Question:

3.2    Identify the role and the six (6) steps of the evidence based process. You may refer to   http://guides.mclibrary.duke.edu/c.php?g=158201&p=1036021   The six steps of (EBP) are:   1. Assess the Patient-during the care of a patient a clinical question or problem arises. 2. Ask the question-create a question from the case. Comparison, outcome. 3. Acquire the evidence-research using appropriate resources. 4. Evaluate the evidence- valid results and applying results to care of patients. 5. Apply and discuss with the patient. Patient Values and Preferences. 6. Self-Evaluation-reflection of care.

3.3         Explain whether the future results of your study might contribute to evidence based practice. 3.4         We hope that our study will aid the improvement of the immunity of babies and children under 5 years old living on the Sunshine Coast QLD, through providing medically based information to parents living on the Sunshine Coast QLD. According to the articles, EBP is one approach to improving the impact of practice in the      psychology, social work, nursing and allied fields.

3.5         Briefly explain how your research will contribute to nursing practice and continuous improvement programs, e.g. better enforcement of hand washing protocols leading to decreased number of nosocomial infections. Our research will contribute to the improvement by informing parents with medically based information to increase vaccinations of babies and children under 5 years old living on the Sunshine Coast QLD,. Our research will aid nursing practice and improve programs by starting follow-up appointments with parents who refuse to vaccinate their children, sending nurses to events and setting up information stalls at childcare centres and schools.

3.6         Identify ONE (1) member of the multidisciplinary healthcare team who would contribute to your research. Briefly explain his/her participation in the study. With Our research, we will invite GPs to be involved.  Their role would be to provide data to show parents the benefits of vaccinations. This will provide peace of mind to the parents of the children that are not at high risk of a potentially fatal disease. One member of the multidisciplinary team:  Paediatric Registered/ Enrolled Nurse. The Nurse will aid by helping the community to build trust regarding immunisations.

Answer:

Introduction

Smoking is a habit in which substances burn and the smoke is inhaled and absorbed into the blood of a human body. The most common things that are used for smoke or tobacco leaves. Some people also used to smoke Cannabis and marijuana known as weed. Both of the substances are crushed into small pieces, and then rolled into a small cylindrical shape with the help of a paper. Smoking generally causes negative health effects as the inhalation of smoke needs to various problems in respiration (Di Paco et al. 2015). The smoking generally causes harmful diseases which leads to the death of people.  Smoking of tobacco is the most common type of recreational drug. Cannabis and opium is used by a very small amount of people as these are not available easily.

There are many reasons that a teenager used to smoke. Most common reason is the relationship between the friends and a development of habit. Generally if a friend used to smoke there is an increased chance of being habituated of smoking. These include the social factors also such as the attraction of the advertisement by tobacco companies. Some other factors are there such as stress related to school family or relationship may also lead to smoking. At the teenage the people thought that cigarette can eliminate the stress but this is not true rather smoking a cigarette is harmful to health as it causes lung cancer it increases the blood pressure and heart rate tenses the muscles and the blood vessels begin to construct as a result the oxygen availability to the brain and body becomes less. Smoking affects the health of everyone the one who is smoking a cigarette directly and one who is inhaling the smoke. This assignment deals with the smoking habits of the children aging 12 to 15 years. It briefly describes the causes of the smoking, the intervention and the prevention of further smoking habits (Karimy et al., 2013).

Definition of key terms

Key term	Variations or synonyms	Definition
smoking	active smoking	the act of inhaling smoke from cigarette
chain smoke	chain smoker, heavy smoker	to smoke one cigarette immediately after another
Habit	routine, pattern	a need of a person to smoke regularly
Puff	pull, inhale	the action in which a person breathe in the smoke

 

Research question/hypothesis and its purpose

PICO – How can we educate to reduce the amount of 12 to 15 year old children taking up smoking?

