#课题申请：关注一下“轨迹研究”的类型~ | 以一篇SCI文献为例
# 2021
# 课题申请
关注一下“轨迹研究”的类型~
吸烟是肺癌的独立危险因素，多数肺癌患者都有吸烟史——这是已经被证实了的。在具有吸烟史的肺癌患者中，约有42-50%比例在癌症诊断期间或之后会停止吸烟。但是，研究显示，这种类型的“停烟行为”可能不会持续很久。数据显示是会有60%左右的患者在完成治疗后可能会恢复吸烟。
因此，为了制订有效的戒烟计划，并确定最佳的干预时机，了解肺癌诊断后吸烟行为的变化或轨迹以及与不同轨迹相关的因素是必须的。
Yang, C‐C, Liu, C‐Y, Wang, K‐Y, et al. Trajectory of smoking behaviour during the first 6 months after diagnosis of lung cancer: A study from Taiwan. J Adv Nurs. 2020; 00: 1– 11.
https://doi.org/10.1111/jan.14745
肺癌诊断后6个月内的吸烟行为轨迹：来自台湾的一项研究
Abstract 摘要
Aims To identify different classes of change pattern/ trajectory of tobacco smoking behaviour after diagnosis of lung cancer using multi-wave data and to explore factors associated with the class membership.
研究目的：利用多波数据确定肺癌诊断后不同类别的吸烟行为改变模式/轨迹，并探索与类别相关的因素。
Design This is a multi-wave observational study.
研究设计：一项多波观测研究
Methods Smoking behaviour data were collected at diagnosis and then every month for 6 months from 133 newly diagnosed people with lung cancer who had recently quit smoking or continued to smoke at diagnosis. These patients were recruited from three medical centres and data were collected from May 2014 to January 2017. Smoking behaviour was assessed based on patients’self-reports on whether they smoked during the last month (yes/no) for a total of seven times.Mixture latent Markov model and logistic regression were used to analyse data.
研究方法：研究人员在诊断时收集了吸烟行为数据，然后在6个月的时间里，每个月收集133名新诊断的肺癌患者的吸烟行为数据，这些患者最近戒烟或诊断时继续吸烟。收集2014.05-2017.01期间来自3个医疗中心的数据。吸烟行为的评估是基于患者的自我报告，他们在过去一个月内是否吸烟等，共七项。采用混合潜马尔可夫模型和逻辑回归分析数据。
Results Two latent classes of smoking trajectory were identified among recent quitters or current smokers of people with lung cancer, namely “perseverance for abstinence” and “indecisive for abstinence.” Patients who were younger age (OR = 0.95, p = 0.026), exposure to second-hand smoke (OR = 3.35, p = 0.012) and lower selfefficacy for not smoking (OR = 0.96, p = 0.011) were more likely to belong to the class of “indecisive for abstinence.”
研究结果：在最近戒烟者或肺癌患者中发现了两种潜在的吸烟轨迹，即坚持戒烟和犹豫不决戒烟。年龄较轻(OR = 0.95, p = 0.026)、接触二手烟(OR = 3.35, p = 0.012)、不吸烟自我效能感较低(OR = 0.96, p = 0.011)的患者更有可能属于犹豫不决的戒断类别。
Conclusions Heterogeneous classes of smoking trajectory existed in newly diagnosed people with lung cancer. The risk factors associated with a less favourable smoking trajectory can be incorporated into tailored smoking-cessation programs for patients newly diagnosed with lung cancer.
研究结论：①新诊断的肺癌患者存在不同类型的吸烟轨迹：坚持戒烟和犹豫不决戒烟。②明确不同类型戒烟行为的影响因素，以此可以为制订戒烟干预计划提供依据。
Impact The dynamic trajectory of smoking behaviour had not been adequately explored among newly diagnosed people with lung cancer. Two classes of smoking trajectory and the predictors associated with the class membership were identified. These findings suggest that the diagnosis of cancer is a teachable moment for smoking cessation. Patients with younger age, lower self-efficacy of not smoking and exposure to second-hand smoke at home need special attention.
研究意义：在新诊断的肺癌患者中，吸烟行为的动态轨迹尚未得到充分的探索。确定了两类吸烟轨迹及相关影响因素。这些发现表明，癌症诊断时期是戒烟的一个关键的教育时机，其中年龄较小、不吸烟自我效能感较低、在家接触二手烟的患者需要特别注意。
KEYWORDS change in smoking behaviour, latent Markov model, newly diagnosed lung cancer, nursing,smoking trajectory
关键词：吸烟行为的改变，潜在马尔科夫模型，新确认肺癌，护理，吸烟轨迹