原著 入学前に受けた喫煙防止教育の違いに着目したの比較 松浪容子 1 山口美友紀 2 古瀬みどり 1 3 熱海裕之 1. 山形大学医学部看護学科 2. 山形大学医学部附属病院 3. 国立病院機構山形病院 1.3 67.1 キーワード : 目的 2013 1 7.9 2 21 3 4 6 7 10 9 連絡先 990-9585 2-2-2 TEL: 023-628-5441 FAX: 023-628-5441 e-mail: 2016 1 8 2016 4 13 方法 A A1 4 257B B 1 3120 377 25 7 図 1 31
各質問について当てはまるものを〇で囲み [ ] 内には数字 語句を記入してください 問 1 学年 : 1 年生 2 年生 3 年生 4 年生 問 2 性別 : 女性 男性 問 3 あなたはタバコを吸いますか (1) 現在吸っている (2) していたが やめた (3) 試しに吸ってみたことがある (4) いいえ 問 4 小学校から高校までの期間にタバコの害と受動喫煙の害について学ぶ機会が ありましたか 覚えている範囲で それぞれの回数をお答えください タバコの害 (1) 小学校 [ 回 ] (2) 中学校 [ 回 ] (3) 高校 [ 回 ] 受動喫煙の害 (1) 小学校 [ 回 ] (2) 中学校 [ 回 ] (3) 高校 [ 回 ] 問 5 受動喫煙を避ける行動を普段からしていますか (1) はい (2) いいえ 問 6 他人のタバコの煙を吸うことで かかりやすくなると思う病気 症状全てに 〇をつけてください 妊婦への影響 ( 早産 新生児の低体重化など ) 乳幼児突然死症候群 肺がん 気管支喘息 慢性閉塞性肺疾患 (COPD) 歯周病 脳梗塞 心筋梗塞 注意欠陥多動性障害 (ADHD) アンケートは以上です ご協力ありがとうございました 図 1 アンケート用紙 COPD ADHD 分析方法 2 Mann-Whitney-U 3 Kruskal-Wallis Pearson 2 Searman 5 SPSS 19.0 J for Windows 倫理的配慮 結果 377228 A 61.5B 58.3 60.5 225 59.7 1 1. 対象の属性 ( 表 1) 91.1 31.3 4 1.8 205 91.1 135.8 218 96.9 32
学年人 (%) 性別人 (%) 喫煙状況人 (%) 受動喫煙人 (%) 表 1 対象者の属性 (N 225) A (n 156) B (n 69) 1 48 (21.3) 18 (11.5) 30 (43.5) 2 73 (32.4) 49 (31.4) 24 (34.8) 3 51 (22.7) 36 (23.1) 15 (21.7) 4 53 (23.6) 53 (34.0) 20 ( 8.9) 14 ( 9.0) 6 ( 8.7) 205 (91.1) 142 (91.0) 63 (91.3) 3 ( 1.3) 2 ( 1.3) 1 ( 1.4) 4 ( 1.8) 3 ( 1.9) 1 ( 1.4) 218 (96.9) 151 (96.9) 67 (97.1) 13 ( 5.8) 9 ( 5.8) 4 ( 5.8) 205 (91.1) 142 (91.0) 63 (91.3) 151 (67.1) 104 (66.7) 47 (68.1) 害について学んだ回数平均 中央値 ( 最小 - 最大 ) タバコの害 1.21, 1.0 (0-4) 1.18, 1.0 (0-3) 1.29, 1.0 (0-4) 1.37, 1.0 (0-3) 1.34, 1.0 (0-3) 1.43, 1.0 (0-3) 1.11, 1.0 (0-3) 1.08, 1.0 (0-3) 1.17, 1.0 (0-3) 3.69, 3.0 (0-9) 3.60, 3.0 (0-9) 3.90, 3.0 (0-9) 受動喫煙の害 0.96, 1.0 (0-4) 0.92, 1.0 (0-3) 1.06, 1.0 (0-4) 1.19, 1.0 (0-3) 1.17, 1.0 (0-3) 1.23, 1.0 (0-3) 1.00, 1.0 (0-3) 0.98, 1.0 (0-3) 1.03, 1.0 (0-3) 3.15, 3.0 (0-9) 3.07, 3.0 (0-9) 3.32, 3.0 (0-9) 害について最初に学んだ時期人 (%) タバコの害 159 (70.7) 108 (69.2) 51 (73.9) 32 (14.2) 23 (14.7) 9 (13.0) 10 ( 4.4) 7 ( 4.5) 3 ( 4.3) 24 (10.7) 18 (11.5) 6 ( 8.7) 受動喫煙の害 130 (57.8) 89 (57.1) 41 (59.4) 44 (19.6) 31 (19.9) 13 (18.8) 16 ( 7.1) 11 ( 7.1) 5 ( 7.2) 35 (15.6) 25 (16.0) 10 (14.5) 15167.1 1 0 1 2. 教育機関 性別にみた入学前に学んだ回数 最初に学んだ時期の比較 ( 表 2-1 2-2) A B 表 2-1 表 2-2 33
