlerinin ortancası 5,00 (minimum=0,25, maksimum=37,50) iken, FNBT skorlarının ortalaması 3,39±2,75 idi. Sigara kullanan katılımcıların FNBT skorları değerlendirildiğinde; %41,9'unun (n=13) çok düşük, %25,8'inin (n=8) düşük, %12,9'unun (n=4) orta, %12,9'unun (n=4) yüksek ve %6,5'inin (n=2) çok yüksek derecede nikotin bağımlısı olduğu belirlenmiştir. Hekimlerin %14,3'ü (n=29) sigara bırakma danışmanlığı eğitimi almış, %85,7'si (n=174) herhangi bir eğitim almamıştı. Yaş ile hekimlerin sigara içme durumlarına bakıldığında yaş arttıkça sigara kullanım oranı anlamlı olarak artmıştı (p=0,002). Katılımcıların cinsiyetlerine göre sigara içme durumları incelendiğinde erkek hekimlerin kadın hekimlere oranla anlamlı fazla sayıda sigara kullandığı görüldü (p=0,004). Katılımcıların sigara bırakma danışmanlığı eğitimi alma durumlarına göre bilgi puanları incelendiğinde, eğitim alan katılımcıların bilgi sorularına verdikleri doğru cevap ortalamalarının anlamlı olarak daha yüksek olduğu görüldü (p=0,023). Sonuç: Katılımcıların sigara bırakma danışmanlığı eğitimi almalarının yanı sıra, uzman ve öğretim görevlisi olmak gibi tıp eğitimi içerisinde geçirilmiş sürenin daha fazla olması durumu da sigara ile ilgili farkındalığın yüksek, sigara bırakma tedavileri ile ilgili tutum ve davranışın daha olumlu olması ile ilişkili bulunmuştur. Sigara ve sigara bırakma danışmanlığı ile ilgili hem tıp fakültesindeki hem de mezuniyet sonrası dönemdeki eğitimlerin sayı ve kalitesindeki artış; hekimlerin bu konudaki farkındalık, bilgi, tutum ve davranışlarına önemli katkılar sağlayacaktır. Tüm toplumu kapsayacak şekilde koruyucu sağlık hizmeti sunan aile hekimleri başta olmak üzere tüm hekimlerin, çağımızın en önemli toplum sağlığı sorunlarından birisi olan ve doğru stratejilerle sağlığa olan zararlarının önüne geçilebilecek sigara ve tütün bağımlılığı konusunda daha bilinçli ve daha etkin rol alması gereklidir. Bu konuda gerekli politikaların üretilmesine, sigara bırakma konusuna gereken değerin ve ağırlığın verilmesine, eğitimlerin sayı, kalite ve erişilebilirliğinin artırılmasına ve bu konuda daha kapsamlı bilimsel araştırmalar yapılmasına ihtiyaç vardır. Anahtar Kelimeler: Sigara, Sigara Bırakma Tedavisi, Hekimler
Introduction and Aim: Tobacco use is one of the most important risk factors for chronic non-communicable diseases, and is a preventable cause of morbidity and mortality, and is a global public health problem affecting the whole world. Smoking has an important place among the risk factors for the development of diseases such as cardiovascular diseases, cancer, chronic respiratory system diseases and diabetes, which are the most common causes of death worldwide. Among the basic duties and responsibilities of physicians and health workers are the prevention of diseases and the improvement of existing health. It is both an easy and effective method within the scope of tobacco control that physicians ask each patient who applies to them about their smoking status and recommend that they quit if they do. It is known that physicians can make 5-10% of patients quit smoking even with this questioning and advice alone. It is clear that all physicians, especially primary care physicians who provide various health services to the society, need to increase their awareness about smoking, which is a risk factor for many preventable diseases in the world, to increase their level of knowledge, and to change their negative attitudes and behaviors. This study was planned to evaluate the knowledge, attitudes and behaviors of physicians working in a university hospital about smoking cessation treatments. Materials and Methods: This study is a descriptive and cross-sectional study. The universe of the study consists of physicians (assistant, specialist, lecturer) working at Düzce University Research and Application Hospital between January 1, 2023 and April 1, 2023. 203 physicians who agreed to participate in the study were included. A printed questionnaire was used to collect data in the study. The created questionnaire was hand-delivered to all participants. The nicotine addiction of the smokers was evaluated with the Fagerström nicotine dependence test (FNBT). Data were evaluated in SPSS 23.0 statistical package form. A p value of <0.05 was accepted for statistical significance. Results: A total of 203 physicians participated in the study. 