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