P – 12-15 year old children

I – To educate the children

O – Quit smoking

The purpose of this assignment is to teach the adolescent about the side effects of smoking cigarettes. According to YRBSS can be said that 50% of adolescents have currently tried to quit smoking 12% are there who smoke cigarette daily but were able to quit. Here in this assignment it has been described that to reduce death rates from tobacco use and initiation of cigarette smoking campaign must be taken which could help the current smokers to quit. American Society of Cancer recommended that the youths Included in the initiative of smoking cessation by recognizing the support and encouragement of that person and their family. NRT And bupropion are the two main pharmacotherapy medicine used for the cessation of smoking (American Cancer Society 2015). Although bupropion has many uses but it is not permitted for the use of the children below 18 years. It increases the risk of suicidal thinking and behavior in children and adolescents because this medicine is used for treating depression. As the patient with depression has already at an increased rate of suicide so it is important to closely monitor the patients who are receiving the anti depression in the earlier months of therapy (Di Paco et al. 2015).

Literature review

This part deals with the details of the adolescent smoking in Australia. Most of the states and territories in Australia are prohibited of the selling of tobacco to the person under the age of 18. But those who used to smoke collect the cigarettes from corrupted sellers or also can get from friends or family members (Saracen 2016).

According to the World Health Organisation report of 2012, many of the deaths can be prevented if the persons who smoke may quit smoking in the next 20 years. Persons who begin smoking at an early age are at a higher risk of having cancer in lung as compared to those who starts smoking at a later age (Xi et al. 2016).

Although the tobacco is harmful for consumption of the people, it has been declared as a legal product for use. It is also proved as a most common cause of death all around the world. The smoking of tobacco is widely used as its costing is low, lack of knowledge about its side effects and lack of policies which can restrict the use of tobacco (WHO, 2015).

Tobacco contains different types of chemicals which causes cancers. The death rate of cancer is more than AIDS, intake of drugs, accidents or suicide. The purpose of this study is to identify the factors which contribute to smoking of the teenagers; the ways to educating them about the side effects of smoking and helping them to quit smoking (Klade et al. 2015).

Methodology

Smoking cessation is one of the most effective methods now-a-days among all other health interventions. It is also mostly used methods as it is cost effective too. A cross – sectional study was done among the teenagers in secondary and high school. A total no of 1890 students were selected for this study. All the schools selected are asked for collecting the sample of the selected members and a sampling technique was introduced for obtaining the study unit in which a certain number of students were selected from each of the school. These students are invited to participate in the study (Reda et al. 2012).

The study was done by doing The Global Youth Tobacco Survey (GYTS). The Global Youth Tobacco Survey (GYTS) questionnaire was given to the students and asked them to fill up the questions. The data that were collected was analyzed and coordinated with the members of the survey and then forwarded to the main investigator of the survey. The questionnaire contains total of 60 MCQs which were to be done. The survey contains 41 questions from the GYTS (Walther et al. 2014).

Data collection

The data were collected from the month of March to June 2013, and it had been supported by a total of 13 field staff and a field coordinator. Procedures of the survey were designed as such so that they can protect the students’ privacy by doing an anonymous and voluntary participation. Questionnaire that was provided was self-administered by the members of the survey in the classroom (Di Paco et al. 2015). The responses were given by the student directly on the answer sheet which can be scanned by the computer.

Data analysis

The questions there were asked first was about the background information of the student

1. The age of the student.

• 11 to 17
• Or older

2. Sex of the student.

• Male
• Female

3. Class in which the student used to read.

• 7 (Seven)
• 8 (Eight)
• 9 (Nine)

4. During a week how much money they spend on themselves.

• Don’t spend any money
• < 50
• 51 to 100
• 101 to 150
• 151 to 200
• 201 to 250
• > 250

The next questions asked were about the use of tobacco.

5. Did they ever try smoking?

• Yes
• No

6. What was their age when they smoked for the first time?

• I have never tried smoking a cigarette.
• 7 to 1 years

7. In the past 30 days, how many days did they smoke?

• 0 days
• 1 / 2
• 3 – 5
• 6 – 9
• 10 – 19
• 20 – 29
• All 30

8. During last 30 days, the number of cigarettes did they smoke/day?

• Don’t smoke
• < 1
• 2 – 5
• 6 – 10
• 11 – 20
• > 20

9. Other than cigarettes did they ever smoke any different products (pipes, cigars, water-pipes or hookah)?

• Yes
• No

10. Did they smoke any other types of tobacco products rather than cigarettes in past 30 days?

• Yes
• No

11. Did they feel like they need to smoke cigarette smoking first in the morning?

• Never smoked.
• Don’t feel like smoking tobacco is the first thing in the morning.
• Sometimes feel like tobacco smoking is the first thing.
• Always feel like smoking tobacco in the morning.

