Smoking Cessation Intervention Based On Stage Of Change Theory In Patients With Chronic Obstructive Pulmonary Disease

Objective:(1)To explore the effect of smoking cessation intervention based on Stage of Change theory on smoking cessation behavior and smoking cessation rate in COPD smokers.(2)To explore the effect of smoking cessation intervention based on Stage of Change theory on nicotine dependence and withdrawal symptoms in COPD smokers.(3)To explore the effect of smoking cessation intervention based on Stage of Change theory on anxiety and depression in COPD smokers.Methods: A total of 87 COPD smokers in the outpatient and wards of the Department of Respiratory and Critical Medicine of First Affiliated Hospital of Guangxi Medical University from September 2019 to June 2020 were selected.44 cases from September 2019 to December 2019 were in the control group and43 cases from January 2020 to June 2020 were in the observation group.Patients in the control group received brief smoking cessation intervention.Patients in the observation group received smoking cessation intervention based on the Stage of Change theory.General data questionnaire,smoking cessation behavior stage assessment scale,Fagerstr?m test for nicotine dependence(FTND),Minnesota Nicotine Withdrawal Scale(MNWS),The Hospital Anxiety and Depression Scale were used to investigate.The differences of various indexes before intervention,1 month,3 months and 6 months after intervention were analyzed and compared between the two groups.Results:1.Stage distribution of patients’ behavior changes in quitting smoking:before intervention,there was no statistically significant difference in the distribution of quitting behavior between the two groups(P>0.05).At 1 month,3 months and 6 months after intervention,26(60.5%),29(67.4%)and 29(67.4%)COPD patients in the observation group were in the smoking cessation action stage and maintenance stage,respectively,which were more than 16(36.4%)and 19(43.2%)and 17(38.6%)in the control group,and the difference was statistically significant(P < 0.05).2.Comparison of smoking cessation rates between the two groups: at 1month,3 months and 6 months after intervention,the smoking cessation rates in the observation group were 60.5%,67.4% and 67.4% respectively,which were higher than those in the control group,and the difference was statistically significant(P<0.05).3.Comparison of the average number of cigarettes per day between the two groups: there were no significant difference between the two groups before intervention(P>0.05),but at 1 month,3 months and 6 months after intervention,the average number of daily smoking in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There were significant differences in the inter-group effect,time effect and interaction between the two groups before and after the intervention(P<0.05).4.Comparison of FTND scores between the two groups: before intervention,there was no significant difference in the scores of FTND between the two groups of COPD patients,but at 1 month,3 months and 6 months after intervention,the FTND scores of COPD patients in the observation group were significantly lower than those in the control group(P<0.05).There were significant differences in the scores of FTND between the two groups in the effect,time effect and interaction between the two groups(P<0.05).5.Comparison of the scores of MNWS between the two groups:at 1 month,3 months after intervention,the score of MNWS in the observation group was lower than that in the control group(P<0.05).At 6 months after intervention,the score of MNWS in the observation group was lower,but there was no significant difference(P>0.05).The score of MNWS was significantly different in intergroup effect,time effect(P<0.05),but not in their interaction(P> 0.05).6.Comparison of the anxiety and depression scores between the two groups:before intervention,there was no statistically significant difference in the anxiety scores and the depression scores between the two groups of COPD patients(P>0.05).After 1 month of intervention,the anxiety score in the observation group was significantly higher than that in the control group(P<0.05).There were no significant differences in the anxiety scores between the two groups at 3 months and 6 months after intervention,the depression scores between the two groups at 1 month,3 months and 6 months after intervention(P>0.05).Before and after the intervention,the anxiety score and the depression score were not significantly different in intergroup effect,time effect or their interaction(P>0.05).Conclusion:1.Smoking cessation intervention based on the Stage of Change theory can promote the transformation of smoking cessation behavior of COPD smokers,from the early smoking cessation stage to the action stage or maintenance stage,increase the smoking cessation rate,reduce daily smoking volume,reduce the degree of nicotine dependence of patients,and relieve the symptoms of nicotine withdrawal.2.The effect of smoking cessation intervention based on the Stage of Change theory on anxiety and depression of COPD smokers is not obvious.