喫煙妊婦の禁煙への行動変容過程に影響する因子の質的検討 : 禁煙達成群と非達成群の言動の比較から <原著論文>

本研究は,携帯電話によるe-learningを併用した「妊婦用禁煙支援プログラム」に参加した妊娠22週未満の喫煙妊婦52名を対象としたインタビュー調査を実施し,禁煙へのプロセスに影響する因子について,禁煙達成群(禁煙G)と禁煙非達成群(非達成G)の言動を,内容分析を参考にして比較検討した.その結果,禁煙導入時は,両群において対象者の多くが「禁煙への決意」を述べ,動機づけの高さが示された.特に禁煙Gは,禁煙開始後1ヵ月には,「妊娠を機に節煙している」,「夫も禁煙に協力,一緒に禁煙する」などのデータが抽出され,3ヵ月後には,「このまま禁煙できる」などの禁煙を実行し,達成した言動を認めた.一方,非達成Gは,プログラム導入時に述べた「禁煙の決意」に相当する言動は,禁煙開始後1ヵ月には減少し,さらに禁煙開始後3ヵ月には著しく減少し,禁煙行動への意欲が経時的に減少するプロセスを示した.また,禁煙継続への阻害因子は,禁煙開始前から非達成Gの方が禁煙Gと比較して多く抽出され,阻害因子を多く持っている事が明らかになった.

The aim of this study was to find the factors that affect quit smoking behavior continuation. The participants were 52 pregnant women smokers who were in the first trimester (under 22 weeks). They all possessed mobile telephones and were willing to participate in the designed e-learning program. They were classified into two groups; a group that had been unsuccessful in quit smoking (Group N) and a group that had been successful (Group Q). The ten-minute interviews were conducted during their medical check-ups. The behavioral changes associated with giving up smoking in these two groups were compared, and content analysis was performed.

The results showed that most of the participants in both groups had a strong will to quit smoking when they first gave up. This showed their high motivation to quit smoking. After one month, participants in Group Q stated, "A desire to give up smoking or cut down was triggered by the pregnancy", "My husband helps me to avoid smoking". Then after three months, some stated, "I think I can quit smoking permanently."

On the other hand, the number of codes about the will to quit smoking in Group N gradually decreased while they tried this e-learning program. Furthermore, the codes remarkably decreased after three months, suggesting that the motivation of the participants in Group N to quit smoking had decreased.

In conclusion, this study revealed that Group N showed more factors that inhibited smoking cessation than Group Q.