A discussion on the decision to quit smoking and the items necessary for smoking cessation support

: Factor analysis of a questionnaire survey of psychiatric department staff

Abstract

Abstract
Objectives ： To develop a support system in the psychiatric department for patients who quit smoking, department staff need to improve their ability to systematically explain the health effects of smoking in order to facilitate the decision to quit smoking. We conducted a questionnaire survey on awareness and knowledge of smoking cessation support, and the supportive environment at work, to examine the reliability and validity of items necessary for supporting patients to quit smoking. The aim was to understand the necessity of smoking cessation and improve smoking cessation support.
Methods： A questionnaire was prepared after a discussion that was based on results of a literature review and supervisors’ advice. It was revised after conducting a preliminary study. Subjects were staff of a psychiatric hospital in Prefecture A. A self-administered questionnaire was sent by post (ordinary delivery or poste restante). Ethical considerations were explained in writing, and consent was assumed if a completed questionnaire was returned. The study plan was approved by the ethics review board of our university.
Results：Among 1,390 questionnaire sheets that were distributed, 1,116 (80.3%) were returned, in which 928 (66.8% of the total) were valid. After analyzing questionnaire items, three items were eliminated. Exploratory and confirmatory factor analyses of 12 items found that three factors were strongly involved, namely, “risk of smoking”, “information during abstention from smoking” and “perception of the support for smoking cessation”. Items with a factor loading ＜0.4 under all factors were eliminated from factor analyses. The Cronbach’s coefficient a of the whole scale was 0.820, confirming internal consistency. Correlation coefficients among three factors, indicative of concept association, were 0.609 – 0.768 with a significance level of 1%, confirming criterion-related validity. Covariance structure analysis found a good fit between an individual item and a potential factor. ANOVA showed that interactions of extracted factors related to “risk of smoking” and “information during abstention from smoking” with “perception of the support for smoking cessation”, and of independent variables of “perception of the support for smoking cessation”, training participation and in-house review meetings for smoking cessation with types of professions were significant.
Discussion：The high internal consistency confirmed high reliability across questionnaire items. Significant positive correlations among three factors confirmed validity. Exploratory and confirmatory factor analyses confirmed the validity of factors. Also, it was shown that preparing a good environment, such as training participation and in-house review meetings to help patients to quit smoking, influences the information received by staff members of the department.
Conclusion ： Our results confirmed that these items have certain levels of reliability and validity in relation to the support of smoking cessation given by staff of the psychiatry department.