Support and attitudes of Qatar mental health professionals to a proposed mental health inpatient smoking ban: Results of a cross-sectional survey (original) (raw)
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Psychiatry Journal, 2018
Although the move to smoke-free mental health inpatient settings is an internationally common and popular trend, these policies are neither implemented nor supported by any national program in Iran. This study investigates the attitude of mental health staff and psychiatric patients toward smoking cessation in 2 psychiatric inpatient units (psychosomatic and adult general psychiatry) in the Taleghani general hospital in Tehran. One hundred and twenty participants of this cross-sectional study consist of 30 mental health staff and 90 psychiatric patients. An eight-item questionnaire was used for collecting information. Both staff and patients expressed a positive attitude towards smoking cessation. Patients favoured the implementation of these policies and expressed a more positive attitude towards the feasibility. Sixty-three percent of patients and 57% of staff were opposed to smoking in the units. Seventy percent of patients reported the smoke-free ban as a feasible policy compare...
BMC Public Health, 2010
Background The introduction of total smoking bans represents an important step in addressing the smoking and physical health of people with mental illness. Despite evidence indicating the importance of staff support in the successful implementation of smoking bans, limited research has examined levels of staff support prior to the implementation of a ban in psychiatric settings, or factors that are associated with such support. This study aimed to examine the views of psychiatric inpatient hospital staff regarding the perceived benefits of and barriers to implementation of a successful total smoking ban in mental health services. Secondly, to examine the level of support among clinical and non-clinical staff for a total smoking ban. Thirdly, to examine the association between the benefits and barriers perceived by clinicians and their support for a total smoking ban in their unit. Methods Cross-sectional survey of both clinical and non-clinical staff in a large inpatient psychiatric hospital immediately prior to the implementation of a total smoking ban. Results Of the 300 staff, 183 (61%) responded. Seventy-three (41%) of total respondents were clinical staff, and 110 (92%) were non-clinical staff. More than two-thirds of staff agreed that a smoking ban would improve their work environment and conditions, help staff to stop smoking and improve patients' physical health. The most prevalent clinician perceived barriers to a successful total smoking ban related to fear of patient aggression (89%) and patient non-compliance (72%). Two thirds (67%) of all staff indicated support for a total smoking ban in mental health facilities generally, and a majority (54%) of clinical staff expressed support for a ban within their unit. Clinical staff who believed a smoking ban would help patients to stop smoking were more likely to support a smoking ban in their unit. Conclusions There is a clear need to more effectively communicate to staff the evidence that consistently applied smoking bans do not increase patient aggression. There is also a need to communicate the benefits of smoking bans in aiding the delivery of smoking cessation care, and the benefits of both smoking bans and such care in aiding patients to stop smoking.
Attitudes towards a Complete Smoking Ban among Mental Health Hospital Employees in France
Background: Incitements to smoking cessation in patients hospitalized in mental health settings should be an ethical commitment for the mental health staff. However, worldwide studies have shown that the mental health staff is often reluctant to the implementation of smoking bans, and that the psychological attitude of the nursing staff may even sometimes wreck the efforts to ban smoking. No studies have been made in France investigating the psychological attitudes of mental health employees towards a complete smoking ban. Methods: A given day, all the employees in daily contact with patients were individually interviewed regarding their smoking habits, their psychological attitude towards a complete smoking ban, their opinion regarding the consequences of a complete smoking ban on the behavior of patients, and, for smokers, their willing to change their smoking habits in the eventuality of a complete ban. Results: All 264 employees working the day of the study responded to the questionnaire: 41.6% were smokers, 84% disagreed with a complete ban, 90% believed that a complete smoking ban would worsen the behavior of patients, and, among smokers, 68% were not willing to change their smoking habits. Conclusions: In French mental health hospitals, employees in close contact with patients are not prepared, and in a large majority are opposed, to a complete smoking ban. Such a generalized opposition obviously raises barriers to smoking cessation interventions or other smoking reduction policies. The possible roles of unawareness and denial of the harmfulness of smoking in French mental health employees are discussed. The necessity of implementing educational programs for mental health employees is stressed.
A smoking ban in psychiatric units: threat or opportunity?
Mental health in family medicine, 2008
People with severe mental illness (SMI) experience some of the worst physical health and die younger than almost any section of the population. Mental health professionals have seemed strangely indifferent to this inequality, which in other areas of health would be a national scandal. In this editorial we discuss the recently introduced smoking ban in inpatient mental health service settings, which will offer mental health services an opportunity to implement creative, evidence-based strategies to help people with SMI address smoking and nicotine addiction. In doing this, we refer to National Institute for Health and Clinical Excellence (NICE) guidance. This guidance forms the basis of national smoking policies for the general population and forms a starting point for those with SMI. Such a strategy will necessarily involve close collaboration with primary care, and we specifically examine how this might be achieved.
