title: Staff representations and tobacco-related practices in a psychiatric hospital with an indoor smoking ban.
abstract: The present study describes representations about smoking and practices related to patient smoking among staff of a large public psychiatric hospital. A survey was performed using a specially designed questionnaire. The return rate was 72.4% (n = 155). A large proportion of staff recognized the importance of both smoking status and mental health for patient's well-being (46.9%), and believed that smoking cessation was possible for psychiatric patients (58.6%). However, the role of the psychiatric hospital was perceived as providing information (85.3%) and helping to diminish cigarette consumption (51%), rather than proposing smoking cessation (29.5%). Staff daily practice included reminding patients of smoking restrictions (43.9%), managing cigarettes (46.5%), and nicotine replacement therapy (24.3%). A principal component analysis of tobacco-related practices revealed two main factors (59.8% of variance): basic hospital actions (factor 1) and more specialized interventions (factor 2), which were significantly associated with higher worries about personally developing smoke-related illnesses (Spearman r = 0.38, P < 0.0001). Compared with non-smokers, smokers reported higher perceived vulnerability to develop an illness due to tobacco and a higher level of worry about this. The discussion highlights the need to redefine roles and expectancies of mental health staff, and improve training and collaboration with experts, in order to improve efficiency concerning tobacco issues.
authors.affiliation: Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Ineke
authors.initials: I
authors.lastname: Keizer
authors.forename: Marianne
authors.initials: M
authors.lastname: Gex-Fabry
authors.forename: Aurélia
authors.initials: A
authors.lastname: Bruegger
authors.forename: Patrice
authors.initials: P
authors.lastname: Croquette
authors.forename: Aqal Nawaz
authors.initials: AN
authors.lastname: Khan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006778:Hospitals, Psychiatric; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D011568:Psychiatric Nursing; D061845:Smoke-Free Policy; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D013557:Switzerland; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: cigarette smoking; health-care professional; psychiatric inpatient; staff beliefs; staff practice