表 2-1 教育機関 性別にみた入学前に害について学んだ回数の比較 A (n 142) B (n 63) (n 13) (n 192) 1.20 1.0 (0-3) 1.29 1.0 (0-4) 0.659 1.38 1.0 (0-3) 1.21 1.0 (0-4) 0.583 タバコの害 1.36 1.0 (0-3) 1.41 1.0 (0-3) 0.752 1.69 2.0 (0-3) 1.35 1.0 (0-3) 0.237 1.13 1.0 (0-3) 1.14 1.0 (0-3) 0.681 1.31 1.0 (0-3) 1.12 1.0 (0-3) 0.630 3.68 3.0 (0-9) 3.84 3.0 (0-9) 0.666 4.38 4.0 (0-9) 3.69 3.0 (0-9) 0.330 0.95 1.0 (0-3) 1.06 1.0 (0-4) 0.595 1.08 1.0 (0-3) 0.98 1.0 (0-4) 0.767 受動喫煙 1.20 1.0 (0-3) 1.21 1.0 (0-3) 0.955 1.38 1.0 (0-3) 1.19 1.0 (0-3) 0.584 の害 1.01 1.0 (0-3) 0.98 1.0 (0-3) 0.993 1.00 1.0 (0-3) 1.01 1.0 (0-3) 0.973 3.16 3.0 (0-9) 3.25 3.0 (0-9) 0.856 3.46 3.0 (0-9) 3.17 3.0 (0-9) 0.785 : Mann-Whitney-U 表 2-2 教育機関 性別にみた害について最初に学んだ時期の比較 A (n 142) B (n 63) (n 13) (n 192) 99 (69.7) 46 (73.0) 10 (76.9) 135 (70.3) タバコの害 21 (14.8) 9 (14.3) 0 ( 0.0) 30 (15.6) 0.902 人 (%) 6 ( 4.2) 3 ( 4.8) 0 ( 0.0) 9 ( 4.7) 16 (11.3) 5 ( 7.9) 3 (23.1) 18 ( 9.4) 82 (57.7) 38 (60.3) 8 (61.5) 112 (58.3) 受動喫煙の害 28 (19.7) 12 (19.0) 1 ( 7.7) 39 (20.3) 0.984 人 (%) 9 ( 6.3) 4 ( 6.3) 0 ( 0.0) 13 ( 6.8) 23 (16.2) 9 (14.3) 4 (30.8) 28 (14.6) : Pearson 2 0.176 0.268 3. 受動喫煙の害の認識別にみた入学前に学んだ回数 最初に学んだ時期の比較 ( 表 3-1 3-2 3-3) 0.038 0.031 0.030 0.035 表 3-1 0 9 rs 0.170 0.015 rs 0.109 0.120 rs 0.064 0.361 rs 0.152 0.030 0.005 0.011 表 3-2 0 9 0.031 34
妊婦への影響 乳幼児突然死症候群 肺がん 気管支喘息 COPD 歯周病 脳梗塞 心筋梗塞 ADHD 表 3-1 受動喫煙の害の認識別にみた入学前に受動喫煙の害について学んだ回数の比較 n 1.03 1.0 (0-4) n 0.50 0.0 (0-2) 0.038 1.24 1.0 (0-3) 0.75 0.5 (0-3) 0.031 189 16 1.02 1.0 (0-3) 0.81 1.0 (0-3) 0.322 3.29 3.0 (0-9) 2.06 1.5 (0-8) 0.030 1.10 1.0 (0-4) 0.88 1.0 (0-3) 0.103 1.24 1.0 (0-3) 1.16 1.0 (0-3) 0.328 106 99 0.95 1.0 (0-3) 1.06 1.0 (0-3) 0.491 3.29 3.0 (0-9) 3.09 3.0 (0-9) 0.295 0.99 1.0 (0-4) 0.50 0.5 (0-1) 0.552 1.20 1.0 (0-3) 1.00 1.0 (1-1) 0.897 203 2 1.00 1.0 (0-3) 1.00 1.0 (1-1) 0.846 3.20 3.0 (0-9) 2.50 2.5 (2-3) 0.790 1.06 1.0 (0-4) 0.76 0.0 (0-3) 0.055 1.26 1.0 (0-3) 1.02 1.0 (0-3) 0.097 155 50 1.05 1.0 (0-3) 0.88 1.0 (0-3) 0.272 3.36 3.0 (0-9) 2.66 2.0 (0-9) 0.052 1.03 1.0 (0-3) 0.91 1.0 (0-4) 0.422 1.21 1.0 (0-3) 1.18 1.0 (0-3) 0.525 126 79 1.01 1.0 (0-3) 1.00 1.0 (0-3) 0.763 3.25 3.0 (0-9) 3.09 3.0 (0-9) 0.413 1.15 1.0 (0-3) 0.88 1.0 (0-4) 0.035 1.25 1.0 (0-3) 1.17 1.0 (0-3) 0.251 80 125 1.03 1.0 (0-3) 0.99 1.0 (0-3) 0.642 3.43 3.0 (0-9) 3.04 2.0 (0-9) 0.134 1.09 1.0 (0-3) 0.87 1.0 (0-4) 0.105 1.25 1.0 (0-3) 1.15 1.0 (0-3) 0.361 106 99 1.09 1.0 (0-3) 0.91 1.0 (0-3) 0.136 3.34 3.0 (0-9) 2.93 2.0 (0-9) 0.103 1.10 1.0 (0-3) 0.86 1.0 (0-4) 0.077 1.23 1.0 (0-3) 1.17 1.0 (0-3) 0.579 110 95 1.05 1.0 (0-3) 0.95 1.0 (0-3) 0.307 3.38 3.0 (0-9) 2.97 2.0 (0-9) 0.111 : Mann-Whitney-U 1.10 1.0 (0-3) 0.94 1.0 (0-4) 0.625 1.29 1.0 (0-3) 1.19 1.0 (0-3) 0.696 21 184 1.10 1.0 (0-3) 0.99 1.0 (0-3) 0.646 3.48 4.0 (0-9) 3.16 3.0 (0-9) 0.503 35
