Nursing perceptions and experiences regarding smoking bans in a psychiatric hospital
DOI:
https://doi.org/10.11606/issn.1806-6976.smad.2021.176380Keywords:
Smoking, Nursing, Smoking-Free Policy, Hospitals Psychiatric, Psychiatric NursingAbstract
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.
Downloads
References
Lawn S, Lucas T. Addresing smoking in supported residential facilities for people with severe mental illness: has any progress been achieved? Int J Environ Res Public Health. 2016;13(10):996. doi: https://doi.org/10.3390/ijerph13100996
Malone V, Harrison R, Daker-White G. Mental health servisse user and staff perspectives on tobacco addiction and smoking cessation: a meta-synthesis of published qualitative studies. J Psychiatr Ment Health Nur. 2018;25(4):270-82. doi: https://doi.org/10.1111/jpm.12458.
Woodward ER, Richmond R. Smoking bans in psychiatric units: an issue of medical ethics. Front Psychiatry. 2019;10(134):1-4. doi: https://doi.org/10.3389/fpsyt.2019.00134.
Lei n. 12.546 de 14 dezembro de 2011 (BR). Altera a Lei nº 9.782, de 26 de janeiro de 1999. Institui o Regime Especial de Reintegração de Valores Tributários para as Empresas Exportadoras (Reintegra); dispõe sobre a redução do Imposto sobre Produtos Industrializados (IPI) à indústria automotiva; altera a incidência das contribuições previdenciárias devidas pelas empresas que menciona. Diário Oficial da União, Brasília, 15 dez 1990; Sec.1:3
Decreto 8262 de 31 de maio de 2014 (BR). Altera o Decreto nº 2.018, de 1º de outubro de 1996, que regulamenta a Lei nº 9.294, de 15 de julho de 1996. Diário Oficial da União, Brasília, 2 jun 2014; Sec.1:1
Lei 18.552 de 4 dezembro de 2009 (MG-BR). Altera a Lei nº 12.903, de 23 de junho de 1998, que define medidas para combater o tabagismo no Estado e proíbe o uso do cigarro e similares nos locais que menciona. Diário Oficial do Estado, Belo Horizonte, 5 dez 2009; Sec1:1
Lei 9423 de 9 de dezembro de 2010 (RN-BR). Dispõe sobre a proibição do consumo de produtos derivados do tabaco em recintos coletivos fechados e dá outras providências. Diário Oficial do Estado, Natal, 10 deze 2010; Sec1:1
Lei 13.275 de 14 dezembro de 2010 (RS-BR). Regulamenta a Lei nº 13.275, de 03 de novembro de 2009, que proíbe o uso do fumo e similares, derivados ou não do tabaco, em recinto coletivo fechado em todo o Estado do Rio Grande do Sul. Diário Oficial do Estado, Porto Alegre, 15 dez 2010; Sec1:a
Lei 5517 de 17 agosto de 2009 (RJ-BR). Proíbe o consumo de cigarros, cigarrilhas, charutos, cachimbos ou de qualquer outro produto fumígeno, derivado ou não do tabaco, na forma que especifica, e cria ambientes de uso coletivo livres de tabaco. Diário Oficial do Estado, Rio de Janeiro, 18 ago 2009; Sec1:1
Lei 13.541 de 7 maio de 2009 (SP-BR). Proíbe o consumo de cigarros, cigarrilhas, charutos, cachimbos ou de qualquer outro produto fumígeno, derivado ou não do tabaco, na forma que especifica. Diário Oficial do Estado, São Paulo, 8 maio 2009; Sec1:1
Beyraghi N, Mazaheri Meybodi A, Jafarian Bahri RS. Smoking ban in psychiatric inpatient unit: na iranian study on the views and atitudes of the mental health staff and psychiatric patients. Psychiatry J. 2018; 2018:2450939. doi: https://doi.org/10.1155/2018/2450939
Magor-Blatch LE, Rugendyke AR. Going smoke-free: atitudes of mental health professionals to policy change. J Psychiatr Ment Health Nurs. 2016;23(5):290-302. doi: https://doi.org/10.1111/jpm.12309.
Ballbè M, Gual A, Nieva G, Saltó E, Fernández E. Desconstructing myths, building aliances: a networking model to enhance tobacco control in hospital mental health settings. Gac Sanit. 2016;30(5):389-92. doi: https://doi.org/10.1016/j.gaceta.2016.04.017.
Collins A, Ajayi O, Diamond S, Diamond W, Holroyd S. Tobacco use and associated factors in patients presenting to a psychiatric emergency room. J Addic. 2018;2018:8102165. doi: https://doi.org/10.1155/2018/8102165.
Lores L, Monje A, Bergada M, Arellano E, Rodrígues-Larrea J, Miravittles M. Prevalence of smoking in a psychiatric hospital and its relationship with respiratory symptomsand the prevalence of COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:2797-804. doi: https://doi.org/10.2147/COPD.S165880.
Oliveira RM, Santos JLF, Furegato ARF. Prevalence and smokers' profile: comparisons between the psychiatric population and the general population. Rev Latinoam Enferm. 2019;27:e3149. doi: https://doi.org/10.1590/1518-8345.2976.3149.
Callaghan RC, Veldhuizen S, Jeysingh T, Orlan C, Graham C, Kakouris G, et al. Patters of tobacco-related mortality among individuals diagnosed with schizophrenia, bipolar disorder, or depression. J Psychiatr Res. 2014;48(1):102-10. doi: https://doi.org/10.1016/j.jpsychires.2013.09.014.