12. How much time does it take to feel like smoking tobacco after the smoking of one cigarette?

• Never smoke tobacco.
• Never feel like smoking again after trying tobacco.
• After every 60 minutes
• 1 to 2 hours
• After 4 hours
• > 4 hours but < one full day
• 1 to 3 days

The questions that were asked in the next slot were about the feelings of the students.

13. Did they ever want for quit smoking in recent days?

• Don’t smoke ever.
• Previously was smoking but now left smoking.
• Yes
• No

14. Did they ever try to quit smoking from the last 12 months?

• Don’t smoke ever.
• Now they don’t smoke.
• Yes
• No

15. Do they be able to quit smoking if they ever wanted to?

• Never smoked.
• Don’t smoke now.
• Yes
• No

16. Did they ever ask someone to help them to quit smoking?

• I have never smoked.
• Given by a professional seller
• Given by a friend
• Given by a member of family
• No

The next slot of questions was about your exposure to smoking of other people.

17. For how many days does anyone smoke in their home from past 7 days?

• 0 days
• 1 / 2 days
• 3 – 4 days
• 5 – 6 days
• 7 days

18. During the past 7 days, on how many days did anyone smoked in the presence of them in public places rather than their home?

• 0 days
• 1 / 2 days
• 3 – 4 days
• 5 – 6 days
• 7 days

19. During the past 7 days, how many days a person had smoked in presence of them in the public places?

• 0 days
• 1 / 2 days
• 3 – 4 days
• 5 – 6 days
• 7 days

20. In the last 30 days, do they see any person smoking in the building the school or is premises?

• Yes
• No

21. Did they agree that smoke coming from other people’s smoke is harmful to them?

• Yes
• No

22. Did the favour the banning of smoking inside the enclosed public places?

• Yes
• No

23. Did the favour the banning of smoking at outdoor public places?

• Yes
• No

The next slot of questions was about the way of getting cigarettes.

24. How did they get the cigarette for smoking in past 30 days?

• Did not smoke in past 30 days.
• Bought from a store / street vendor

25. Did anyone refuse to sell them cigarettes in past 30 days as they are below 18 years?

• Didn’t bought in past 30 days
• A person didn’t sell me because of my age.
• No, my age did not keep me from buying cigarettes.

26. How did they buy the last time they smoke a cigarette?

• Never bought cigarettes during the past 30 days.
• In a pack.
• In an individual sticks
• In a whole carton.
• Bought in rolls.

27. How much does a pack of 20 cigarette cost?

• Less than 25
• 26 to 50
• 51 to 75
• 76 to 100
• 101 to 150
• 151 to 200
• More than 200

In the next slot of questions the students was asked about their knowledge about the messages which are against of the use of tobacco (may includes the cigarettes, smokeless tobacco and other smoked tobacco).

28. During the past 30 days, did they watch or heard any Anti tobacco operation or news on media?

• Yes
• No

29. During the last 30 days, did they so any Anti tobacco messages at community events?

• They did not go for sports, fairs, social gatherings in last 30 days.
• Yes
• No

30. In the last 30 days, did they saw the health warnings on the packaging of the cigarettes?

• Yes, but they didn’t thought of them.
• Yes, and it lead me to think about quitting of smoking and further not to start.
• No

31. During the past 12 months, did they have been taught in their classes about the risk of tobacco use?

• Yes
• No
• I don’t know.

The next slot of questions was asked about the knowledge got from advertisements or promotions of tobacco.

