Cristina Martínez Catalan Institute of Oncology
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Transcript of Cristina Martínez Catalan Institute of Oncology
Cristina Martínez Cristina Martínez
Catalan Institute of Oncology Catalan Institute of Oncology
XIII International Conference on XIII International Conference on
Health Promoting HospitalsHealth Promoting Hospitals
INTRODUCTIONINTRODUCTION
The Catalan Institute of Oncology is a Smoke-Free Center since 1998
It was the first establish Hospital in becoming Smoke-Free in Catalonia
Now it is in charge of
Directing Coordinating and Promoting
The Catalan Network of Smoke-Hospitals
We have run annual tobacco consumption surveys to all the staff members of the hospital
INTRODUCTION (I)INTRODUCTION (I)
RESULTS 1997 RESULTS 1998 RESULTS 1999
SMOKERS 41,9 % 33,9 % 44,0 %
NON SMOKERS 34,2 % 45,4 % 32,7 %
FORMER SMOKERS
23,9 % 20,7 % 22,8 %
RESULTS 2001 RESULTS 2002 RESULTS 2004
34,6 % 32,8 % 34,0 %
38,3 % 44,6 % 37,9 %
27,1 % 22,6 % 28,2 %
High turnover
The percentage of tobacco consumption has been gradually decreasing in all staff categories during the last 7 years
INTRODUCTION (II)INTRODUCTION (II)
1997 1998 1999 2001 2002 2004
DOCTORS 29,7 % 30,4% 11,9 % 20,0 % 24,3 % 17,2 %
NURSES 44,4 % 31,0% 57,9 % 34,0 % 32,3 % 30,0 %
ADMINISTRATIVE47,8 % 43,7% 33,3% 21,5 % 46,7 % 31,3 %
OTHER STAFF(turnover=interns...et
c)
44,0 % 31,3% 37,5 35,3 % 30,7 % 47,8 %
Nurses have an important role in the implementation of tobacco control
activities addressed to the community
One of the main objectives is to decrease the number of
smokers
Our first target is the health professional staff , specially
nurses
Nurses work with people from the first phase of life to the last
Nurses are one of the most important health professional
groups to encourage people to stop smoking
INTRODUCTIONINTRODUCTION
OBJECTIVESOBJECTIVES
To decrease the number of smokers in our
hospital
How? including Mentoring process in a
cessation program
WHAT DOES THE MENTORING METHODOLOGY BRING WHEN WHAT DOES THE MENTORING METHODOLOGY BRING WHEN APPLIED TO A TOBACCO CONTROL PROGRAM ? (I)APPLIED TO A TOBACCO CONTROL PROGRAM ? (I)
Hypothesis
It is guided by a workmate who acts like a good model at the same time that gives an active supportIntense process that includes advice and instructions This methodology is especially addressed to smoking women, because:
Evaluates and follows the substance dependency closelyGives social individualized guidance through the cessation process
Mentoring is a teaching tool widely used in the business and educational fieldIt is the process in which the person with more experience –mentor - teaches, guides, suggests and helps-others –mentees - in the development of his/her professional or personal development, investing for it his/her own time, energy and
knowledge
WHAT IS MENTORING ?
MENTORING APPLIED TO A TOBACCO PROGRAM
WHAT DOES THE MENTORING METHODOLOGY BRING TO A WHAT DOES THE MENTORING METHODOLOGY BRING TO A TOBACCO CONTROL PROGRAM ? (II)TOBACCO CONTROL PROGRAM ? (II)
Hypothesis
OFFERS InformationMotivation Changes strategies and behaviorsRespect to the individuals and their own process of learning Transforms personal proposals or intentions in realistic actions
The mentoring develops the capacities of auto control and
auto perception of the smoker
In addition, it makes the abilities and skills
of the individual operative to achieve the change of his/her own aptitudes and attitudes
MATERIAL AND METHOD MATERIAL AND METHOD Pilot program
• The program was firstly addressed to nurses in our center in a pilot fashion• Mentoring leaflets about the program were distributed in the nursing wards • Nurses who wanted stop smoking could use this help free • The nurse interested could choose among the available mentors under her/his own will• The program was coordinated by one nurse and
carry out by six trained nurses• The follow-up time was 6 months (from May 2002 to December 2003)
PLANNING PLANNING
Hypothesis
The mentor assesses the person according to the change phases of Prochaska and Diclemente modelThey evaluate the physical dependency (Fageström test)Afterwards, they also assess the social and psychological dependency of the smoker (Russell test)Finally, they explore the personal tobacco consumption (n. cigarettes, years of consumption, etc..)
Assess
Planning Mentor and mentee draft a plan to give up smokingThey establish a minimum of 8 sessions in 6 months (there is no maximum!) They schedule the day “D” before a month They work in anticipating the weak points of the personThey reinforce the strong points They anticipate the prospective difficultiesAnd they plan alternatives to smoking in advance (sports…)
The mentor is chosen and they establish the first
encounter
a) Phase of smoker
c) Motivation
PreContemplation
don’t think in quitting in the prospective 6 months
Pre-observance
Contemplation:
- Think In quitting bef. 6 months
Preparation
-Think in quitting bef. 1 month - The + aspects are more valuable
Physic dependence: F < 6 Mentoring supportNursing support6 months
Physic dependence F: ≥ 6 Mentoring SupportDerivation to specialist unit TNR
Following 6 months Individual support individualSchedule Day “D” Work strategies
Abstinenceduring 6 months
No abstinenceStart to smoke again
The smoker nurse registers to the
program
b) Dependence phase:•Physical PhysicalSocial
RESULTS
FOLLOWING PLANNING FOLLOWING PLANNING
RESULTS (I)RESULTS (I)
Profile of the group
16 Women Nurses were enrolled freely in the pilot
program
Fageström media: 4, 7 (S.D= ± 1,99)
Media of cigarette consumption: 15,67 (S.D= ± 5,52)
Media of the years of consumption: 17 (S.D= ± 6,70)
41,7 % they had had previous experience in
quitting
RESULTS (II)RESULTS (II)
The 83,3 % of the mentees scheduled Day “D”
4 of them abandoned the program before being
treated
The rest were in preparation phase and started the
process of quitting with a mentor nurse
At the end of the process 5 of the 16 succeed in
quitting :meaning 31,25% of success
Hypothesis
CONCLUSIONS (I)CONCLUSIONS (I)
STRONG POINTS OF THE MENTORING PROGRAMSTRONG POINTS OF THE MENTORING PROGRAM
• The mentor is not just the therapist is also a personal support that the individual has during his/her process of quitting
• The role of the mentor is to advice and help choosing the best options for the person to achieve his/her goal
• The mentor helps the person to fix objectives and plans steps to reach them
•The mentor Helps the person to recognize and develop auto control capacities such confidence, self-esteem, etc..
• And, gives a feedback and a critical point of view to the person about his/her personal growing process
THE MENTORING IS AN USEFUL METHODOLOGICAL TOOL WHICH
OFFERS SUPPORT TO THE PROCESS OF QUITTING
IT HAS A LEVEL OF SUCCESS SIMILAR TO OTHER SMOKE
CESSATION INTERVENTIONS
CONCLUSIONS (II)CONCLUSIONS (II)
THANK YOUTHANK YOU