Dejar de fumar, terapia cognitivo-conductual y perfiles diferenciales con árboles de decisión

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Abstract

RESUMEN Este estudio evalúa si el sexo, la dependencia a la nicotina y variables emocionales (ansiedad, depresión e ira) permiten describir un perfil de paciente que pueda beneficiarse de una terapia cognitivo-conductual para abandonar la adicción al tabaco. Se analizaron los resultados de una muestra de 120 fumadores adultos que voluntariamente recibieron TCC. Se valoró la adherencia de los pacientes y el éxito del programa a través de árboles de decisión. Los resultados indicaron que la adherencia al tratamiento ya implica alta probabilidad de éxito (86.4%), aumentando hasta el 95.6% cuando los participantes presentaban altos niveles de ira externa. Además, la adherencia al tratamiento fue completa (100%) cuando la ansiedad en contexto de evaluación, la ansiedad fisiológica y la motivación fueron altas. La obtención de este tipo de perfiles diferenciales permite determinar qué personas son más indicadas para cada tratamiento, lo que incrementaría la eficacia de los mismos.

Translated abstract

ABSTRACT The aim of this study is to analyse if gender, nicotine dependence, and emotional variables (anxiety, depression, and anger) help to describe a patient profile that could benefit from a cognitive behavioral therapy (CBT) to quit tobacco addiction. The sample consisted of 120 adult smokers who voluntarily received the CBT. Decision trees were used to assess patients' treatment adherence and program success. Data showed that just programme adherence implied a high success probability (86.4%), increasing to 95.6% when participants showed a high anger response. Besides, treatment adherence was 100% when anxiety in an evaluative context, physiologic anxiety, and motivation were high. Finding these differential profiles would help to determine the patient profile that would benefit most from treatment, and would increase their effectiveness.

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Most cited references 27

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The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire

Todd F Heatherton, Lynn T. Kozlowski, Richard Frecker … (1991)

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Breath carbon monoxide as an indication of smoking habit.

Antoine Morice, Laura E. Middleton (2000)

To assess whether the breath carbon monoxide (CO) concentration can be used to determine a patient's smoking habits in a respiratory outpatient clinic. To provide a normal range for smokers and nonsmokers, 41 outpatients and 24 healthy subjects were questioned on their smoking habits and asked to provide two breaths into a CO monitor (EC50 Smokerlyser; Bedfont Instruments; Kent, UK). In a subsequent single-blind study, 51 different outpatients were not told of the purpose of the study and were assessed by extensive questionnaire, spirometry, and Smokerlyser estimation. The Chest Clinic and Pulmonary Medicine Department at the Northern General Hospital, Sheffield, UK. Phase 1 involved 41 outpatients attending the Chest Clinic and 24 nonoutpatient colleagues. In phase 2, an additional 51 different outpatients were studied. The mean (SD) breath CO levels were 17.4 (11.6) parts per million (ppm) for smokers and 1.8 (1.3) ppm for nonsmokers (p 6 ppm (7.5 to 42 ppm). Of these, three admitted to smoking after being explained the implication of the reading. Breath CO concentration provides an easy, noninvasive, and immediate way of assessing a patient's smoking status. A reading > 6 ppm strongly suggests that an outpatient is a smoker.