32. In the last 30 days, did they saw any one smoking tobacco while watching TV video or movie?

• I did not watch TV, videos, or movies in last 30 days.
• Yes
• No

33. During the past 30 days, did they saw any advertisement for tobacco products?

• I did not visit any points of sale in the past 30 days.
• Yes
• No

34. Did they ever wore something that is having a tobacco related product name or picture?

• Yes
• Maybe
• No

35. Do they have anything with tobacco logo on it?

• Yes
• No

36. Did a person working in a tobacco company ever offered them a free product?

• Yes
• No

37. If someone offered them a tobacco product will they use it?

• Yes
• No

38. Do they think of using tobacco in next 12 months?

• Yes
• No

39. If someone is smoking tobacco does it will be difficult for them to quit?

• Yes
• No

40. What do they think about smoking tobacco; does it make them feel more comfortable at different times?

• More
• Less
• No difference

41. Do they agree with the following tagline: “I think I may enjoy smoking a cigarette.”

• I currently smoke
• Strongly agree
• Agree
• Disagree
• Strongly disagree

Validity of the research

Smoking and smoking cessation are not steady and clear practices among youngsters; they can mean distinctive things and change ordinarily amongst youth and adulthood. It is outstanding at this point smoking is the main behavioural reason for sudden passing in Australia. Cigarettes are ensnared in one of every five deaths in Australians every year, including roughly 33% of deaths because of tumour. Smoking can likewise cause handicapping medical issues, including coronary illness, stroke, and endless obstructive pneumonic malady (Kalabokaet al. 2014).

Strengths and weaknesses

A few general wellbeing activities are gone for keeping adolescents from smoking. These incorporate raising duties on cigarettes, which makes them more costly; passing laws to limit presentation to second-hand smoke and tobacco publicizing and to keep youngsters from obtaining cigarettes and propelling broad communications battles to empower counteractive action. The smoking of tobacco is widely used as its costing is low, lack of policies which can restrict the use of tobacco and lack of knowledge about its side effects. What’s more, various school-based counteractive action programs are offered across the nation (Towns et al. 2017).

Clinical strategies

The most current clinical practice rule emphasizes doctors, medical attendants, and different clinicians to get some information about smoking conduct amid office visits, and after those utilization age-suitable techniques to help adolescents to stop (Dahlui et al. 2015). The rule prescribes that clinicians do the accompanying:

• Regularly screen teenagers and their folks to decide if they smoke and, assuming this is the case, give consolation and recommend intercessions to quit smoking.
• Using behavioural and guiding medications.
• If a juvenile has turned out to be subject to nicotine and communicates a want to stop smoking, consider solutions for bupropion (Zyban) or nicotine substitution treatment.

School-based projects

Two model projects supported by the Substance Abuse and Mental Health Services Administration meet these criteria: the Not on Tobacco (NOT) program and Project EX. Despite the fact that they vary in a few regards, both utilize an approach that joins the accompanying three components (Agaku et al. 2014):

• Motivational improvement, so youngsters are urged to stop
• Coping abilities guideline, so teenagers figure out how to manage nicotine withdrawal, stress, and control trigger
• Goal setting, with the goal that adolescents make an individual responsibility regarding stopping

Ethical, cultural and religious considerations

Before doing this study, an ethical clearance was taken from the schools that are involved in this study. A letter of consent was sent to the school authorities for the permission of conducting the study. While distribution of the questionnaires, the students were told that the information that was collected will be kept secret and the purpose of the study was explained to the participants for getting their approval (Ashraf et al. 2013). The students were also told about the privacy of the response of the student and the importance that they provide the correct information.

Results

Information were collected, the data was then feed into the computer and then examined utilizing SPSS Version 15 factual programming. Analyses were done by using different variables through logistic degeneration to determine the connection between the result variable (regularly smoking) and non-smokers (Agaku et al. 2014). Among the total of 1890 students who were provided with the questionnaire, the number of student responded in the study are 1721. In this study the response rate of the student are about 91.1%. Among these 856 i.e. 50.1% are males and 851 i.e. 49.9% are females. Thus the mean age of the students those participated in the study is 16.4 years (Morioka et al.2016).

Smoking status of the study

Among the total participants; 214 were the people who used to smoke only one puff of the cigarette, i.e. 4.4% were females and 20.6% are males. 72 students were daily smokers and they used to smoke on an average of 5.9 cigarettes daily (Cosh et al. 2015).

