Interventionen zur Prävention gesundheitlicher Risiken durch Tabakrauch für Schwangere, Frauen post partum und deren Kinder

Zusammenfassung

Ziel dieser Arbeit ist die Entwicklung von Empfehlungen für Interventionen zur Reduktion gesundheitlicher Risiken des Tabakrauchens bei Schwangeren, Frauen post partum und deren Kindern. Metaanalysen und ausgewählte Arbeiten zum Thema werden resümiert. Die empirische Evidenz zu epidemiologischen Befunden gesundheitlicher Folgen des Tabakrauchens wird einführend zusammengefasst. Anschließend werden Ergebnisse verschiedener Interventionsstudien referiert und abschließend in Form von Handlungsempfehlungen zusammengefasst. Interventionen lassen sich in drei Kategorien einteilen: 1. Interventionen zur Erlangung einer Abstinenz während der Schwangerschaft, 2. Interventionen zur Verhinderung eines Rückfalls nach erlangter Abstinenz in der Schwangerschaft, 3. Interventionen zur Verhinderung von Tabakrauch in der Atemluft in Wohnungen, in denen Kinder leben. Empirische Evidenz für Interventionen wird zu folgenden Schwerpunkten referiert: 1. Selbsthilfematerialien, 2. Kurzberatungen, 3. zeitintensivere Beratungen, 4. Interventionen zur Reduktion von Tabakrauch in der Atemluft und 5. Interventionen durch Hebammen. Ergebnisse von Metaanalysen wie auch der ausgewählten Arbeiten legen folgende Empfehlungen nahe: 1. Nutzung eines Vertrauensverhältnisses für die Beratung, 2. Wiederholung der Beratungen, 3. Selbsthilfemanuale flankierend zur Beratung nutzen - als alleinige Interventionsform ist ihre Wirkung nicht ausreichend, 4. Nutzung von State-of-the-Art-Beratungskonzepten, 5. theoretische Fundierung und entsprechende Individualisierung der Beratung.

Abstract

The aim of this study was to develop recommendations for interventions aiming at reducing health risks due to tobacco smoking in pregnant women, women postpartum and their infants. Meta-Analyses and selected studies are summed up. Epidemiological findings and health risks due to smoking are summed up. Subsequently findings from intervention studies are cross-referenced and integrated as recommendations. Interventions may be divided into three categories: 1. interventions to obtain abstinence in pregnancy, 2. interventions for relapse prevention after abstinence has been attained in pregnancy, 3. interventions aimed at reducing exposure to environmental tobacco smoke in homes with children. Empirical evidence is cross-referenced to the following points: 1. Self-help materials, 2. brief counselling, 3. more time-consuming counselling, 4. interventions to reduce exposure to environmental tobacco smoke and 5. interventions by midwives. Results from meta-analyses as well as results from selected studies suggest the following recommendations: 1. use of a trusting relationship in counselling, 2. repeated counselling, 3. complementary use of self-help materials; self-help material alone is not effective enough, 4. use of state-of-the-art counselling approaches and, 5. theoretical foundation and appropriate individualized counselling.

Schlüsselwörter

Rauchen - Schwangerschaft - post partum - Intervention

Key words

Smoking - pregnancy - post partum - intervention

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