Han B, Compton WM, Blanco C. Tobacco use and 12-Month suicidality among adults in United States. Nicotine Tob Res. 2017;19(1):39-48. doi: https://doi.org/10.1093/ntr/ntw136.
Hahn L, Rigby A, Galletly C. Determinants of high rates of smoking among people with psychosis living in a socially disadvantaged region in South Australia. Aust N Z J Psychiatry. 2014;48(1):70-9. doi: https://doi.org/10.1177/0004867413491158.
Fluharty M, Taylor AE, Grabski M, Munafò MR. The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review. Nicotine Tob Res. 2017;19(1):3-13. doi: https://doi.org/10.1093/ntr/ntw140.
Skov-Ettrup LS, Nordestgaard BG, Petersen CB, Janne S, Tolstrup JS. Does High Tobacco Consumption Cause Psychological Distress? A Mendelian Randomization Study. Nicotine Tob Res. 2017;19(1):32-8. doi: https://doi.org/10.1093/ntr/ntw186.
Ballbè M, Sureda X, Martínez-sánchez JMM, Fu M, Saltó E, Gual A, et al. Secondhand smoke in psychiatric units: patient and staff misperceptions. Tob Control.2015;24(e3):212-20. doi: https://doi.org/10.1136/tobaccocontrol-2014-051585.
Okoli CTC, Seng S. Associations between secondhand tobacco smoke exposure and nicotine dependence and smoking cessation attempts among adult tobacco users with a psychiatric disorder. Biol Res Nurs. 2018;20(5):558-65. doi: https://doi.org/10.1177/1099800418781914.
Santos CMC, Pimenta AM, Nobre MRC. A estratégia pico para a construção da pergunta de pesquisa e busca de evidências. Rev. Latino-Am. Enfermagem. 2007;15(3):508-11. doi: https://doi.org/10.1590/S0104-11692007000300023
Andrews T, Mariano GJS, Santos JLG, Koerber-Timmons K, Silva FH. The methodology of classic grounded theory: considerations on its application in nursing research. Texto Contexto-Enferm. 2017;26(4):e1560017. doi: https://doi.org/10.1590/0104-070720170001560017.
Cassiani SHB, Caliri MHL, Pelá NTR. A teoria fundamentada nos dados como abordagem da pesquisa interpretativa. Rev. Latino-Am. Enfermagem. [Internet]. 1996 [cited 2020 Jun 22];4(3):75-88. Available from: http://www.revistas.usp.br/rlae/article/view/1208/1227
Jorgensen DL. Participant Observation: A Methodology for Human Studies. California: Sage Publications; 1989.
Strauss A, Corbin J. Pesquisa Qualitativa: técnicas e procedimentos para o desenvolvimento de teoria fundamentada. Porto Alegre: Artmed; 2008.
Charmaz K. A construção da teoria fundamentada: guia prático para análise qualitativa. Porto Alegre: Artmed; 2009.
Smith CA, Mc Neill A, Kock L, Shahab L. Exploring mental health professionals' practice in relation to smoke-free policy within a mentalhealth trust: qualitative study using the COM-B model of behaviour. BMC Psychiatry. 2019;19(1):54. doi: https://doi.org/10.1186/s12888-019-2029-3.
Mares J. Resistance of health personnel to changes in healthcare. Kontakt. 2018;20(3):e262-72. doi: https://doi.org/10.1016/j.kontakt.2018.04.002.
Martin K, Dono J, Sharplin G, Bowden J, Miller C. Staff and patient perspectives of a smoke-free health services policy in South Australia: A state-wide implementation. Health Policy. 2017;121(8):895-902. doi: https://doi.org/10.1016/j.healthpol.2017.06.003.
Riad-Allen L, Dermody SS, Herman Y, Bellissimo K, Selby P, George TP. Becoming tobacco-free: Changes in staff and patient attitudes and incident reports in a largeacademic mental health and addictions hospital. Am J Addict. 2017;26(2):183-91. doi: https://doi.org/10.1111/ajad.12513.
Huddlestone L, Sohal H, Paul C, Ratschen E. Complete smokefree policies in mental health inpatient settings: results from a mixedmethodsevaluation before and after implementing national guidance. BMC Health Serv Res. 2018;18(1):542. doi: https://doi.org/10.1186/s12913-018-3320-6.
Spaducci G, McNeill A, Hubbard K, Stewart D, Yates M, Robson D. Smoking-related violence in a mental health setting following the implementation of a comprehensive smoke-free policy: a content analysis of incident reports. Int J Ment Health Nurs. 2020;29(2):202-11. doi: https://doi.org/10.1111/inm.12659.
Sohal H, Huddlestone L, Ratschen E. Preparing for Completely Smoke-Free Mental Health Settings: Findings on Patient Smoking, Resources Spent Facilitating Smoking Breaks, and the Role of Smoking in Reported Incidents from a Large Mental Health Trust in England. Int J Environ Res Public Health. 2016;13(3).E256. doi: https://doi.org/10.3390/ijerph13030256.
Dean TD, Cross W, Munro I. An Exploration of the Perspectives of Associate Nurse Unit Managers Regarding the Implementation of Smoke-free Policies in Adult Mental Health Inpatient Units. Issues Ment Health Nurs. 2018;39(4):328-36. doi: https://doi.org/10.1080/01612840.2017.1413461.
Metse AP, Wiggers J, Wye P, Bowman JA. Patient receipt of smoking cessation care in four Australian acute psychiatric facilities. Int J Ment Health Nurs. 2018;27(5):1556-63. doi: https://doi.org/10.1111/inm.12459.