When they were asked for the reasons of smoking they said that there were various reasons. The study suggested that among the total 113 people used to smoke for enjoyment 92 people for trial and 9 people for the other reasons such as depression or anxiety.  When they were asked about the places of smoking they reported that they used to smoke in public areas like bar and restaurant at 60, at home is 57 and at school compound it’s 52. There are also some of the students like 92 of them who are currently smoking but want to quit smoking (Cosh et al. 2015)

Counselling

Investigations of advising intercessions have been promising. In one review associated examination including an underlying 45-minute meeting and resulting phone catch up with a tobacco treatment guide, 18 percent of young people who already smoked were abstinent at a half year, and 11.5 percent were abstinent following five years. These rates are fundamentally higher than those in past observational investigations of immature smokers. A few examinations have demonstrated expanded discontinuance rates after subjective conduct treatment. A current investigation of more than 2,500 young people found that a multipart tobacco intercession expanded forbearance rates even up to two years after the fact (Agaku et al. 2014).

Discussion

The present study says that 12.2% of students used to smoke cigarette among which 4.4 % are females and 20.6% are males.  Thus the current smoking practice in Australia is 4.2% among the teenagers the study that was conducted for the Global youth tobacco survey reported that 10.1% among the students had never smoke the secrets where as 2.9% are currently smoking (Kalaboka et al. 2016).

The cessation rate was lowered down among the students who used to smoke daily. Smoking among student’s specialists and everyday presentation to uninvolved smoking were not huge factors (Towns et al. 2017).

Strengths and limitations of the study

Our review is not illustrative of all young people or age gatherings, and as it is led among students it may not really be generalizable to teenagers not enlisted in auxiliary or secondary schools. Besides, the overview applies just to adolescences who went to classes upon the arrival of the study and who finished the GYTS surveys. Henceforth reprobate students may be unique in relation to the populace contemplated as they are relied upon to have larger amounts of substance utilize (Towns et al. 2017). Be that as it may, as the reaction rate was high (over 90%) among the students exhibit at the season of the review, inclination owing to non-reaction among the populace considered are relied upon to be restricted.

Limitation

A restriction of this investigation is its reaction rate of just 67%; determination inclination may have affected on our outcomes (Walther et al. 2014). In any case, even in the event that each of the 11 medicinal schools not taking part in our study had sufficient instructing and appraisal techniques set up, the extent of restorative schools not evaluating their understudies’ guiding abilities would even now be around 33%. Another potential risk to the legitimacy of our discoveries may emerge from senior members not being completely mindful of all parts of the educational modules where tobacco-related subjects are examined, subsequently prompting an underestimation of curricular scope (Walther et al. 2014).

Conclusion

This investigation inferred that high extent of school young people in Australia at any point smoked cigarettes. A humble extent of these was present smokers. Sex, age and associated impact were distinguished as vital determinants of smoking. Generally if a friend used to smoke there is an increased chance of being habituated of smoking. These include the social factors also such as the attraction of the advertisement by tobacco companies. Some other factors are there such as stress related to school family or relationship may also lead to smoking. Most students utilize cigarettes for delight and the individuals who have companion who smoke cigarettes were more in danger. This finding shows that there is a requirement for early savvy intercessions and instruction crusades that objective pre-auxiliary and optional school students. Consideration ought be kept to optional school as well as stretch out to their place of living arrangement with the goal that impacts in the home condition and social surroundings that add to substance utilize are additionally handled.

Smoking is a big problem for the adolescents and some organizations are emphasizing to help the peoples to quit. A few examinations after subjective conduct treatment have demonstrated expanded discontinuance rates. The investigation imitates prior discoveries of significant deficiencies in undergrad therapeutic preparing on smoking suspension. A few examinations demonstrated after doing subjective conduct treatment result in expanded discontinuance rates.  Given the tremendous populace effect of tobacco-related distress what’s more, mortality and the cost-viability of medications to help smoking discontinuance, therapeutic schools need to consider methods for enhancing curricular scope of these points. The decision of using pharmacotherapy must be combined with psychosocial and behavioural methods for treatments.

 

 

 

 

 

 

 

 

 

References

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Saracen, A., 2016. Cigarette Smoking and Respiratory System Diseases in Adolescents.

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