Smoking bans in psychiatric inpatient settings? A review of the research
Australian and New Zealand Journal of Psychiatry, 2005
Objective: This paper reviews the findings from 26 international studies that report on the effectiveness of smoking bans in inpatient psychiatric settings. The main aim is to identify which processes contribute to successful implementation of smoking bans and which processes create problems for implementation in these settings. Method: After performing an electronic search of the literature, the studies were compared for methods used, subjects involved, type of setting, type of ban, measures and processes used and overall results. Total bans were distinguished from partial bans. All known studies of smoking bans in psychiatric inpatient units from 1988 to the present were included. Results: Staff generally anticipated more smoking-related problems than actually occurred. There was no increase in aggression, use of seclusion, discharge against medical advice or increased use of as-needed medication following the ban. Consistency, coordination and full administrative support for the ban were seen as essential to success, with problems occurring where this was not the case. Nicotine replacement therapy was widely used by patients as part of coping with bans. However, many patients continued to smoke post-admission indicating that bans were not necessarily effective in assisting people to quit in the longer term.
Views and Attitudes of Patients in Mental Facilities Regarding Smoking
Global Journal of Health Science, 2015
Introduction: Smoking rates amongst people with a mental health disorder are significantly higher than in the general population and there is growing evidence to show a strong association between smoking and mental health disorders. The aim of the present study was to investigate views and attitudes of mental patients regarding smoking. Material and Methods: The sample is composed of 356 patients treated in the Attica Psychiatric Hospital (a.k.a. "Dafni") as well as in other Units affiliated with the Hospital. The 'Smoking in psychiatric hospitals-a survey of patients' views' questionnaire was used in the form of semi-structured interviews. The PASW 18 (SPSS Inc.) package was used for the statistical analysis and statistical significance was set to p= 0.05. Results: Overall, 40% of the participants were in-patients, the rest being treated in other settings, the average length of hospital stay was 4.4 years, and the most common diagnosis (61.5.%) was schizophrenia (F20, according to ICD-10), while almost all of the participants (97.5%) were smokers. Most patients (58.8%) said they had had a hard time trying to quit smoking although they had sufficient information and encouragement (≈90%); they also reported that watching the staff smoking did not affect them inasmuch as watching other patients smoking (41 % vs 54.8%). 75.5% of the patients felt that they had no particular difficulty to quit smoking. Men smoked significantly more cigarettes per day compared to females (36.70 vs 30.82, p=0.002). There were no significant differences among males and females regarding previous attempts to quit smoking. Information gathered from such studies should be taken into account when designing systematic smoking management plans in mental institutions. Conclusion: Although almost all mental patients smoke, they seem to be receptive to quitting smoking, since two thirds of them have already tried to quit, but one-third of the patients find smoking a little or not at all dangerous.
Patient reactions to a no smoking policy in a community mental health center
… mental health journal, 1989
The prevalence of cigarette smoking in a CMHC population was surveyed and patient attitudes and affective reactions regarding the implementation of a no smoking policy were assessed. The prevalence of smoking (80-84%) was in line with previous reports which have suggested that an extraordinarily high percentage of psychiatric patients engage in cigarette smoking. Significant differences were observed between smokers' and nonsmokers' reactions to the no smoking policy which resulted partially from negative reactions by smokers but also from positive reactions by nonsmokers. Although a slight decrease in client satisfaction was observed, the emotional reactions of smokers were generally not clinically substantive. A 16 month follow-up survey of clinicians further supported the idea that the negative reactions of smokers were not of major magnitude and were probably transitory. The authors conclude that the primary effects of a mental health center smoking policy may be the protection of the service environment and improvements in the well-being of nonsmoking patients and staff who would otherwise be at risk for the effects of secondhand smoke. While there have been recent attempts to control smoking in hospitals and health care facilities (Dawley, Fleischer, & Dawley, 1985; We wish to thank Karen Israel, Michael Donegan, Jane Eberle, and Tina Lu for their assistance. Definitions of serious and chronic mental illness, copies of the HCMHC Smoking Questionnaire,
Mental Health and Addiction Research
Objective: to describe psychiatrists' views regarding implementation of smoke free policies in inpatient units, the acceptability and perceived helpfulness of a clinical pathway, and the frequency of provision and acceptability of various interventions. Method: Sequential mixed-methods combining a questionnaire based survey with interviews with 43 psychiatrists working in two services in Queensland, Australia. Data were analysed descriptively and thematically. Results: Psychiatrists agree that they have responsibility to assess smoking, encourage quitting and optimise management of nicotine withdrawal during admissions. Uncertainty remains about the rationale for 'smoke free', however. Psychiatrists express concern about 'rights' of patients and others, paternalistic restriction of choice and their roles as agents of government, rather than health professionals. Most psychiatrists assess smoking informally, with intervention titrated to perceived motivation to quit. The manner in which conversations are approached and interventions are offered is critical to engagement of patients. Conclusions: Psychiatrists are overcoming longstanding ambivalence and therapeutic nihilism that have hindered integration of management of smoking in clinical care. Sustained improvement will depend on frank engagement with lingering concerns, careful management of the 'unintended' consequences of smoke-free policies and ensuring that clinicians are resources appropriately.