[1]施丽莎,何 菁,杨经玉,等.基于COM-B框架从慢性阻塞性肺病患者视角探讨减少戒烟复吸的研究[J].医学信息,2024,37(03):40-47，60.[doi:10.3969/j.issn.1006-1959.2024.03.007]
　SHI Li-sha,HE Jing,YANG Jing-yu,et al.Study on Reducing Relapse from the Perspective of Patients with Chronic Obstructive Pulmonary Disease Based on the COM-B Framework[J].Journal of Medical Information,2024,37(03):40-47，60.[doi:10.3969/j.issn.1006-1959.2024.03.007]
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基于COM-B框架从慢性阻塞性肺病患者视角探讨减少戒烟复吸的研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年03期
页码:
40-47，60
栏目:
公共卫生信息学
出版日期:
2024-02-01

文章信息/Info

Title:
Study on Reducing Relapse from the Perspective of Patients with Chronic Obstructive Pulmonary Disease Based on the COM-B Framework
文章编号:
1006-1959（2024）03-0040-09
作者:
施丽莎; 何 菁; 杨经玉; 等
（1.首都医科大学护理学院，北京 100069；2.北京世纪坛医院呼吸科，北京 100038；3.首都医科大学附属朝阳医院北京市呼吸疾病研究所烟草依赖治疗研究室，北京 100020；4.中国医学科学院阜外医院呼吸与肺血管病诊治中心，北京 100037）
Author(s):
SHI Li-sha; HE Jing; YANG Jing-yu; et al.
(1.Nursing College of Capital Medical University,Beijing 100069,China;2.Department of Respiratory Medicine,Beijing Shijitan Hospital,Beijing 100038,China;3.Tobacco dependence treatment Lab, Beijing Institute of Respiratory Diseasers, Beijing Chaoyang HospitalBeijing 100020,China;4 .Center of Respiratory and Pulmonary Vascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciencesand Peking Union Medical College, Beijing 100037,China）
关键词:
慢阻肺; COM-B; 吸烟; 复吸; 能力; 机会; 动机
Keywords:
COPD; COM-B; Smoking; Relapse; Ability; Opportunity; Motivation
分类号:
R563
DOI:
10.3969/j.issn.1006-1959.2024.03.007
文献标志码:
A
摘要:
目的 探讨COPD患者戒烟心理行为改变演变过程和动机、能力和机会因素对戒烟行为的影响。方法 以COM-B行为改变框架为理论基础，于2019年1月-12月选取来自北京市两家三级甲等医院4例COPD患者进行半结构式深度访谈，每位患者随访1年，共4次（男3例，女1例；成功戒烟1例，复吸3例），多次质性研究追踪患者的心理状态和行为变化特点。结果 能力因素：①生理能力-病情因素，病情加重促进戒烟。病情好转可促进戒烟复吸，也可促进戒烟。②心理能力中不利于戒烟的因素：?訩知道戒烟知识但不认可；?訪对戒烟后对身体的影响认知不足；?訫对吸烟习惯的认知，认为吸烟是一种习惯，很难改变习惯；心理能力中有利于戒烟的因素：较强的意志力与自制力。机会因素：①物理机会中不利于戒烟的因素：逢年过节，周围有人在抽，家里有烟；②社会机会-家庭支持，弱个人内驱力和一般家庭支持，戒烟效果一般；③社会机会-工作制约，工作体制对吸烟会有一定的约束，但离开制度或工作环境后，依然会复吸。动机因素：①自动动机-情绪的影响，负性情绪时会引起复吸，戒烟需要做好心理准备；②反思动机-认识的改变快乐转移，喝茶或锻炼转移注意力，有利于减少复吸；③反思动机-理想与希望，理想与希望有助于戒烟，研究发现专注做热爱的事情时，患者会自觉主动不吸烟。结论 动机上，如果患者的戒烟动机不强烈，一般较难触动行为的改变，所以首先需要转变患者的动机，将不愿意引导为愿意。能力和机会上，当患者有了戒烟意愿，并不代表戒烟行为就会成功，还需做好准备和反复训练。随着时间的推移，反思动机逐渐让位给自动动机，控制行为的过程从有意识的决策转变为常规和环境触发，从而使行为以最小的努力发生，最终成功戒烟。
Abstract:
Objective To explore the evolution of psychological behavior change and the influence of motivation, ability and opportunity on smoking cessation behavior in COPD patients.Methods Based on COM-B behavioral change framework, four patients with COPD from two third-grade grade A hospitals in Beijing were selected for semi-structured in-depth interviews from January to December 2019. Each patient was followed up 4 times for 1 year (3 males, 1 female; 1 case of successful smoking cessation, 3 cases of relapse). Multiple qualitative studies tracked the mental state and behavioral characteristics of the patients.Results Ability factor: ①physiological ability-disease factor, disease aggravation promoted smoking cessation, while getting better could promote smoking cessation and relapse, as well as smoking cessation. ②The psychological ability of the factors that were not conducive to smoking cessation: ?訩knowing the knowledge of smoking cessation but do not recognize; ?訪lacking of awareness of the effects of smoking cessation on the body;?訫perceptions of smoking as a habit that was difficult to change; among the factors of mental ability in favor of smoking cessation: strong willpower and self-control. Opportunity factors: ①factors that were not conducive to smoking cessation in physical opportunities: people around smoking and smoking at home during holidays; ②social opportunities - family support, when somebody had weak personal drive and general family support, the effect of smoking cessation was moderate; ③social opportunity-job restriction, work system would have certain constraints on smoking, but after leaving the system or work environment, they would still smoke again. Motivation factors: ①automatic motivation-the influence of mood, when the mood was bad would cause relapse, smoking cessation needed to be prepared psychologically; ②reflective motivation-cognitive change happiness shift, tea or exercise shift attention, was conducive to reduce relapse; ③reflect on the motivation-ideals and hopes, ideals and hopes could help to smoking cessation. Studies had found that there was a situation in which patients will voluntarily not smoke, and that was when they focus on doing what they love.Conclusion In terms of motivation, if the motivation of patients to quit smoking is not strong, it is generally difficult to trigger the change of behavior. Therefore, it is necessary to change the motivation of patients from reluctance to willingness. In terms of ability and opportunity, when patients have the intention to quit smoking, it does not mean that the quitting behavior will be successful. They need to be prepared and trained repeatedly. Over time, reflective motivation gradually gives way to automatic motivation, and the process of controlling behavior shifts from conscious decision making to routine and environmental triggering, thus enabling behavior to occur with minimal effort and ultimately successful quitting.

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更新日期/Last Update: 1900-01-01