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مجله پژوهش در بهداشت محیط

مجله پژوهش در بهداشت محیط

مروری بر راهکارهای اجرایی ارائه خدمات مشاوره و ترک دخانیات درنظام مراقبت‌های بهداشتی اولیه: یک خلاصه سیاستی

نوع مقاله : مقاله کوتاه

نویسندگان
1 گروه آموزش بهداشت و ارتقای سلامت، دانشکده بهداشت، مرکز تحقیقات محیط کار، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران.
2 گروه اپیدمیولوژی و آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی قم، قم، ایران.
3 گروه آموزش بهداشت و ارتقای سلامت، مرکز تحقیقات آلاینده‌ای محیطی، دانشکده بهداشت، دانشگاه علوم پزشکی قم، قم، ایران.
چکیده
زمینه و هدف: مصرف دخانیات یکی از مهم‌ترین عوامل خطر قابل پیشگیری بیماری‌های غیرواگیر و از علل عمده مرگ‌ومیر است. این مطالعه با هدف ارائه راهکار برای ارائه خدمات مشاوره و ترک دخانیات در نظام مراقبت‌های بهداشتی اولیه انجام شد.

مواد و روش‌ها: این مطالعه به صورت پژوهش مروری و در قالب یک خلاصه سیاستی انجام شد. برای شناسایی شواهد و تدوین راهکارهای اجرایی، مقالات علمی، دستورالعمل‌ها، راهنماهای بالینی و اسناد سیاستی در پایگاه‌های PubMed، Google Scholar، ScienceDirect و SID و هم‌چنین وب‌سایت‌های سازمان جهانی بهداشت و وزارت بهداشت با استفاده از کلیدواژه‌های مرتبط با دخانیات، مشاوره، ترک دخانیات، سیگار و مراقبت‌های بهداشتی اولیه جستجو شدند. در نهایت، 26 سند بر اساس در دسترس بودن، به‌روز بودن و ساختار مناسب انتخاب و بررسی شد.

یافته‌ها: بر اساس شواهد بررسی‌شده، اجرای یک مدل یکپارچه سه‌سطحی شامل غربالگری و ثبت وضعیت، مداخله مختصر و ترغیب برای ترک و درمان تخصصی و ارجاع هدفمند پیشنهاد می‌شود. هم‌چنین آموزش کارکنان، حمایت سازمانی، تأمین دارو، پیگیری از راه دور، تأمین مالی پایدار و همکاری بین‌بخشی از الزامات مهم اجرای موفق این مدل بودند. محدودیت منابع، آموزش ناکافی کارکنان، بار کاری، هزینه دارو و ضعف همکاری بین‌بخشی از مهم‌ترین موانع شناسایی‌شده بود.

نتیجه‌گیری: ارائه خدمات مشاوره و ترک دخانیات در مراقبت‌های بهداشتی اولیه می‌تواند ضمن افزایش دسترسی و اثربخشی خدمات ترک، موجب صرفه‌جویی اقتصادی و ارتقای عدالت در سلامت شود. اجرای پایدار این سیاست مستلزم تأمین منابع مالی، تقویت نیروی انسانی، ایجاد مشوق‌های عملکردی، تعهد مدیریتی و سیاسی و تقویت همکاری بین‌بخشی است.
کلیدواژه‌ها

عنوان مقاله English

A Review of Operational Strategies for Delivering Tobacco Counseling and Cessation Services in Primary Health Care: A Policy Brief

نویسندگان English

Mostafa Nasirzadeh 1
Abolfazl Mohammadbeigi 2
Mohammad Aligol 3
1 Department of Health Education and Health Promotion, School of Health, Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
2 Department of Epidemiology and Biostatistics, School of Health, Qom University of Medical Sciences, Qom, Iran.
3 Department of Health Education and Health Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.
چکیده English

Background and Objective: Tobacco use is one of the most important preventable risk factors for non-communicable diseases and a major cause of mortality and economic burden on health systems. This study aimed to develop operational strategies for providing tobacco counseling and cessation services within the primary health care system.

Materials and Methods: This review study was conducted in the form of a policy brief. To identify the available evidence and develop operational strategies, scientific articles, guidelines, clinical practice guidelines, and policy documents were searched in PubMed, Google Scholar, ScienceDirect, and SID, as well as on the websites of the WHO and the Ministry of Health. Relevant keywords included tobacco, counseling, tobacco cessation, smoking, and primary health care. Ultimately, 26 documents were selected and reviewed based on their accessibility, currency, and appropriate structure.

Results: Based on the evidence reviewed, an integrated three-tier model is proposed, comprising systematic screening and documentation of tobacco use status, brief intervention and encouragement to quit, and specialized treatment with targeted referral. Staff training, organizational support, medication availability, remote follow-up, sustainable financing, and intersectoral collaboration were also identified as important requirements for successful implementation of this model. Limited resources, inadequate staff training, workload, medication costs, and weak intersectoral collaboration were identified as the major barriers.

Conclusion: Providing tobacco counseling and cessation services within primary health care can improve access to and effectiveness of cessation services while contributing to economic savings and greater health equity. Sustainable implementation of this policy requires adequate financial resources, and enhanced intersectoral collaboration.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

کلیدواژه‌ها English

Counseling, Tobacco Cessation
Primary Health Care System
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