表 3-2 受動喫煙の害の認識別にみた受動喫煙の害について最初に学んだ時期の比較 妊婦への影響 乳幼児突然死症候群 肺がん 気管支喘息 COPD 歯周病 脳梗塞 心筋梗塞 ADHD :Pearson 2 n % n % 115 (60.8) 5 (31.3) 0.005 37 (19.6) 3 (18.8) 9 ( 4.8) 4 (25.0) 28 (14.8) 4 (25.0) 63 (63.6) 57 (53.8) 0.225 18 (18.2) 22 (20.8) 3 ( 3.0) 10 ( 9.4) 15 (15.2) 17 (16.0) 119 (58.6) 1 (50.0) 39 (19.2) 1 (50.0) 13 ( 6.4) 0 ( 0.0) 32 (15.8) 0 ( 0.0) 96 (61.9) 24 (48.0) 0.152 28 (18.1) 12 (24.0) 7 ( 4.5) 6 (12.0) 24 (15.5) 8 (16.0) 76 (60.3) 44 (55.7) 0.203 28 (22.2) 12 (15.2) 7 ( 5.6) 6 ( 7.6) 15 (11.9) 17 (21.5) 55 (68.8) 65 (52.0) 0.011 14 (17.5) 26 (20.8) 0 ( 0.0) 13 (10.4) 11 (13.8) 21 (16.8) 67 (63.2) 53 (53.5) 0.345 21 (19.8) 19 (19.2) 5 ( 4.7) 8 ( 8.1) 13 (12.3) 19 (19.2) 70 (63.6) 50 (52.6) 0.419 20 (18.2) 20 (21.1) 6 ( 5.5) 7 ( 7.4) 14 (12.7) 18 (18.9) 13 (61.9) 107 (58.2) 0.635 4 (19.0) 36 (19.6) 0 ( 0.0) 13 ( 7.1) 4 (19.0) 28 (15.2) 表 3-3 受動喫煙の害について最初に学んだ時期別の害についての認識項目数の比較 (n 120) 5.62 6.0 (1-9) 0.031 (n 40) 5.22 5.5 (0-9) (n 13) 3.85 3.0 (1-7) (n 32) 4.88 5.0 (1-9) Kruskal Wallis 36
4. 受動喫煙の回避行動別にみた入学前に学んだ回数 最初に学んだ時期の比較 ( 表 4-1 4-2) 表 4-1 表 4-2 考察 1. 看護師養成機関入学前の害についての学習の実態 1 09 表 4-1 受動喫煙の回避行動別にみた入学前に害について学んだ回数の比較 (n 205) A (n 142) B (n 63) 1.06 1.0 (0-4) 0.82 0.0 (0-3) 0.137 1.22 1.0 (0-3) 1.15 1.0 (0-3) 0.669 1.01 1.0 (0-3) 0.98 1.0 (0-3) 0.756 3.29 3.0 (0-9) 2.95 2.0 (0-9) 0.456 1.01 1.0 (0-3) 0.81 0.0 (0-3) 0.137 1.17 1.0 (0-3) 1.26 1.0 (0-3) 0.669 0.98 1.0 (0-3) 1.09 1.0 (0-3) 0.756 3.16 3.0 (0-9) 3.16 3.0 (0-9) 0.456 1.16 1.0 (0-4) 0.83 1.0 (0-2) 0.137 1.33 1.0 (0-3) 0.89 1.0 (0-2) 0.669 1.09 1.0 (0-3) 0.72 1.0 (0-2) 0.756 3.58 3.0 (0-9) 2.44 2.0 (0-6) 0.456 : Mann-Whitney-U 表 4-2 受動喫煙の回避行動別にみた害について最初に学んだ時期の比較 (n 205) A (n 142) B (n 63) : Pearson 2 n (%) n (%) 89 (61.8) 31 (50.8) 0.231 23 (16.0) 17 (27.9) 10 ( 6.9) 3 ( 4.9) 22 (15.3) 10 (16.4) 62 (62.6) 20 (46.5) 0.183 15 (15.2) 13 (30.2) 6 ( 6.1) 3 ( 7.0) 16 (16.2) 7 (16.3) 27 (60.0) 11 (61.1) 0.607 8 (17.8) 4 (22.2) 4 ( 8.9) 0 ( 0.0) 6 (66.7) 3 (16.7) 37
11 2. 受動喫煙の害の認識 回避行動と入学前の受講歴との関係 7 12 8 1 この研究の限界と今後の課題 1 2 8 引用文献 1 2013 htt://www.nurse.or.j/home/ublication/ df/2014/tabakohokoku-2014.df ( 2015 1 28 ) 2 WHO The Role of Health Professionals in Tobacco Control htt://www.ncc.go.j/j/who/tobacco2007ro/ ( 2015 1 28 ) 3 2012/2013; 59: 97. 4 (htt://www.mext.go.j/a_menu/shotou/new-cs/ youryou/1304417.htm) ( 2015 1 28 ) 5 (htt://www.mext.go.j/a_menu/shotou/new-cs/ youryou/1304424.htm) ( 2015 1 28 ) 6 (htt://www.mext.go.j/a_menu/shotou/new-cs/ youryou/1304427.htm)( 2015 1 28 ) 7, 6 153 7,585 2013; 60: 444-452. 8,,. 38
