无烟医院政策执行的障碍

目的了解无烟医院政策执行的障碍,为发展干预策略提供科学的背景资料。方法联合应用专题小组访谈和个人深入访谈对医务人员进行调查。结果无烟医院政策执行的障碍有:①倾向因素:医务人员吸烟严重,上班时间吸烟常见;医务人员对吸烟和被动吸烟的危害认识不清;对创建无烟医院没有足够的信心;②促成因素:医院执行政策的能力不足;③强化因素:吸烟是个人的生活权利;吸烟受社会风俗的影响;领导不重视控烟;担心劝烟会影响同事关系或医患关系。结论研究结果表明,倾向因素不是阻碍医院执行无烟政策的主要因素,强化和促成因素才是主要障碍。采取综合性的干预措施,营造良好的控烟氛围,促进社区参与,提高医院控烟能力,效果或许更理想。

Barriers in the Implementation of Smoke Free Hospital Policies

Objective To explore barriers in the implementation of smoke free hospital policies(SFHP)to support for the development of intervention strategies.MethodsFocus group discussion and in-depth individual interview were conducted with the health professionals(HPS).ResultsBarriers in the implementation of SFHP included:1)Predisposing factors:High smoking prevalence and frequent smoking at work hours among HPS,without awareness of harmfulness Of smoking and passive smoking,lacking the confidence to develop smoke free hospitals.2)Enabling factors:Low staff competence in the implementation of SFHP.3)Reinforcing factors:Smoking as personal lifestyle choice was influenced by social norms.Tobacco control was not on the hospital president'agenda,and HPs were afraid of breaking the relationship with colleagues or the relationship between doctor-patient by providing smoking cessation advice.ConclusionThe findings indicated that enabling factors and reinforcing factors were the main barriers in the implementation of SFHP.Applying comprehensive intervention strategies such as creating a supportive environment for tobacco control.promoting community participation,developing skill of tobacco control,may be more effective.