47.8% (n=97) of the physicians were female and 52.2% (n=106) were male. When the general branches of the participants are examined; 4.9% (n=10) were preclinical, 68.5% (n=139) were internal medicine physicians, 26.6% (n=54) were surgical specialists. Of the physicians participating in the study, 80.8% (n=164) were research assistants, 2% (n=4) were specialists, and 17.2% (n=35) were faculty members. The mean age of the participants was 31.34±6.87 (minimum=24, maximum=61). It was determined that the average number of correct answers given by the participants to a total of 20 questions measuring the level of knowledge about smoking cessation counseling was 13.41±3.80 (minimum=1, maximum=20). Of the physicians participating in the study, 15.8% (n=32) stated that they used to smoke, 8.4% (n=17) had quit smoking, and 75.9% (n=154) had never smoked. 32 smokers; He had been smoking for an average of 9.81±6.32 years and smoked an average of 13.78±6.86 cigarettes per day. While the median of package/year values was 5.00 (minimum=0.25, maximum=37.50), the mean of FNBT scores was 3.39±2.75. When the FNBT scores of the smoking participants were evaluated; 41.9% (n=13) very low, 25.8% (n=8) low, 12.9% (n=4) moderate, 12.9% (n=4) ) and 6.5% (n=2) were determined to be highly addicted to nicotine. 14.3% (n=29) of the physicians received smoking cessation counseling training, and 85.7% (n=174) did not receive any training. Considering the age and smoking status of physicians, the rate of smoking increased significantly as age increased (p=0.002). When the smoking status of the participants was examined by gender, it was seen that male physicians smoked significantly more than female physicians (p=0.004). When the knowledge scores of the participants were examined according to their smoking cessation counseling training, it was seen that the average of correct answers to the information questions of the participants who received the training was significantly higher (p=0.023). Conclusion: In addition to receiving smoking cessation counseling training, the fact that the participants had more time spent in medical education such as being a specialist and lecturer was also associated with higher awareness about smoking and more positive attitudes and behaviors related to smoking cessation treatments. Increase in the number and quality of education on smoking and smoking cessation counseling, both in the medical school and in the postgraduate period; It will make important contributions to the awareness, knowledge, attitudes and behaviors of physicians on this issue. All physicians, especially family physicians, who provide preventive health services to cover the whole society, should take a more conscious and more active role in smoking and tobacco addiction, which is one of the most important public health problems of our age and whose harm to health can be prevented with the right strategies. It is necessary to produce the necessary policies in this regard, to give the necessary value and weight to the issue of smoking cessation, to increase the number, quality and accessibility of trainings, and to conduct more comprehensive scientific research on this subject. Keywords: Smoking, Smoking Cessation Treatment, Physicians
Introduction and Aim: Tobacco use is one of the most important risk factors for chronic non-communicable diseases, and is a preventable cause of morbidity and mortality, and is a global public health problem affecting the whole world. Smoking has an important place among the risk factors for the development of diseases such as cardiovascular diseases, cancer, chronic respiratory system diseases and diabetes, which are the most common causes of death worldwide. Among the basic duties and responsibilities of physicians and health workers are the prevention of diseases and the improvement of existing health. It is both an easy and effective method within the scope of tobacco control that physicians ask each patient who applies to them about their smoking status and recommend that they quit if they do. It is known that physicians can make 5-10% of patients quit smoking even with this questioning and advice alone. It is clear that all physicians, especially primary care physicians who provide various health services to the society, need to increase their awareness about smoking, which is a risk factor for many preventable diseases in the world, to increase their level of knowledge, and to change their negative attitudes and behaviors. This study was planned to evaluate the knowledge, attitudes and behaviors of physicians working in a university hospital about smoking cessation treatments. Materials and Methods: This study is a descriptive and cross-sectional study. The universe of the study consists of physicians (assistant, specialist, lecturer) working at Düzce University Research and Application Hospital between January 1, 2023 and April 1, 2023. 