Nurses’ Perspectives on Smoking Policies, Safety and Cessation Support in Psychiatric Wards: A Cross-Sectional Survey (original) (raw)
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Nursing perceptions and experiences regarding smoking bans in a psychiatric hospital
OBJECTIVE:to learn about the experience of nursing professionals in the implementation of the smoking ban in a psychiatric hospital. METHOD: a qualitative study was carried out with 73 nursing professionals from a psychiatric hospital in São Paulo's countryside, using Grounded Theory as a methodological reference and Symbolic Interactionism as a theoretical reference. There were 1260 hours of participant observation with field diary records. The data were analyzed from the open, axial and selective coding. RESULTS: different facets of the smoking ban were observed, such as insecurity, pessimism, resistance and boycott, especially in the private internment unit. However, many nursing professionals supported the ban when they saw the benefits to patients. FINAL CONSIDERATIONS: the process of implementing the smoking ban was accompanied by difficulties, but it proved to be a viable intervention. Professionals who were initially against the ban began to support it.
Paidéia (Ribeirão Preto), 2014
The aim was to identify the barriers for implementing the restriction on smoking in psychiatric hospitalization services, its impact on the hospitalized smokers, and the positioning of the professionals. Integrative review of 19 articles published (1989-2011) in MEDLINE and SCOPUS. Descriptive analysis was carried out. The studies revealed that the main barriers for the implementation of the restriction were: beliefs in the patients’ increased aggressiveness, damage to the professional-patient relationship, and lack of preparation to address the theme. After the implementation, the restrictions showed a positive impact: reduction of cigarettes smoked, increased motivation to quit smoking, and more attempts to stop smoking. The professionals who smoked and those who did not believe that quitting smoking benefits mental health patients were those that least supported the implementation of the restrictions. In conclusion, the restriction on smoking is effective in psychiatric hospitali...
View of hospitalized psychiatric patients on the smoking habit
Smad Revista Eletronica Saude Mental Alcool E Drogas, 2012
This is an exploratory descriptive study with quantitative and qualitative approach, which aims to know the opinion of patients about smoking in the hospital and the degree of dependence on smoking. We used a semi-structured interview and Fagerström questionnaire on smokers. We observed 25 patients: 44.0% with mood disorder, schizophrenia 28.0%, 52.0% 10 or more years of disease, 64.0% 1-5 hospitalizations. Of these, 24.0% were smokers, 83.3% had a high degree of dependence. Most nonsmokers agreed to ban smoking in collective environments, without privileges for the mentally ill. Smokers were shown to be opposed to smoke-free policies, but in favor of nicotine replacement therapy during hospitalization. It is expected the investment of the team in tobacco-free environment, health services and raise awareness of smokers to seek smoking cessation treatment.
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.
The feasibility of smoking bans on psychiatric units
General Hospital Psychiatry, 1993
We conducted a prospective study of a smoking ban on a general inpatient psychiatry service in response to staff concerns about the feasibility of a proposed hospital-wide ban. Demographic information, smoking history, and DSM 111-R diagnoses were obtained for consecutively admitted patients during two study cdnditions: smoking and nonsmoking. A log of p.r.n. medication, seclusion, restraint, elopement, incident reports, and smoking-related discharges was kept for each patient. Chi-square analysis of 232 patients for whom demographic, smoking, diagnostic, and log data were complete showed no significant differences between study conditions for demographic or diagnostic variables. Two-tailed t-test analysis of the log data for these 232 patients showed no significant difference in disruptive incidents during smoking and nonsmoking coriditions (p = 0.283). Fifty staff members answered pre-and post-ban questionnaires. Paired t-test analysis demonstrated a significant change in staff attitude toward supporting the ban. These data indicate that smoking can be stopped on inpatient psychiatry units without increases in unit disruption or adverse effects on staff morale.
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.
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...
There's no smoke without fire: Smoking in smoke-free acute mental health wards
PLoS ONE, 2021
Background People who smoke with serious mental illness carry disproportionate costs from smoking, including poor health and premature death from tobacco-related illnesses. Hospitals in New Zealand are ostensibly smoke-free; however, some mental health wards have resisted implementing this policy. Aim This study explored smoking in acute metal health wards using data emerging from a large sociological study on modern acute psychiatric units. Methods Eighty-five in-depth, semi-structured interviews were conducted with staff and service users from four units. Data were analysed using a social constructionist problem representation approach. Results Although high-level smoke-free policies were mandatory, most participants disregarded these policies and smoking occurred in internal courtyards. Staff reasoned that acute admissions were not the time to quit smoking, citing the sceptres of distress and possibly violence; further, they found smoking challenging to combat. Inconsistent enforcement of smoke-free policies was common and problematic. Many service users also rejected smoke-free policies; they considered smoking facilitated social connections, alleviated boredom, and helped them feel calm in a distressing environment-some started or increased smoking following admission. A minority viewed smoking as a problem; a fire hazard, or pollutant. No one mentioned its health risks.