Cristina Martínez Catalan Institute of Oncology XIII International Conference on Health Promoting Hospitals

INTRODUCTION 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) RESULTS 1997 RESULTS 1998RESULTS 1999 SMOKERS 41,9 %33,9 %44,0 % NON SMOKERS34,2 %45,4 %32,7 % FORMER SMOKERS 23,9 %20,7 %22,8 % RESULTS 2001RESULTS 2002RESULTS ,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) DOCTORS29,7 %30,4%11,9 %20,0 %24,3 %17,2 % NURSES44,4 %31,0%57,9 %34,0 %32,3 %30,0 % ADMINISTRATIVE 47,8 %43,7%33,3%21,5 %46,7 %31,3 % OTHER STAFF (turnover=interns...etc) 44,0 %31,3%37,535,3 %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 INTRODUCTION

OBJECTIVES To decrease the number of smokers in our hospital How? including Mentoring process in a cessation program

WHAT DOES THE MENTORING METHODOLOGY BRING WHEN 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 support Intense process that includes advice and instructions This methodology is especially addressed to smoking women, because: Evaluates and follows the substance dependency closely Gives social individualized guidance through the cessation process Mentoring is a teaching tool widely used in the business and educational field It 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 TOBACCO CONTROL PROGRAM ? (II) Hypothesis OFFERS Information Motivation Changes strategies and behaviors Respect 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 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 Hypothesis The mentor assesses the person according to the change phases of Prochaska and Diclemente model They 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 smoking They 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 person They reinforce the strong points They anticipate the prospective difficulties And 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 support Nursing support6 months Physic dependence F: ≥ 6 Mentoring Support Derivation to specialist unit TNR Following 6 months Individual support individual Schedule Day “D” Work strategies Abstinence during 6 months No abstinence Start to smoke again The smoker nurse registers to the program b) Dependence phase: Physical  Physical  Social RESULTS FOLLOWING PLANNING

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) 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) STRONG 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)

THANK YOU