Effects of an educational intervention with nursing professionals on approaches to hospitalized smokers: a quasi-experimental study

Boni, Fernanda Guarilha; da Rosa, Yasmin Lorenz; Leite, Renata Meirelles; Lopes, Fernanda Machado; Echer, Isabel Cristina

doi:10.1590/1980-220X-REEUSP-2021-0569en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 56 • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0569en copy

Effects of an educational intervention with nursing professionals on approaches to hospitalized smokers: a quasi-experimental study^* * Extracted from the dissertation “Desenvolvimento e avaliação de uma ação educativa com profissionais de enfermagem sobre abordagem ao paciente tabagista”, Universidade Federal do Rio Grande do Sul, 2021.

Efectos de una intervención educativa con profesionales de enfermería en el abordaje de pacientes fumadores: un estudio cuasi-experimental

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to assess the effects of an educational intervention on smoking cessation aimed at the nursing team.

Method:

this is a quasi-experimental study with 37 nursing professionals from a Brazilian hospital from May/2019 to December/2020. The intervention consisted of training nursing professionals on approaches to hospitalized smokers divided into two steps, the first, online, a prerequisite for the face-to-face/videoconference. The effect of the intervention was assessed through pre- and post-tests completed by participants. Smokers’ medical records were also analyzed. For analysis, McNemar’s chi-square test was used.

Results:

there was an increase in the frequency of actions aimed at smoking cessation after the intervention. Significant differences were found in guidelines related to disclosure to family members of their decision to quit smoking and the need for support, encouragement of abstinence after hospital discharge, and information on tobacco cessation and relapse strategies.

Conclusion:

the educational intervention proved to be innovative and with a great capacity for disseminating knowledge. The post-test showed a positive effect on the frequency of actions aimed at smoking cessation implemented by the nursing team.

DESCRIPTORS
Tobacco Use Cessation; Health Education; Nursing Team; Education; Nursing; Continuing; Teaching

Variables analyzed	N (%)
Sex
Female	34 (91.9%)
Age*	47.1 ± 7.6
Professional category
Nursing technician	12 (32.4%)
Nurse	25 (67.6%)
Job tenure in years*	23.1 ± 7.7
Education level
High school	10 (27%)
Undergraduate education	1 (2.7%)
Specialization	14 (37.8%)
Master’s degree	9 (24.3%)
Doctoral degree	3 (8.1%)
Smoking status
Smoker	1 (2.7%)
Smoking time in years	1
Packs consumed per year	18
Non-smoker	34 (91.9%)
Non-smoker, but lives with smokers	2 (5.4%)

Variables assessed	Before intervention	After intervention	p
You feel prepared to approach hospitalized smokers			0.065
Yes	15 (40.5%)	27 (73%)
No	5 (13.5%)	2 (5.4%)
Partially	17 (45.9%)	8 (21.6%)
Assesses whether patients are motivated to quit smoking			0.179
Always	13 (35.1%)	21 (56.8%)
Sometimes	20 (54.1%)	15 (40.5%)
Never	4 (10.8%)	1 (2.7%)
Addresses patients about smoking cessation during hospitalization			0.062
Always	12 (32.4%)	23 (62.2%)
Sometimes	20 (54.1%)	11 (29.7%)
Never	5 (13.5%)	3 (8.1%)
Relates the reason for the current hospitalization with smoking			0.064
Always	13 (35.1%)	23 (62.2%)
Sometimes	17 (45.9%)	13 (35.1%)
Never	7 (18.9%)	1 (2.7%)
Guides smoking cessation strategies and provides support material (folders/manuals)			0.272
Always	10 (27%)	11 (29.7%)
Sometimes	18 (48.6%)	22 (59.5%)
Never	9 (24.3%)	4 (10.8%)
Advises patients to set a date to quit smoking			0.170
Always	6 (16.2%)	10 (27%)
Sometimes	14 (37.8%)	19 (51.4%)
Never	17 (45.9%)	8 (21.6%)
Guides on difficulties related to abstinence symptoms			0.672
Always	15 (40.5%)	15 (40.5%)
Sometimes	14 (37.8%)	17 (45.9%)
Never	8 (21.6%)	5 (13.5%)
Encourages the disclosure to family members of their decision to quit smoking and the need for support			0.028
Always	7 (18.9%)	16 (43.2%)
Sometimes	14 (37.8%)	16 (43.2%)
Never	16 (43.2%)	5 (13.5%)
Guides and encourages tobacco abstinence after hospital discharge			0.033
Always	14 (37.8%)	27 (73%)
Sometimes	17 (45.9%)	8 (21.6%)
Never	6 (16.2%)	2 (5.4%)
Guides that relapses are part and that patients should analyze strategies to quit smoking			0.006
Always	9 (24.3%)	21 (56.8%)
Sometimes	16 (43.2%)	13 (35.1%)
Never	12 (32.4%)	3 (8.1%)

Variables assessed	N (%)
Sex
Male	604 (53.5%)
Age in years*	58.2 ± 17.4
Hospital stay in days ^†	8.2 (4.1–15)
Smoking status
Smoker	80 (7.1%)
Smoking time in years*	33.9 ± 15.4
Cigarettes consumed per day ^†	20 (10–27.5)
Smoker in abstinence	85 (7.5%)
Time without smoking in years ^†	10.5 (3–20.7)
Non-smoker	940 (83.3%)
No medical records	23 (2%)

Variables assessed	N (%)
Reasons for hospitalization
Biopsy/staging and diagnosis of neoplasia/oncologic surgery/chemotherapy	34 (20.6%)
By-pass/vascular surgery/arteriography	22 (13.3%)
Chemical dependence	12 (7.3%)
Abdominal pain/weight loss/diarrhea/vomiting	11 (6.7%)
Orthopedic surgery	11 (6.7%)
Correct record in anamnesis in relation to tobacco use	73 (44.2%)
Presence of Nursing Diagnosis related to substance abuse	9 (4.9%)
Risk-prone health behavior	5 (62.5%)
Risk of acute substance abstinence syndrome	2 (25%)
Acute substance abstinence syndrome	1 (12.5%)
Nursing care prescription	11 (6%)
Assists patients to identify realistic and attainable goals	3
Encourages treatment compliance	1
Assesses verbal and nonverbal signs of anxiety	1
Provides calm and comfortable environment	1
Communicates abstinence signals	1
Communicates anxiety indicator behavior	1
Reinforces important information	1
Encourages patients to develop control and responsibility over their own treatment	2

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Fernanda Guarilha Boni R. São Manoel, 963, Rio Branco 90620-110 – Porto Alegre, RS, Brazil fernandagboni@gmail.com