203 physicians who agreed to participate in the study were included. A printed questionnaire was used to collect data in the study. The created questionnaire was hand-delivered to all participants. The nicotine addiction of the smokers was evaluated with the Fagerström nicotine dependence test (FNBT). Data were evaluated in SPSS 23.0 statistical package form. A p value of <0.05 was accepted for statistical significance. Results: A total of 203 physicians participated in the study. 47.8% (n=97) of the physicians were female and 52.2% (n=106) were male. When the general branches of the participants are examined; 4.9% (n=10) were preclinical, 68.5% (n=139) were internal medicine physicians, 26.6% (n=54) were surgical specialists. Of the physicians participating in the study, 80.8% (n=164) were research assistants, 2% (n=4) were specialists, and 17.2% (n=35) were faculty members. The mean age of the participants was 31.34±6.87 (minimum=24, maximum=61). It was determined that the average number of correct answers given by the participants to a total of 20 questions measuring the level of knowledge about smoking cessation counseling was 13.41±3.80 (minimum=1, maximum=20). Of the physicians participating in the study, 15.8% (n=32) stated that they used to smoke, 8.4% (n=17) had quit smoking, and 75.9% (n=154) had never smoked. 32 smokers; He had been smoking for an average of 9.81±6.32 years and smoked an average of 13.78±6.86 cigarettes per day. While the median of package/year values was 5.00 (minimum=0.25, maximum=37.50), the mean of FNBT scores was 3.39±2.75. When the FNBT scores of the smoking participants were evaluated; 41.9% (n=13) very low, 25.8% (n=8) low, 12.9% (n=4) moderate, 12.9% (n=4) ) and 6.5% (n=2) were determined to be highly addicted to nicotine. 14.3% (n=29) of the physicians received smoking cessation counseling training, and 85.7% (n=174) did not receive any training. Considering the age and smoking status of physicians, the rate of smoking increased significantly as age increased (p=0.002). When the smoking status of the participants was examined by gender, it was seen that male physicians smoked significantly more than female physicians (p=0.004). When the knowledge scores of the participants were examined according to their smoking cessation counseling training, it was seen that the average of correct answers to the information questions of the participants who received the training was significantly higher (p=0.023). Conclusion: In addition to receiving smoking cessation counseling training, the fact that the participants had more time spent in medical education such as being a specialist and lecturer was also associated with higher awareness about smoking and more positive attitudes and behaviors related to smoking cessation treatments. Increase in the number and quality of education on smoking and smoking cessation counseling, both in the medical school and in the postgraduate period; It will make important contributions to the awareness, knowledge, attitudes and behaviors of physicians on this issue. All physicians, especially family physicians, who provide preventive health services to cover the whole society, should take a more conscious and more active role in smoking and tobacco addiction, which is one of the most important public health problems of our age and whose harm to health can be prevented with the right strategies. It is necessary to produce the necessary policies in this regard, to give the necessary value and weight to the issue of smoking cessation, to increase the number, quality and accessibility of trainings, and to conduct more comprehensive scientific research on this subject. Keywords: Smoking, Smoking Cessation Treatment, Physicians
Description
Keywords
Aile Hekimliği, Family Medicine
