The Perception and Intervention of Internship Nursing Students Helping Smokers to Quit: A Cross-Sectional Study in Chongqing, China

Abstract

Background: Smoking is among the most preventable causes of death globally. Tobacco cessation can lessen the number of potential deaths. The China Tobacco Cessation Guidelines encourage medical staff to perform the 5As (Ask, Advise, Assess, Assist, Arrange) when delivering tobacco dependence treatments to patients. Nursing students will develop to be nurses in the future and they have to finish 9 months of clinical practicum study in the last year at hospitals or care centers. However, the frequency of behaviors used to help smokers quit among Chinese nursing internship students is unclear. This study analyzed the rate of nurse interns’ performance of the 5As and which demographic characteristics, perceptions of smoking and knowledge predicted higher performance of the 5As. Methods: The cluster sampling method was used to select 13 teaching hospitals among 29. All nursing intern students were expected to finish the questionnaire about their 5As behaviors to help patients quit smoking. Their 5As performances were scored from one to five with 5 being the best and scores were summed. A multivariate linear mixed-effect model was employed to test the differences between their 5As. Results: Participating in the survey were 1358 interns (62.4% response rate). The average scores were as follows—Ask—3.15, Advise—2.75, Assess—2.67, Assist—2.58 and Arrange—2.42. A total of 56.3% students perceived that medical staff should perform the 5As routinely to help patients quit smoking. On the other hand, 52.1% viewed clinical preceptors as role models of the 5As. School education regarding tobacco control, smoking dependence treatment, self-efficacy and positive intentions were predictors of higher performance of the 5As (p < 0.001). Conclusions: Nursing internship students seldom administered tobacco dependence treatments to patients. It is essential to improve the corresponding education, skills and self-efficacy of the 5As. Meanwhile, clinical preceptors should procure more training in the responsibilities and skills related to tobacco cessation. In this way, clinical preceptors can be role models of the 5As and impart positive influences on interns.

The Study of the Impact Factors of Behaviors of Nursing Intern Students:&nbsp;PRECEDE-Based Structural Equation Modeling Analysis

“…The study found that tutors' instruction, though not much, was the major factor that in uenced students' 5As behaviors to help smokers to quit [20] . Overseas schools had implemented theoretical education on tobacco cessation among medical students on campus and clinical tutors had administered intensive instruction on smoking cessation in practicum, which played signi cant roles in instructing students to help smokers to quit [15] .…”

“…This study, based on the theory of PREEDE, developed a structural equation model and analyzed the 5As behaviors that in uenced the participation of nursing students in the tobacco cessation. It found that students scarcely performed smoking cessation behaviors [20] , and the enabling factor exerted the greatest effect on the implementation of tobacco cessation education; the next one was the reinforcing factor (the smoking cessation environment involving the smoking cessation behavior of the clinic tutor in the hospital); while the predisposing factor (knowledge, attitude and self-e cacy) had little effect on the implementation of 5As.…”

“…The design and method of this cross-sectional study in Chongqing has been previously reported [20] . To get to know the 5As behaviors and in uencing factors of nursing students in helping smokers to quit in clinic work, a web-based survey was conducted among nursing students in 13 teaching hospitals in Chongqing in January 2019.…”

“…Demographic characteristics: Students aged 16-32, average 20.15 ± 1.920, 101 males (7.4%) and 1257 females (92.6%),36 (2.7%) current smokers, 19 (18.8%)men and (1.4%)women. The characteristics of the participants had been reported in relevant literature [20] . Among the 1358 students, 1243 (91.5%) ever asked about the status of smoking, 1148 (84.5%) advised smokers to quit, 1115 (82.1%) assessed the willingness of patients to quit smoking, 1080 (79.5%) assisted smokers to quit, and 974 (71.7%) arranged follow-up service about smoking quit.…”

The study of the impact factors of behaviors of nursing intern students: PRECEDE-based structural equation modeling analysis

“…Demographic characteristics: Students aged 16-32, average 20.15 ± 1.920, 101 males (7.4%) and 1257 females (92.6%),36 (2.7%) current smokers, 19 (18.8%)men and 17 (1.4%)women. The characteristics of the participants had been reported in relevant literature [20] . Among the 1358 students, 1243 (91.5%) ever asked about the status of smoking, 1148 (84.5%) advised smokers to quit, 1115 (82.1%) assessed the willingness of patients to quit smoking, 1080 (79.5%) assisted smokers to quit, and 974 (71.7%) arranged follow-up service about smoking quit.…”