2010; 52: 159-173. 9. 2010; 3: 30-34. 10,,,. 2009; 18: 17-22. 11 U-To-Date- -.THE LUNG-ersectives 2013; 21: 26-29. 12,,, 2 3 2012; 7: 76-82. Comarison of the relationshi between recognition of the issue of secondhand smoke among student nurses and the level of anti-smoking education received before college entr y Yoko Matsunami 1, Midori Furuse 1, Miyuki Yamaguchi 2, Hiroyuki Atsumi 3 Abstract Aim: We comared recognition of the issue of secondhand smoke among student nurses according to the levels of anti-smoking education they had received before nursing school entry. Method: We analyzed student nurses self-reorted questionnaires. Results: The smoking rate among all subjects was 1.3%. Overall, 67.1% of all subjects were trying to avoid secondhand smoke. In terms of recognition of the harm caused by secondhand smoke, students who understood the influence on regnant women and the relationshi between secondhand smoke and bronchial asthma and eriodontal disease had received significantly more education sessions about secondhand smoke than had those who did not understand these issues. Moreover, among students who had first received education sessions at elementary school about secondhand smoke, significantly more students understood the influence on regnant women and the relationshi between secondhand smoke and eriodontal disease than did not understand these issues. Furthermore, students who had first received education sessions at elementary school about secondhand smoke understood significantly more harmful effects of assive smoking than did students who had not received such education. However, there were no significant differences in rates of avoidance of secondhand smoke and the number of times anti-smoking education had been received before nursing school entry. Discussion: The anti-smoking education received before entry to nursing school may influence a student nurse s knowledge and recognition of the issues associated with secondhand smoke. Conclusion: To raise student recognition of secondhand smoke issues, continuous and develomental education from an early stage is imortant. Key words Anti-smoking education, Secondhand smoke, Student nurse 1. School of Nursing, Yamagata University, Faculty of Medicine, Yamagata, Jaan 2. Yamagata University Hosital, Yamagata, Jaan 3. Yamagata Hosital, National Hosital Organization, Yamagata, Jaan 39