THE ASSESSMENT OF THE EFFICIENCY OF COGNITIVE BEHAVIORAL ADVISORY METHODS FOR SMOKING CESATION IN FAMILY MEDICINE PRACTICE

Uvod Korist od prestanka pušenja je nemjerljiva u bilo kojoj životnoj dobi. Cilj istraživanja je komparativna evaluacija i procjena efikasnosti krajnjeg rezultata prestanka pušenja metodama tri najčešće primjenjivane bihevioralno- kognitivne nefarmakološke intervencije u svakodnevnom radu porodičnog ljekara. U procesu odvikavanja korišten je 5P model. Metode i ispitanici: Program bihevioralno kognitivnih intervencija za prestanak pušenja je proveden u ambulantama porodične medicine u Domu zdravlja Zenica, u registriranih pacijenata- pušača dobi >od 17 godina, u periodu 2005. do 2009. godine. Ukupno je realizovano 8.366 intervencija-savjetovanja. Promotivne intervencije provedene su u tri faze primjenom različitih aktivnosti čiji je krajnji rezultat prestanak pušenja bilježen i evaluiran za svaku posebno: 1. kratkotrajni intervju o pušačkom statusu i sistematična identifikacije pušačkog statusa u 375 zdravstvenih kartona pacijenata i evaluacija efikasnosti tretmana (re-test) uz ponovljenu aktivnost u periodu od 6-12 mjeseci kasnije; 2. individualno kratkotrajno savjetovanje u trajanju od 3-10 minuta u okviru nekog terapeutskog odnosa i evaluacija efikasnosti tretmana (re-test) uz ponovljenu aktivnost u periodu od 6-12 mjeseci kasnije; 3. kontinuirano, kontrolirano savjetovanje pušača sa zakazivanjem posjeta za podršku pri prestanku pušenja do postizanja cilja. Ovaj metod sadržava 5 faza: inicirano predrazmišljanje, razmišljanje, pripremu, aktivnost prestanak pušenja i održavanje. Efekti kontinuiranog savjetovanje pušača sa zakazivanjem posjeta praćeni su u 100 pacijenata istraživačke skupine. Rezultati: Primjenom individualnog kratkotrajnog savjetovanja u okviru terapeutskog odnosa ljekar- pacijent postiže se zadovoljavajući efekat prestanka pušenja u 11% odnosno u 655 od ukupno 5984 pacijenata. Najbolja efikasnost prestanka pušenja postiže se primjenom kontinuiranog, kontroliranog savjetovanja pušača sa zakazivanjem posjeta za podršku jer je 55% ili 55 pacijenata od ukupno 100 prestalo pušiti. Zaključak Zlatni standard u borbi protiv pušenja je planirano promotivno kontinuirano savjetovanje pušača sa zakazivanjem posjeta.Introduction The benefits of patient`s cessation smoking are important in any age. The goal of the research is a comparative evaluation and assessment of outcome of the three most commonly used cognitive behavioral- pharmacological interventions during smoking cessation procedures regarding 5A model in the daily work of a family medicine physicians. Methods and patients: The behavioral cognitive intervention of cessation smoking was conducted in a Family medicine centre at the Primary health care home in Zenica among registered patients-smokers aged >17 years, from 2005 to 2009. A total of 8366 interventions were realized counseling. Interventions were carried out in three stages using various activities whose end result quitting recorded and evaluated for each particular: 1 brief interview about smoking status and systematic identification of smoking status in 375 medical records of patients and evaluation of treatment effectiveness (re-test) with repeated activity in the period of 6-12 months later; second individual short-term counseling for a period of 3-10 minutes in the framework of a therapeutic relationship and evaluation of treatment effectiveness (retest) with repeated activity for a period of 6-12 months later, 3 continuous, controlled advising smokers to schedule visits for smoking cessation support to achieve the goal. This method includes five stages: Initiated before thinking, reflection, preparation, action and maintenance of smoking cessation. Effects of continuous counseling smokers to schedule visits were observed in 100 patients, the research group. Results: Applying the results of individual brief counseling in the therapeutic relationship physicianpatient achieves a satisfactory effect of smoking cessation in 11% or 655 of the total of 5984 patients. The best efficiency is achieved by smoking cessation applying continuous, controlled counseling smokers to schedule visits for support because the 55% or 55 out of 100 patients to stop smoking. Conclusion: The gold standard in the fight against smoking is planned promotional continuously advising smokers to schedule a visit